Retraction & exposure
Technique description
By grasping the fundus of the gall bladder and pulling it towards the patient's right shoulder, the undersurface of the liver is exposed and dissection can begin:
To expose the triangle of Calot, and achieve the Critical View of Safety (CVS), Hartman's pouch is retracted towards the patient's right hip:
Hartman's pouch can also be retracted to the patient's left shoulder to provide a clear view of the Sulcus of Rouviere, to ensure dissection stays well clear of the right portal pedicle:
In all laparoscopic cholecystectomies, every effort should be made to fully dissect Calot's triangle and achieve the critical view of safety (CVS).