Three-dimensional video laparoscopic technology in the surgical treatment of patients with acute calculous cholecystitis

Darvin Vladimir, Stepanov Aleksandr, Krasnov Evgenij, Vasil'ev Vasilij

To date, patients with acute calculous cholecystitis cholecystectomy through traditional laparotomy access is replaced by mini-invasive technologies - laparoscopic cholecystectomy and cholecystectomy from mini-access. The most important conditions determining the choice of technology for performing cholecystectomy are maximum safety of manipulations in the zone of the neck of the gallbladder, the bladder duct and the vesicle artery. The frequency of intraoperative damage of extrahepatic bile ducts with cholecystectomy ranges from 0.1 to 3.0%. The main factors of iatrogenic damage in cholecystectomy are the difficulties in visualization and differentiation of tubular structures (especially in patients with acute cholecystitis), the involvement of hepatoduodenal ligament elements in the inflammatory process, and individual structural and topographic-anatomical relationships, and the surgeon's inadequate experience. To successfully overcome iatrogenic factors, it is necessary to expand and deepen the experience and knowledge of the operating surgeon (both clinically and through the use of virtual learning technologies), as well as innovative technical and technological solutions. The article analyzes the results of the clinical use of the technology of three-dimensional video laparoscopy with the help of the digital surgical video system of volume endoscopy "EndoSite 3DiDigitalVisionSystem" in 1595 patients with acute calculous cholecystitis. The analysis of the obtained results showed the possibilities of innovative technology in improving the immediate results of treatment and prevention of damage to tubular structures (bile ducts and feeding vessels).

Keywords:cholelithiasis, laparoscopic cholecystectomy, three-dimensional volumetric video laparoscopy, EndoSite 3DiDigitalVisionSystem, cholecystectomy from mini-access.