Description

Laparoscopic cholecystectomy is the gold standard treatment for symptomatic gallstones and chronic gallbladder disease. In this educational surgical video from World Laparoscopy Hospital, Prof. Dr. R.K. Mishra demonstrates the successful laparoscopic removal of a gallbladder containing a large gallstone using the renowned Mishra's Knot technique. This step-by-step procedure highlights advanced laparoscopic principles, precise dissection, and safe intracorporeal knotting, making it an invaluable learning resource for surgeons, gynecologists, and minimally invasive surgery trainees. The procedure begins with the establishment of pneumoperitoneum and optimal trocar placement, followed by careful exposure of the hepatocystic triangle. Meticulous dissection is performed to clearly identify the cystic duct and cystic artery while maintaining the Critical View of Safety (CVS) to minimize the risk of bile duct injury. Due to the presence of a large gallstone, the gallbladder is carefully manipulated to maintain adequate traction and visualization throughout the operation. A key highlight of this surgery is the application of Mishra's Knot, an advanced intracorporeal knotting technique developed for secure ligation during laparoscopic procedures. The knot provides excellent holding strength, reliability, and ease of application in challenging surgical situations. Viewers will gain practical insights into knot construction, instrument handling, tissue traction, and ergonomic movements that contribute to efficient laparoscopic performance. The video also demonstrates safe gallbladder separation from the liver bed using energy devices, meticulous hemostasis, specimen retrieval, and final inspection before closure. Throughout the procedure, emphasis is placed on surgical precision, anatomical orientation, complication prevention, and adherence to international laparoscopic standards. This comprehensive surgical demonstration serves as an excellent educational resource for postgraduate residents, fellowship candidates, practicing surgeons, and healthcare professionals seeking to enhance their laparoscopic cholecystectomy skills. It showcases modern minimally invasive techniques combined with the innovative Mishra's Knot to achieve safe and effective outcomes even in technically demanding cases involving large gallstones.