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:

Your gallbladder is a small organ under your liver that stores bile. If gallstones or inflammation cause pain, infection, or blockage, your doctor may recommend removing the gallbladder. Most people do well without it. Gallstones can cause pain and complications when they block bile ducts.  

Professional-facing version:

Cholecystectomy is indicated for symptomatic cholelithiasis, acute or chronic cholecystitis, gallstone pancreatitis after stabilization, biliary dyskinesia in selected patients, and other gallbladder pathology. The standard operative approach is laparoscopic cholecystectomy, with selective conversion to open based on inflammation, adhesions, anatomy, bleeding, or concern for bile duct injury.  

Include:

• Liver

• Gallbladder

• Cystic duct

• Common hepatic duct

• Common bile duct

• Cystic artery

• Right hepatic artery

• Calot’s triangle / hepatocystic triangle

• Cystic plate

• Duodenum

• Transverse colon

Include:

• Symptomatic gallstones

• Acute cholecystitis

• Chronic cholecystitis

• Choledocholithiasis

• Biliary colic

• Gallstone pancreatitis

• Gangrenous gallbladder

• Hydrops / empyema

Include:

• History and symptoms

• Physical exam

• CBC, CMP, LFTs

• Bilirubin

• Lipase if pancreatitis suspected

• Ultrasound as typical first-line imaging

• Possible MRCP / HIDA / CT depending on situation

• Anesthesia evaluation

• Antibiotic planning when indicated

NIDDK notes that clinicians may use blood tests and imaging such as ultrasound, CT, MRI, cholescintigraphy, or ERCP depending on the diagnostic question. 

Include three pathways:

• Laparoscopic cholecystectomy

• Open cholecystectomy

• Robotic cholecystectomy

LDS logic:

Let the user toggle between approaches and compare:

• incision pattern

• visualization

• equipment

• recovery

• OR time

• training requirements

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