NEW RETRACTION TECHNIQUE TO ALLOW BETTER VISUALIZATION OF CALOTS TRIANGLE DURING LAPAROSCOPIC CHOLECYSTECTOMY

Background: Bile duct injuries during laparoscopic cholecystectomy (LC ) are thought to occur because surgeons tend to confuse the common bil e duct (CBD) with the cystic duct, Among reasons for this misidentific ation, the difference in the way the operating field is exposed in LC compared to open cholecystectomy should be noticed. Using Dr. Reddick' s technique, which is commonly practiced, the upward and the lateral t raction of the gallbladder results in a narrower Calot's triangle and angulation of the CBD. These anatomical distortions are thought to con tribute to ductal injuries during LC. Methods: We propose a new method to expose Calot's tri angle during LC, The principle of this techniqu e is to expose the hepatic hilus by retracting the caudal surfaces of the quadrate and lateral lobes of the liver using an atraumatic curved instrument. Results: The advantages of this technique are that one ga ins wide exposure of the hepatic hilus, leaves Calot's triangle undist orted, and avoids tenting the CBD, Conclusions: This new technique may make LC safer and decrease the number of bile duct injuries associate d with the misidentification of the anatomy.