UPDATED TOPICS IN MINIMALLY INVASIVE ABDOMINAL SURGERY

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Updated Topics in Minimally Invasive Abdominal Surgery
in diameter providing a surgical field area of 11.33 cm2, and another which is 10 cm long but
5 cm in diameter providing to surgical field area of 19.62 cm2 . These sizes have been based
on the distance between the wall and the hepatocystic triangle, measured in open surgery,
and the minimally area necessary for the identification and dissection of its structures.
We currently use a transparent methacrylate plunger that there exercises an effect of
magnifying glass and once introduced into the abdomen allows visualization of the surgical
field before unplugging (figure 1).
Fig. 1. Cylinders used in Transcylindrical cholecystectomy
The cylinder commonly used is made of stainless steel, though we occasionally use a
cylinder totally made in methacrylate to facilitate intraoperative cholangiography. The size
of cylinders is always 10.0 cm long and either 3.8 or 5 cm in diameter. But we have cylinders
12 and 14 cm in length, rarely needed in the bigest patients or abnormal liver depth under