Periprocedural Care
Equipment
The following equipment is used for transvaginal cholecystectomy:
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Port (5 mm) for the umbilical site
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Port (12 mm)
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Extracorporeal sutures
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Maryland dissector
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Scissors
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Clip applier
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Electrocautery
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Gallbladder retrieval bag
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Patient Preparation
Anesthesia
General anesthesia is required because of the need to insufflate the abdominal cavity to ensure adequate visualization.
Positioning
The patient is placed in the low lithotomy position with stirrups (see the image below). After Veress needle insufflation of the abdominal cavity through the umbilical site, the patient is placed in a steep Trendelenburg position.
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Monitoring & Follow-up
Patients are recommended to refrain from sexual intercourse for a period of 2 weeks, as recommended by the gynecologists in the authors’ institution.
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Media Gallery
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Transvaginal cholecystectomy. Position of patient.
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Transvaginal cholecystectomy. Incision for entry into cul-de-sac.
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Transvaginal cholecystectomy. Clips on cystic artery.
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Transvaginal cholecystectomy. Division of cystic artery between clips.
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Transvaginal cholecystectomy. Dissection of gallbladder off gallbladder fossa.
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Transvaginal cholecystectomy. Closure of culdotomy.
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