This module should do four things at once:

1. Educate the patient in plain language

2. Support the surgeon and care team with structured workflow logic

3. Map devices, supplies, and pharma to each phase of the case

4. Create a reusable LDS digital product for web, app, LMS, and sales enablement.

A. Module title

Cholecystectomy: A Guided Digital Surgical Experience

B. Module audience

• Patients and families

• Surgeons

• OR staff

• Hospitals

• Device reps

• Pharma partners

• Educators and training programs

Patient-facing version

A cholecystectomy is surgery to remove the gallbladder.

The gallbladder is a small pouch under the liver that stores bile. Bile helps digest fat. When gallstones, inflammation, infection, or blockage occur, the gallbladder can cause pain, nausea, vomiting, fever, and serious complications.

Most gallbladder surgery is done using small incisions with a camera, called laparoscopic surgery. Some patients may be candidates for robotic cholecystectomy, which uses advanced 3D visualization and wristed instruments.

Professional-facing version

Cholecystectomy is the surgical removal of the gallbladder, most commonly performed for symptomatic cholelithiasis, acute or chronic cholecystitis, biliary dyskinesia, gallstone pancreatitis after stabilization, or gallbladder polyps with concerning features.

Primary approaches include:

• Laparoscopic cholecystectomy

• Robotic-assisted cholecystectomy

• Open cholecystectomy

• Subtotal or fenestrating cholecystectomy in hostile anatomy

Core safety objective: obtain the Critical View of Safety before clipping/dividing ductal or vascular structures.

Key structures

Gallbladder

Stores bile produced by the liver.

Liver

Produces bile and sits directly above the gallbladder.

Cystic duct

Connects the gallbladder to the common bile duct.

Common bile duct

Carries bile from the liver and gallbladder area into the small intestine.

Cystic artery

Blood supply to the gallbladder.

Calot’s Triangle

Important surgical zone bordered by:

• Cystic duct

• Common hepatic duct

• Inferior edge of the liver

This is where surgeons identify the cystic duct and cystic artery.

Common reasons for surgery

Symptomatic gallstones

Gallstones cause recurring right upper abdominal pain, often after fatty meals.

Acute cholecystitis

Inflamed or infected gallbladder, often requiring urgent surgery.

Chronic cholecystitis

Long-term irritation from gallstones.

Biliary dyskinesia

Poor gallbladder emptying despite no stones.

Gallstone pancreatitis

Gallstones block bile/pancreatic drainage and inflame the pancreas.

Gallbladder polyps

Some polyps require removal depending on size and risk profile.

Patient-facing

Before surgery, patients may need:

• Physical exam

• Blood work

• Liver function tests

• Ultrasound

• CT scan or HIDA scan in selected cases

• Review of medications

• Anesthesia evaluation

Professional-facing

Typical evaluation includes:

• CBC

• CMP

• LFTs

• Bilirubin

• Lipase if pancreatitis suspected

• RUQ ultrasound

• HIDA scan for dyskinesia or equivocal cholecystitis

• MRCP/ERCP consideration if choledocholithiasis suspected

• Antibiotics for acute infection when indicated

• • DVT prophylaxis based on risk

Laparoscopic cholecystectomy

Most common approach. Uses small incisions, camera, laparoscopic instruments, clips, and electrosurgery.

Robotic cholecystectomy

Uses robotic arms, 3D visualization, wristed instruments, and may include Firefly fluorescence imaging with ICG to help visualize biliary anatomy.

Open cholecystectomy

Larger incision. Used when anatomy is unsafe, inflammation is severe, bleeding occurs, or conversion is needed.

Subtotal cholecystectomy

Used when full removal is unsafe due to severe inflammation or distorted anatomy.

Patient version

1. You receive anesthesia.

2. Small incisions are made.

3. The abdomen is inflated with CO₂ gas.

4. A camera is inserted.

5. The surgeon identifies the gallbladder.

6. The cystic duct and artery are carefully exposed.

7. Safety anatomy is confirmed.

8. The duct and artery are clipped and divided.

9. The gallbladder is removed from the liver bed.

10. It is placed in a bag and removed.

11. Incisions are closed.

12. You recover in the post-anesthesia area.

Professional version

1. Supine positioning

2. General anesthesia

3. Veress or Hasson entry

4. Pneumoperitoneum

5. Trocar placement

6. Diagnostic laparoscopy

7. Retraction of fundus and infundibulum

8. Dissection of hepatocystic triangle

9. Achieve Critical View of Safety

10. Clip/divide cystic duct

11. Clip/divide cystic artery

12. Gallbladder dissected off liver bed

13. Hemostasis and irrigation as needed

14. Specimen bag extraction

15. Port closure

• 16. PACU recovery

The Critical View of Safety is the key safety checkpoint in gallbladder surgery.

Before cutting anything, the surgeon should confirm:

1. Only two structures enter the gallbladder.

2. The lower third of the gallbladder is separated from the liver bed.

3. The hepatocystic triangle is cleared of fat and fibrous tissue.

LDS visual concept

Interactive 3D module showing:

• Gallbladder

• Cystic duct

• Cystic artery

• Common bile duct

• Liver edge

• Safe clip zone

• Danger zone

• • Firefly/ICG toggle

Core equipment

Laparoscopic setup

• Laparoscope

• Camera system

• Light source

• Insufflator

• Trocars

• Graspers

• Maryland dissector

• Hook cautery

• Clip applier

• Suction irrigator

• Specimen retrieval bag

Robotic setup

• da Vinci Xi or da Vinci 5 platform

• Robotic camera

• Robotic trocars

• Fenestrated bipolar forceps

• Monopolar curved scissors

• Cadiere forceps

• Assistant port

• Firefly fluorescence imaging

• ICG dye

Clip and closure products

• Titanium clips

• Polymer locking clips

• Endoscopic retrieval bag

• Fascial closure device

• • Skin adhesive or sutures

Pre-op / intra-op medications

• General anesthetics

• Paralytics

• Opioid or non-opioid analgesics

• Antiemetics

• Antibiotics when indicated

• ICG for fluorescence imaging when used

• Local anesthetic at port sites

Post-op medications

• Acetaminophen

• NSAIDs if appropriate

• Limited opioid prescription if needed

• Antiemetics

• • Stool softener if opioids are used

Patient-facing risks

• Bleeding

• Infection

• Bile leak

• Injury to the bile duct

• Injury to nearby organs

• Blood clots

• Hernia at incision site

• Need to convert to open surgery

• Continued abdominal symptoms in some patients

Professional-facing complications

• Common bile duct injury

• Right hepatic duct injury

• Cystic duct stump leak

• Bile leak from liver bed or duct of Luschka

• Vascular injury

• Retained common bile duct stone

• Post-op abscess

• Port-site hernia

• Conversion to open

• • Need for ERCP or reoperation

Typical recovery timeline

Same day

Many patients go home the same day.

First 24–48 hours

Soreness, bloating, shoulder discomfort from gas, mild nausea.

First week

Light walking encouraged. Avoid heavy lifting.

1–2 weeks

Many patients return to desk work or light activity.

2–4 weeks

Most patients return to normal activity depending on surgeon instructions.

Red flags

Patients should contact their care team for:

• Fever

• Worsening abdominal pain

• Yellow skin or eyes

• Persistent vomiting

• Chest pain

• Shortness of breath

• Drainage or redness at incision sites

• Dark urine or pale stools

LDS Decision Engine Questions

1. Do you have gallstones?

2. Are you having pain after meals?

3. Have you had fever, nausea, or vomiting?

4. Was your diagnosis acute or chronic?

5. Has your doctor recommended surgery?

6. Are you interested in laparoscopic vs robotic options?

7. Do you want to know which hospitals near you offer advanced imaging or robotic technology?

8. Do you want help preparing questions for your surgeon?

Suggested patient CTA

Understand your gallbladder surgery before you schedule it.
Compare laparoscopic, robotic, and open approaches. Learn what devices may be used, what recovery looks like, and what questions to ask your surgeon.

Surgeon-facing data fields

• Approach preference

• Case volume

• Robotic availability

• Firefly/ICG usage

• Clip preference

• Energy device preference

• Conversion rate

• Bile duct injury prevention protocol

• Acute cholecystitis management strategy

• Subtotal cholecystectomy threshold

• ERCP referral pathway

• Hospital outpatient capability

Rep-facing opportunity layer

Device companies

• Robotic platform placement

• Fluorescence imaging adoption

• Clip systems

• Retrieval bags

• Energy devices

• Trocars

• Visualization systems

Pharma companies

• ICG

• Antibiotics

• Antiemetics

• Non-opioid pain pathways

• ERAS-related medications

LDS Positioning Statement

Cholecystectomy is not just gallbladder removal. It is a high-volume surgical pathway where patient education, surgeon decision-making, device selection, imaging technology, and recovery planning all intersect.

Let’s Do Surgery turns that pathway into a clear, visual, connected experience.