Abstract
Background:
Laparoscopic cholecystectomy, a cornerstone of modern surgery, continues to undergo refinements in technique to optimize patient outcomes. 1 The Diagonal Line (D-line) of the liver segment IV approach represents a recent innovation in this field, offering potential advantages over traditional methods and providing a step-by-step approach for achieving the critical view of safety. 1 –3 This video aims to provide a comprehensive overview of the D-Line approach, elucidating its technical nuances and clinical implications.
Materials and Methods:
A female patient suffered from mild acute biliary pancreatitis and improved dramatically after conservative treatment for one week. Follow-up Magnetic resonance cholangiopancreatography (MRCP) showed gallbladder stones and a normal common bile duct (CBD). So, laparoscopic cholecystectomy was performed during the same admission using the D-line approach. The operation was performed using the conventional four ports technique. Key technical steps, including anatomical landmarks identification, and dissection techniques, are meticulously demonstrated in the provided video. Intraoperative footage is complemented by detailed narration and graphical overlays to enhance clarity and understanding.
Results:
The operative time was 41 minutes with minimal intraoperative blood loss. The patient was discharged home the next day without intra- or postoperative complications.
Conclusions:
Laparoscopic cholecystectomy using the diagonal line approach is a feasible and useful step-by-step approach for achieving the critical view of safety. Furthermore, it allows surgeons to perform laparoscopic subtotal cholecystectomy in difficult cases safely. Informed consent from the patient has been received and archived by the author(s) before video recording of the procedure.
Financial support and sponsorship:
Authors did not receive any funding/grants for this work.
Disclosure:
The authors of this article have no conflicts of interest to disclose.
Runtime of video:
9 mins and 59 secs
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