Open Cholecystectomy

Okay, here goes.

I was supposed have a night duty (11pm -7am) instead of PM (3pm-11pm) yesterday. My senior staff would not allow me to have another straight duty because I have been doing the 16-hour shift for twice this month. The first one was not a toxic night, after our party (yes, we eat every now and then -- perhaps one of the reason that after my contract I could not fit in my pants), we slept. The next time, I scrubbed in for like 5-6 hours for Open Chole with IOC -- one of the longest cases I loathe.


One of the perks being inside the operating room is that, if there is no patient (meaning, no stab wounds or cesarean section or any patient that is in a matter of life and death that is in need of an emergency surgical operation). After the routine, meaning cleaning and scrubbing the floors, we can sleep until the wee hours of the morning.

If you ask me what in the world the surgeons are doing in their field, I wouldn't really know. I try to mind my own business to make sure that my sponges, needles and instruments are complete. Not to forget to maintain the sterility of the field. Some surgeons forget the rules on sterility, I wish they would take a crash course every now and then to remind them :)

One of last night operation’s is open cholecystectomy. A surgery in which the abdomen is opened to allow cholecystectomy or the removal of the gall bladder. The surgeons would jokingly name this as the new appendectomy because we are performing this kind of operation ALMOST daily.

This kind of operation has been used for over a century and is proven safe and effective method to treat symptomatic gallstones. During surgery, there is a direct visualization and palpation of the gall bladder, cystic duct, bile duct, and blood vessels. Further, this allows safe and accurate dissection and removal of the gall bladder. Often times, intra-operative cholangiography has been variably used as an adjunct to this operation. This is why the operation could take ages!

This is our specimen, the patient's gall bladder stones & the gall bladder itself 

Thankfully, the operation lasted for less than 3 hours. Some would take around 4-5 hours.

Special Instruments used during the procedure are:
1. Mixter Right Angle Forcep

2. Randalls Forcepis used in removal of choledochal stones and in exploration and manipulation of the bile ducts and ampulla.