Novel Technique of Subserosal Inner Layer Dissection Using Saline Injection in Laproscopic Cholecystectomy

MATSUMOTO Toshifumi, OYAMA Tabito, HASEGAWA Takumi, YOSHIDA Daisuke, KAI Seiichiro, KAWANAKA Hirofumi

doi:10.3919/jjsa.84.1159

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Other Title

腹腔鏡下胆嚢摘出術における漿膜下層内層生理食塩水注入剥離法
腹腔鏡下胆囊摘出術における漿膜下層内層生理食塩水注入剥離法
フククウキョウカタンノウテキシュツジュツニオケルショウマクカソウナイソウセイリショクエンスイチュウニュウハクリホウ

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<p>Continuous exposure of the subserosal inner layer of the gallbladder wall to prevent from bleeding and bile duct injuries in laparoscopic cholecystectomy. We invented a novel technique of dissecting the subserosal layer after saline injection and appraised its efficacy and safety. In this study, ten cases with concave and wide gallbladder bed and thin subserosal layer were included. When the subserosal inner layer was exposed around the gallbladder body to a certain extent, saline solution was injected into the layer toward the gallbladder bed. The boundary between the inner and outer layers of the subserosa was dissected by energy devices. As a result, the amount of intraoperative bleeding was minimum, and the gallbladder was safely dissected from the gallbladder bed with easy identification of the subserosal inner layer by saline injection. All patients were discharged early from the hospital without postoperative complications. This technique would also be useful to young surgeons in understanging the surgical anatomy of the subserosal inner layer of the gallbladder.</p>

Journal

Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association)

Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) 84 (8), 1159-1163, 2023

Japan Surgical Association

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