Comparative efficacy of body first versus conventional techniques in achieving critical view of safety in laparoscopic cholecystectomy a single blinded block randomized controlled trial

Gall stone disease is a major health problem affecting people all around the world. Evidences suggests that prevalence of gall stone diseases are on the rise. Gold standard treatment for symptomatic gall stone diseases is laparoscopic cholecystectomy. Critical view of safety is measured as a end point of Hepatocystic triangle dissection, which can be achieved by different methods of dissection. The present prospective randomized trial was undertaken to compare the efficacy of achievement of the Critical View of Safety and to analyse the operative time required for each technique.

The study will be conducted at the Department of General Surgery, All India Institute of Medical Sciences, Gorakhpur Uttar Pradesh India. This tertiary care centre is equipped with advanced medical facilities and a high volume of surgical cases, providing a suitable environment for conducting a randomized controlled trial. The setting ensures access to a diverse patient population undergoing elective Laparoscopic cholecystectomy, allowing for robust data collection and analysis. This study is a prospective, randomized, controlled, single-blinded, parallel assignment, single centre trial designed to compare the efficacy and safety of the body-first technique versus the conventional technique in achieving a critical view of safety during Laparoscopic cholecystectomy . A patient who will fulfill the inclusion criteria and does not satisfy any of the exclusion criteria will be randomized in to body first or conventional approach. The institution’s experienced surgical teams and state-of-the-art surgical suites will support the accurate assessment of both surgical techniques under study . CONSORT guidelines for randomized controlled trials will be followed. Outcome measures include the successful achievement of the Critical View of Safety which will be defined according to Strasberg criteria of doublet photography and Comparison of duration of surgery ,intraoperative and postoperative complications, recovery of gastrointestinal function , post-operative pain, nausea and vomiting, length of hospital stay, pre and post op change in inflammatory marker, patient satisfaction  between the two techniques.