Background & Theory

Background

Anatomy

The gallbladder is a pear-shaped organ that lies beneath the liver. It stores concentrated bile before it is released to the small intestine.

Image from [2].

The Clinical Problem

Inflammation or gallstones in the gallbladder

Cholecystitis or inflammation of the gallbladder is the main indication for a cholecystectomy. Another reason can be abnormal gall stones in the gallbladder.

Image from [3]

The Current Solution

Laparoscopic Cholecystectomy:

Procedure Description

A laparoscopic cholecystectomy (removal of the gallbladder) is done 92% of the time [1]. A laparoscopic procedure is done by the physician giving a few small 1 cm incisions in the abdomen creating pathways for long and skinny instruments. These instruments are navigated in the abdomen by using a camera. They remove the gallbladder by putting into a bag then pulling the bag out of the small incision.

Image from [4]

Problem Statement

During some of these procedures the gallbladder can ball up in the bottom of the bag. This can make the gallbladder very difficult to pull through a 1 cm incision. When this happens, this increases procedure time and the aggressive pulling by the physician increases force exerted on the patient. We are creating a device to decrease the procedure time when pulling the gallbladder out and decrease the amount of force exerted on the patient.

Theory for Proposed Solution

The primary concepts driving development of this device are linearization and orientation of the gallbladder specimen.

Linearization

The funnel is used to drive the mechanism of linearizing the gallbladder. The funnel is chosen because it is able to compact into the shaft of laparoscopic devices and expand upon deployment into the abdomen. This aims to compress the gallbladder as it is being pulled out of the abdomen. The use of a metal that is compressible while retaining its original shape should allow for the funnel to be retracted and deployed in order to ensure it can be stored within the shaft of the device.

Orientation

By holding the gallbladder by the cystic duct, the surgeon can use the force of gravity to make the gallbladder be removed in a linear shape. This will aid in the ability to pull the gallbladder out. Pulling the gallbladder out will be easier when linear rather than when it is a ball at the bottom of the bag since the diameter of the largest area of the gallbladder will theoretically be smaller when it is linearized.

Image from [5]

[1] Jones MW, Deppen JG. (2019). Open Cholecystectomy. In: StatPearls [online]. Available at: https://www.ncbi.nlm.nih.gov/books/NBK448176/ [Accessed 15 Sep. 2019].
[2] Winslow, Therese. (2010). Anatomy of the Gallbladder. Available at: https://www.ncbi.nlm.nih.gov/books/NBK65963/figure/CDR0000270720__198/
[3] Saurabh Sethi. (2018). How do I Recognize Gallbladder Inflammation? Available at : https://www.medicalnewstoday.com/articles/306602
[4] Gallbladder Removal by Laparoscopy. (2018). Available at: https://www.dovemed.com/common-procedures/procedures-surgical/gallbladder-removal-by-laparoscopy-laparoscopic-cholecystectomy/
[5] Will Milne Photography. Woman's Hand Holding Water Balloon. Available at: https://creativemarket.com/Will_Milne/52039-Womans-Hand-Holding-Water-Balloon

Page updated

Report abuse