CHOLECYSTECTOMY TECHNIQUE Russian patent published in 2014 - IPC A61B17/00 A61B18/20 

FIELD: medicine.

SUBSTANCE: laparoscopic surgery is performed. The cystic duct and the cystic artery are separated, clipped and transected. A laser light guide is inserted through a 5-mm port mounted in the right hypochondrium above the gall bladder. The gall bladder is separated within a bed, and the liver parenchyma is coagulated simultaneously with the use of a holmium laser at a wave length of 2088 nm in the repetitively-pulsed mode at the pulse spatial length of 600 mcs, maximum repetition rate of 5-10 Hz, power of 10 W. The laser light covers the gall bile tissue surface immediately within its attachment to the bed in the liver. A dissection involves retracting the gall bladder right about with the use of a clamp pre-applied onto its neck. A coagulation area is controlled by means of a pilot beam to prevent perforating the gall bladder wall and the common bile duct. The coagulation intensity is regulated by a distance of the light guide from the liver and bed surfaces, not exceeding 2 cm. After the gall bladder is separated from the bed completely, it is removed through the 10-mm port mounted in the epigastrium. The ports are removed from the abdominal wall after eliminating the carboxyperitoneum. The skin wounds are closed.

EFFECT: method provides the evident and stable haemostatic and antibacterial effect, reduced risk of tissue injuries and intra- and postoperative complications, reducing the length of the surgical intervention by bringing the laser light guide through the 5-mm port in the right hypochondrium into the abdominal cavity under visual control and simultaneous separation of the gall bladder and the bed coagulation.

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