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 hernia happens when tissue, fat, or intestine pushes through a weak spot in the muscle wall. Hernia repair closes that weak area, often with sutures and/or surgical mesh to reinforce the repair. Common types include inguinal, femoral, umbilical, ventral, incisional, hiatal, and parastomal hernias. Surgery may be open, laparoscopic, or robotic. ACS notes that surgery is the only definitive repair for many hernias, though watchful waiting may be appropriate for some reducible, minimally symptomatic hernias. (ACS)

Professional-facing version:
Hernia repair restores abdominal wall integrity, reduces risk of incarceration/strangulation, relieves symptoms, and lowers recurrence risk through defect closure, mesh reinforcement, or both. Technique depends on hernia type, defect size, prior surgery, contamination risk, patient BMI/comorbidities, tissue quality, and recurrence status.

Core anatomy:
Abdominal wall layers: skin, subcutaneous tissue, fascia, muscle, peritoneum.
Key hernia zones: inguinal canal, femoral canal, umbilicus, linea alba, prior incision sites, and parastomal defects.

Visual LDS elements:
3D abdominal wall map, hernia bulge animation, mesh placement overlay, nerve/vessel danger-zone labels, recurrence-risk heat map.

Common hernia categories:

Hernia Type

Location

Key Concern

Inguinal

Groin

Most common; direct or indirect

Femoral

Below inguinal ligament

Higher incarceration risk

Umbilical

Belly button

Common in adults with obesity/pregnancy history

Ventral

Abdominal wall

Primary abdominal wall weakness

Incisional

Prior surgical incision

Fascial failure after surgery

Hiatal

Diaphragm/stomach

Reflux/paraesophageal risk

Parastomal

Around ostomy

Complex recurrence risk

Patient-facing:
Evaluation includes physical exam, symptom review, hernia size, reducibility, pain, prior surgeries, and sometimes CT or ultrasound.

Professional-facing:
Assess reducibility, defect size, loss of domain, bowel involvement, prior mesh, infection history, anticoagulation, smoking, diabetes, BMI, nutrition, and contamination risk. CT is especially useful for complex ventral/incisional/recurrent hernias.

Approach

Best For

Advantages

Tradeoffs

Open repair

Large, complex, recurrent, contaminated cases

Direct access, flexible reconstruction

Larger incision, more wound morbidity

Laparoscopic repair

Selected ventral/inguinal cases

Smaller incisions, faster recovery

Requires intraperitoneal access, fixation considerations

Robotic repair

Ventral, inguinal, complex abdominal wall reconstruction

Enhanced suturing, 3D visualization, retromuscular options

Cost, setup time, platform availability

SAGES describes laparoscopic/robotic hernia repair as minimally invasive approaches using small incisions, specialized instruments, and often mesh, with many patients experiencing easier recovery and faster return to activity compared with open repair. (SAGES)

Core laparoscopic workflow:

1. Patient positioning

2. Anesthesia and prep

3. Port placement

4. Abdominal entry and insufflation

5. Retraction of gallbladder

6. Exposure of hepatocystic triangle

7. Dissection of peritoneum

8. Achieve Critical View of Safety

9. Clip and divide cystic duct

10. Clip and divide cystic artery

11. Separate gallbladder from liver bed

12. Hemostasis and irrigation

13. Retrieval bag extraction

14. Closure and dressing

SAGES recommends the Critical View of Safety for anatomic identification of the cystic duct and cystic artery during laparoscopic cholecystectomy as part of safe cholecystectomy practice.  

This should be one of the strongest parts of LDS.

Teach the 3 components:

• Clear the hepatocystic triangle of fat and fibrous tissue

• Separate the lower third of the gallbladder from the cystic plate

• Confirm that only two structures enter the gallbladder

Digital tools:

• “CVS achieved / not achieved” visual quiz

• surgeon mode with operative image annotation

• AI overlay for duct and artery recognition

• safety timeout checkpoint before clipping

Break it down by category:

Access

• Veress needle or optical trocar

• 5 mm / 10–12 mm trocars

Visualization

• laparoscope

• camera head

• light source

• insufflator

Dissection

• Maryland dissector

• hook cautery

• blunt grasper

• atraumatic grasper

• suction irrigator

Hemostasis / division

• clip applier

• laparoscopic clips

• energy device if used

Specimen handling

• endoscopic retrieval bag

Closure

• fascial closure device

• sutures

• skin adhesive / steri-strips / staples

LDS feature:

Every step opens the relevant devices, manufacturers, SKU fields, rep contacts, and preference-card notes.

Include:

• general anesthetics

• peri-op antibiotics when indicated

• analgesics

• antiemetics

• local anesthetic at port sites

• VTE prophylaxis per protocol

• indocyanine green if fluorescence cholangiography is used

Patient-friendly and professional versions should both be included.

Commonly discussed risks include:

• bleeding

• infection

• bile leak

• bile duct injury

• retained stones

• injury to bowel or liver

• need to convert to open surgery

• DVT/PE

• anesthesia-related complications

NHS and hospital discharge materials also emphasize gradual recovery, mobility, and awareness of complications after surgery.  

Most patients having laparoscopic gallbladder removal recover faster than those having open surgery and may return to work in roughly 1–2 weeks depending on job demands, while open surgery usually involves a longer recovery.  

Recovery module should include:

• day of surgery

• pain expectations

• diet progression

• walking and mobility

• wound care

• lifting restrictions

• return-to-work timeline

• when to call the surgeon

• emergency red flags

Include:

• Why remove the gallbladder?

• What happens if I wait?

• Will I still digest food normally?

• What are the alternatives?

• What happens during surgery?

• How long until I feel normal?

For surgeons / hospitals / reps:

• case type

• complexity score

• anatomy variant alerts

• preferred device stack

• conversion triggers

• intraoperative bailout strategy

• documentation checklist

• rep notification logic

• cost-per-case dashboard