GALL BLADDER AND BILE DUCT STONES AND BILE DUCT DISEASES AND ROBOTIC PROCEDURES
Gall bladder and bile duct diseases encompass a range of benign and malignant conditions affecting the biliary system. Common disorders include gall bladder stones (cholelithiasis), bile duct stones (choledocholithiasis), bile duct strictures, bile leaks, choledochal cysts, biliary injuries, cholangitis, and bile duct cancers (cholangiocarcinoma). These conditions can obstruct the normal flow of bile, leading to pain, jaundice, infection, and impaired liver function.
Robotic cholecystectomy and bile duct surgeries are performed under general anaesthesia with the patient positioned to provide optimal access to the upper abdomen. Several small incisions are made for the placement of robotic ports, through which a high-definition three-dimensional camera and robotic instruments are introduced. After docking the robotic system, the abdominal cavity is explored, and the gall bladder, liver, and biliary tree are carefully assessed. The gall bladder is retracted to expose the structures within the hepatocystic triangle, allowing meticulous identification of the cystic duct and cystic artery to achieve the critical view of safety. These structures are clipped and divided before the gall bladder is dissected from the liver bed and removed.
For bile duct surgeries, the common bile duct is carefully exposed, and the underlying pathology, such as bile duct stones, strictures, choledochal cysts, or tumours, is addressed. Depending on the indication, the procedure may involve bile duct exploration with stone extraction, excision of diseased bile ducts, repair of bile duct injuries, or biliary reconstruction, such as a hepaticojejunostomy, to restore normal bile drainage. Throughout the procedure, meticulous haemostasis is maintained, and bile leaks are carefully assessed and managed. The specimen is retrieved through a small protected incision, a surgical drain may be placed when indicated, and the robotic instruments are removed before the port sites are closed, completing the procedure.