The impact of electronic imaging in intraoperative biliary endoscopy (choledochoscopy).
In the last decade, choledochoscopy has become an essential tool for biliary surgery. It is widely accepted, but it is not employed by every surgeon who performs choledocholithotomies. The reason is the limited experience of surgeons performing 30-40 cholecystectomies per year. A survey of 150 hospitals clearly showed that common bile duct exploration is performed in 10%-15% of these cases. General surgeons are not endoscopists. A new video choledochoscope that displays the image in a large format via the TV monitor was developed, which can be viewed with both eyes and an assistant's help; this expedites and coordinates the procedure. The entire process is videotaped and can be used for further analysis and during consultation. It has become the method of choice for teaching. Most importantly, the learning curve of general surgeons has become significantly shorter. The procedure is taught and the surgeon can learn it easily. Its use will contribute to a decrease in the incidence of retained stones and will improve patient care.
Berci
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Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA 90048.
Morgenstern
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Paz-Partlow
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D000818:Animals; D002769:Cholelithiasis / Q000601:surgery*; D003135:Common Bile Duct / Q000473:pathology*; D019723:Endoscopes; D004724:Endoscopy; D006801:Humans; D007430:Intraoperative Care; D013690:Television