Three Cases of Laparoscopic Cholecystectomy by Double Scope Method.

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  • Ｄｏｕｂｌｅ　ｓｃｏｐｅを用いた腹腔鏡下胆嚢摘出術の３例

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An important difference between laparoscopic cholecystectomy and open cholecystectomy is that laparoscopic cholecystectomy must be done under two dimensions and one visual field. Therefore, biliary tract injuries can occur. We usually insert the 5th trocar between the 10mm trocar below the xyphoid processus and the 5mm trocar on the midclavicular line, and insert another 5mm laparoscope. Cholecystectomy is carried out using the two scopes. The laparoscope at the umbilicus is necessary to guide the instruments when they are taken in and out. The usefulness of the double scope method is as follows.(1) We can observe the Calot triangle from the same direction at laparotomy with the second laparoscope. The common bile duct and the common hepatic duct are easily confirmed.(2) We can identify the cystic duct and the cystic artery from two directions and prevent clipping and dissecting excessive tissues.(3) We can dicide on the correct point to clip the cystic duct from two directions.(4) We can ablate safely omental and duodenal adhesions to the liver through front vision by the second laparoscope.

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