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Laparoscopic Cholecystectomy Cholangiogram Set

Steriseal Horner 1530

Laparoscopic Cholangiopraphy Technique

Ref Outer Diameter Length Minimum Order Qty
1530 2.36mm (13G) 230mm (9") 10
Individually packed sterile, single use only.

 

During the procedure of laparoscopic cholecystectomy, the cystic duct is defined and incised with micro-scissors. The escape of a small quantity of bile usually confirms incision into its lumen.

A 1mm stab incision is made in the skin of the right upper quadrant of the anterior abdominal wall, vertically over the position of the incised cystic duct. The metal guide is then pushed, via the small skin puncture, through the abdominal wall and into the peritoneal cavity, under full video control.

The tip of the guide is positioned immediately adjacent to the incision previously created in the cystic duct. The cholangiogram catheter, having previously been attached to a saline filled syringe, is passed through the guide to protrude through its laterally placed end opening. The catheter is then flushed with saline to remove all air bubbles. The guide tip, with approximately 1cm of protruding catheter, is positioned over the opened cystic duct by the operating surgeon.

The guide is rotated and manipulated as desired to achieve the correct angle of entry of the catheter onto the cystic duct and with a one or two handed technique, the catheter is advanced through the guide and slipped into the opened cystic duct.

Once the catheter is advanced into the cystic duct, its position in the duct is monitored and confirmed by the black marker rings 1cm and 2cm from its tip. It is not necessary to advance the catheter beyond the second marker at 2cm. The lowest marker at 2cm gives an indication of how much available catheter length remains in the cystic duct sufficient for clip fixation.

After securing the catheter at the distal site of entry and checking for leakage or occlusion with saline, the guide can be withdrawn out of the abdominal wall and secured to the catheter hub.

The saline syringe is exchanged for a syringe containing contrast which is then slowly injected down the catheter and into the cystic duct. Imaging can now take place.