Mayo stand and back table instruments for Cholecystectomy surgery setup

Clamping & Occluding

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  Allis Forceps

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  Curved Hemostat

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  Kelly Forceps

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  Right Angle Clamp

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  Tonsil Clamp

Cutting & Dissecting

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  #3 Knife Handle

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  Curved Mayo Scissor

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  Metzenbaum Scissor

Grasping & Holding

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  Adson Forceps

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  Debakey Forcep

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  Ferris Smith Tissue Forceps

Retracting & Exposing

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  Army-Navy Retractor

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  Bookwalter Retractor

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  Richardson Retractor

Suctioning

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  Poole Suction Probe

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  Yankauer Suction

Suturing & Stapling

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  Mayo-Hegar Needle Holder

What to expect during Cholecystectomy

Cholecystectomy is a surgical procedure to remove the gallbladder. The gallbladder is a small organ located under the liver that stores bile, a fluid that helps digest fats. Cholecystectomy is typically performed to treat conditions such as gallstones, inflammation of the gallbladder, or gallbladder cancer. During the procedure, the gallbladder is removed either through a single large incision in the abdomen or through several small incisions using laparoscopic techniques. Cholecystectomy is a common and generally safe procedure, but it can involve some risks such as bleeding, infection, or injury to nearby organs. After the surgery, most people can resume their normal activities within a few days to a week.

Step 1: Incision
The surgeon will make the initial incision with a 10 blade on a #3 knife handle.

Step 2: Dissection
To reach the gallbladder, the surgeon will use Metz and Adson forceps with teeth, and a bovie to dissect down. The gallbladder will then need to be dissected from the liver.

Step 3: Tying and Clamping
Ties should be loaded on tonsils ready to pass. Two long, larger clamps such as Kelly’s will be used to clamp across the gallbladder while it is tied and cut off. The clamps also prevent it from spilling bile.

Step 4: Pathology
Once the gallbladder has been removed, it should be sent to pathology.

Step 5: Closing
The abdomen will be irrigated, all bleeding will be stopped, and the incision will be sutured closed.

Tips and tricks
For a successful cholecystectomy, it is essential to have both long and standard length instruments available. Additionally, Vicryl or silk ties should be on hand. Open cholecystectomies often result in significant bleeding, particularly if laparoscopy is not possible due to a pre-existing medical condition. The liver is particularly prone to bleeding, even from the smallest cut.

The Surgery Sparknotes

1. The surgeon will use a 10 blade on a #3 knife handle, Metz and adsons with teeth, and the bovie to dissect down to the gallbladder.
2. The gallbladder will need to be dissected from the liver and tied with tonsils.
3. Use two long, larger clamps such as Kelly’s to clamp across the gallbladder.
4. Once the gallbladder is removed, it should be sent to pathology.
5. Irrigate the abdomen, stop any bleeding, and suture the incision closed.