**6.1 Critical view of safety**

Critical view of safety (CVS) technique is composed of three steps:


This concept is widely accepted and represents the basis of the safe cholecystectomy model to minimise the incidence of iatrogenic biliary ducts injuries [20].

#### **Figure 4.** *Schematic image of critical view of safety.*

Combination of this method and correct indication for surgery, good preoperative preparation and planning, and meticulous dissection constitute a modern approach towards safe cholecystectomy with reduced risk of biliary structure injury. Due to the scientific verification of reduction in BDIs, the critical view of safety is routinely recommended over other methods [22]. However, CVS cannot always be easily achieved with the most frequent incompleteness in the separation of the infundibular part of the gallbladder from the gallbladder bed. In other cases, the CVS cannot be utilised because of advanced inflammation or scar formation in the hepatocystic triangle due to ongoing or former inflammatory processes [23]. The literature recognised the BDIs to be more frequent in surgeries performed by young residents during the early part of their learning curve in the laparoscopic cholecystectomy. Therefore, it is important for the resident to complete a critical view of safety with the mentoring surgeon to confirm it before ligating any structures [23].
