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Daytona Negligent Gallbladder Surgery | Ormond Surgical Malpractice

7 Ways Your Laparoscopic Surgeon Can Avoid Negligently Cutting Your Bile Duct

Laparoscopic cholecystectomy gallbladder surgeries can sometimes end with terrible injury if the patient’s bile duct is misidentified or otherwise mistakenly cut, transected or severed.

Noted surgeons have published guidelines to be followed to prevent such error. If you underwent Laparoscopic cholecystectomy gallbladder surgery, your surgeon likely should have taken these seven preventive measures:

1. Use a 30 degree forward oblique telescope to identify the common bile duct. The 30 degree rotation provides surgeons a better view than a non-rotating optic device. Some surgeons use a 0 degree optic that does not rotate. Thus they cannot see the common bile duct as well and are more likely to make an erroneous cut.

2. Move the gallbladder bottom toward the patients head to reveal the junction between the cyctic duct and gallbladder. This is called cephalic traction on the gallbladder fundus. If this movement is not performed, surgeons will have difficulty identifying the junction and therefore difficulty identifying the appropriate organs.

This is a critical step for inexperienced surgeons because it marks the point in gallbladder surgery during which the surgeon should decide whether to convert from laparoscopic to open surgery. If too much blood obscures the junction or if gallbladder holes have developed or if any of the organs or structures are difficult to identify, then open surgery should be performed beginning at this point. However, inexperienced or imprudent surgeons struggle with making the right choice here.

3. Another way to make identifying the correct anatomy easier is to move the neck of the gallbladder so the cystic duct is at a right angle to the common bile duct. This is called laterally retracting the gallbladder neck.

4. Surgeons should not place a clip or make any cuts until they clearly identify the transition between the gallbladder infundibulum and the cystic duct. Sometimes surgeons think it is adequate to see the cystic duct “entering” the gallbladder. However, this type of identification can be erroneous if chronic inflammation has caused structural changes to the organs. A proper identification requires the surgeon to see the cystic duct widening into the gallbladder. If the cystic duct is absent, short or wide, surgeons must consider converting to open surgery or learn to stitch the cystic duct without impinging on the lumen of the common bile duct.

5. Cholangiography during surgery uses dye to identify the cystic duct and biliary tree. If those areas are not seen with dye, then the wrong organ has been identified. However, surgeons sometimes skip this step, mistakenly believing it to be too difficult, slow and dangerous. Noted surgeons have published studies showing the procedure to take 5-10 minutes with proper technique. Less professional surgeons do not take the time to learn proper technique.

6. Surgeons should never use their cauterizing devices, lasers or clips to control bleeding without first seeing what they are using the devices on.

7. Surgeons should Keep the area clean of blood and other obscuring substances by using a cauterizing implement with both suction and irrigation features.

For more on medical safety issues, see the library of articles by Daytona Beach medical malpractice attorney.

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