简介：
Overview
This article discusses the use of intraoperative video consultation to expedite surgical care for a bile duct injury during laparoscopic cholecystectomy. The case highlights the benefits of remote collaboration between a rural hospital and an academic center.
Key Study Components
Area of Science
- Surgery
- Telemedicine
- Hepatobiliary Procedures
Background
- The patient was a 63-year-old male with a history of coronary artery disease, COPD, and diabetes.
- He underwent laparoscopic cholecystectomy for cholelithiasis.
- A complete transection of the bile duct was identified during surgery.
- Intraoperative video consultation was utilized to assess the injury and plan for repair.
Purpose of Study
- To demonstrate the effectiveness of intraoperative video consultations in surgical decision-making.
- To improve patient outcomes by facilitating immediate diagnosis and treatment.
- To minimize delays in surgical care during the COVID pandemic.
Methods Used
- Intraoperative video consultation between surgeons.
- Cholangiogram to confirm bile duct injury.
- Robotic-assisted Roux-en-Y hepaticojejunostomy for injury repair.
- Use of a vessel seal device and Endo GIA stapler during surgery.
Main Results
- The video consultation allowed for immediate assessment and planning for the patient's transfer.
- The patient underwent successful repair of the bile duct injury.
- Post-operative follow-up showed no complications three years later.
- The case exemplifies the benefits of enhanced communication in surgical settings.
Conclusions
- Intraoperative video consultations can significantly improve surgical care.
- They facilitate timely decision-making and reduce unnecessary delays.
- This approach can enhance collaboration between rural and academic medical centers.
What is the main benefit of intraoperative video consultation?
It improves communication between surgeons, allowing for timely decision-making and enhanced patient care.
How was the bile duct injury confirmed?
A cholangiogram was performed during the consultation to visualize the injury.
What surgical technique was used for the repair?
A robotic-assisted Roux-en-Y hepaticojejunostomy was performed to repair the transected bile duct.
What was the patient's condition post-surgery?
The patient is now three years post-op without any complaints.
How does this case relate to the COVID pandemic?
The consultation allowed for immediate care despite hospital capacity issues during the pandemic.
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