0
Correspondence |

Patient Safety in Laparoscopic Cholecystectomy

Brij B. Agarwal, MBBS, MS, Dip Yoga, FIMSA
Arch Surg. 2009;144(10):977-980. doi:10.1001/archsurg.2009.180.
Text Size: A A A
Published online

Extract

Fluorescent cholangiography improves outcomes of LC.1 Fluorescent cholangiography is a welcome addition to the surgical tools available for the “new world of patient safety,”2 helping to deliver the best to all patients, all the time. Bile duct injury–prevention strategies focus on avoiding misidentification of biliary anatomy owing to misperception. Structured granting of professional privileges, judicious avoidance of energized dissection, and the systems approach have helped,3 but the risk of human error2 due to spatial disorientation leading to psychoheuristic cognitive ambiguity continues to haunt the BDI-fearing surgeon.4 Risk of error is high in LC because the operator does not manipulate reality directly but works from images.4 This video-perceptive illusion, ie, error of perception from working indirectly, is disastrous. Even minor errors may result in BDI. Fluorescent cholangiography neither needs additional resources (besides an optic filter) nor increases the invasiveness of LC.1 Fluorescent cholangiography facilitates the clear interpretation of biliary anatomy. It minimizes cognitive error by allowing surgeons to believe what they see rather than trying to see what they believe. Fluorescent cholangiography pre-empts any possibility of video-perceptive heuristics going wrong. It augments the cognitive skill of physicians, enabling them to execute surgical movements as planned and envisioned mentally.

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

First Page Preview

View Large
/>
First page PDF preview

Figures

Tables

References

Correspondence

CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Topics
PubMed Articles
Jobs
brightcove.createExperiences();