Video and Photographic Documentation for the Critical View of Safety: A Method for Improving Quality Control in Laparoscopic Cholecystectomy
Thawatchai Tullavardhana MD*, Thammanij Rookkachart MD*, Prinya Akranurakkul MD*
Affiliation : * Department of Surgery, Faculty of Medicine, Srinakharinwirot University, Nakhon Nayok, Thailand
Background : Currently, Laparoscopic cholecystectomy (LC) is the gold standard surgical treatment of stones in the gall
bladder. However, the disadvantage of LC was increases in the incidence of bile duct injury up to 0.20-3.40%. The critical
view of safety (CVS) technique has been developed in an attempt to prevent the complication.
Objective : To verify the adequacy of performing CVS technique by auditing the operative note, video record and photographic
documentation.
Material and Method: From January until December 2015, we investigated the accuracy of CVS establishment on video and
photo prints. Two experienced laparoscopic surgeons were independent analyzer of the documentations, which classified into
conclusive, probably, inconclusive and not established.
Results : A twenty-four patients underwent an elective LC. The video records provide a superior quality to prove the CVS than
the photo prints (90-95% versus 75-80%). However, a combination of documenting modality including operative note, video
and photo print proved that a conclusive CVS establishment could be achieved in all cases. There was no postoperative
complication occurred in this study.
Conclusion : Mandatory use of the imaging documentation methods for assessment of adequate CVS generally facilitates a
good quality control in surgical practice and patient care.
Keywords : Laparoscopic cholecystectomy, Technique, Quality control, Critical view of safety
