Medical mistakes and injuries in gallbladder removal operations that lead to Missouri medical malpractice case, can often be avoided by knowing the anatomy.
One of the methods for properly identifying the anatomy is call the “Critical View of Safety” or CVS for short. Using the CVS technique, Calot’s triangle is completely unfolded by mobilizing the gallbladder neck from the gallbladder bed of the liver before transecting the cystic artery and duct. Thus proper identification of the anatomy and fewer instances of surgical medical malpractice related to laparoscopic gallbladder removal.
The figure to the right is a depiction of the critical view of safety. Circumferential dissection, visualization of the anatomy via the triangle of calot, and using the CVS technique; a surgeon can obtain confident identification of the anatomy, and use of an intraoperative cholangiogram if there is any doubt by the surgeon. The CVS approach eliminates complications from negligent identification of the anatomy, as the improper or just lack of anatomical identification leads to cutting and or clipping of the wrong ducts or vessels.
The operative video below is a must watch for any personal injury lawyer trying to understand the critical view of safety. The video was done to show the anatomy of gall bladder region, the safe zone, dangerous zone, and the critical view of safety.
Even if the gallbladder is highly inflamed (often a major reason to remove the gallbladder in the first place), the CVS technique still works:
[I]n cases of badly inflamed gallbladders, it is often hard to achieve a critical view of safety, because Calot’s triangle is often solid and cannot be expanded. In our standardized procedure, which is based on exposing the inner layer of the subserosal layer (the ss-i layer), the critical view of safety can be safely achieved. We have safely performed LC, using our standardized procedure, for many cases with cholecystitis with highly inflamed gallbladders
Quote from: The critical view of safety in laparoscopic cholecystectomy is optimized by exposing the inner layer of the subserosal layer
St. Louis injury attorney Ben Sansone runs the Missouri injury law firm of Sansone & Lauber.
Ben Sansone handles multiple Missouri gallbladder removal malpractice cases.