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Resident's Forum
Dec 2011

Raising The Thinker: New Concept for Dissecting the Cystic Pedicle During Laparoscopic Cholecystectomy

Author Affiliations

Author Affiliations: Department of Surgery, Danbury Hospital Medical Arts Center, Danbury, Connecticut.

Arch Surg. 2011;146(12):1441-1444. doi:10.1001/archsurg.2011.572

Imprecise dissection due to poor visualization of anatomic structures is among the major causes of biliary injuries during laparoscopic cholecystectomy. Developing new illustrational and rendering techniques represents an important part in decreasing visual deception and subsequent bile duct injuries. We use the model of one of the most well-known pieces of art, Rodin's The Thinker, to visualize the gallbladder and cystic pedicle structures. This minimizes visual deception before dissection, especially in cases with obscured structures. Our method, raising The Thinker, is based on the remarkable similarity between the sculpture and the topographic anatomy of the gallbladder. The method can be used not only for better orientation and visualization during laparoscopic cholecystectomy but also as a tool to complement the teaching of laparoscopic biliary anatomy to surgical residents and medical students.