{ "vercy": "1.0-draft", "publication": { "status": "research-draft", "adjudicationStatus": "unreviewed", "publishableCanonical": false, "generatedAt": "2026-09-12T08:59:29Z", "providers": [ "Codex" ], "breadth": "recalled by Codex without web access - no source was read", "missingProviders": [], "pass": 2, "cost": { "grok": { "seconds": 22.3, "error": "Reading additional input from stdin...\nOpenAI Codex v0.153.4\n--------\nworkdir: R:\\02_PROJECTS\\02_Meta_Models_Platforms\\Ver.cy\\current\\thing-registry-backlog\nmodel: gpt-6-astra\nprovider: openai\napproval: never\nsandbox: read-only\nreasoning effort: none\nreasoning summaries: none\nsession id: 01a094d6-bb40-7083-952e-a6b7b40e068d\n--------\nuser\nDescribe what is already known about one registered thing. Answer as JSON only, no prose around it.\n\nThing: Cystohepatic triangle\nSense to describe: (none recorded)\nDomain code: PHY.OBJ\nAlso known as: (none)\n\n\nContext for this batch of 1001 things:\n# Batch 043", "usd": 0.0, "recall": true }, "codex": { "seconds": 73.8, "error": "Reading additional input from stdin...\nOpenAI Codex v0.153.4\n--------\nworkdir: R:\\02_PROJECTS\\02_Meta_Models_Platforms\\Ver.cy\\current\\thing-registry-backlog\nmodel: gpt-6-astra\nprovider: openai\napproval: never\nsandbox: read-only\nreasoning effort: none\nreasoning summaries: none\nsession id: 01a094d6-bb4d-7541-bd1e-dc4b964d5eaf\n--------\nuser\nYou are drafting a Vercy meta-model for one registered thing. Answer as JSON only, no prose around it.\n\nThing: Cystohepatic triangle\nRegistry id: vr.tr.cystohepatic-triangle\nPlane / domain: PHY / PHY.OBJ\nRegistry definition: (none recorded)\nNames folded into t" } }, "enrichment": { "pass": 3, "engine": "claude", "producedAt": "2026-10-06T12:00:00Z", "ingestedAt": "2026-10-06T08:51:02+00:00", "fields": [ "agent_conduct", "ethics", "failure_modes_and_hazards", "owners", "visual_identification" ] } }, "metaModel": { "id": "THING-Q604046", "registryId": "vr.tr.cystohepatic-triangle", "name": "Cystohepatic triangle", "version": "0.1.0-research.1", "entryKind": "thing", "family": "Thing Registry", "domain": [ "PHY.OBJ" ], "status": "research-draft" }, "canonicalUrl": "https://ver.cy/models/thing/q604046/", "model": { "registry_id": "vr.tr.cystohepatic-triangle", "name": "Cystohepatic triangle", "purpose": "Enable an agent to recognize the cystohepatic triangle, document its anatomical boundaries and observed contents, and identify uncertainty relevant to clinical interpretation.", "definition": "The cystohepatic triangle, also called the hepatocystic triangle, is an anatomical region bounded by the cystic duct inferiorly, the common hepatic duct medially, and the inferior surface of the liver superiorly, used as a landmark in gallbladder surgery.", "scope_statement": "This model owns the anatomical region registered as vr.tr.cystohepatic-triangle in PHY / PHY.OBJ, using the liver-bounded hepatocystic triangle as its working definition while preserving source-specific terminology and patient-specific observations.", "in_scope": [ "The cystic duct, common hepatic duct and inferior liver surface as defining boundary landmarks", "Terminological distinctions between the hepatocystic triangle and historical descriptions of Calot's triangle", "Spatial relationships of observed ducts, vessels and other tissues within or bordering the region", "Anatomical variation and distortion affecting recognition of the triangle", "Evidence supporting identification and the triangle's contribution to assessment of the critical view of safety" ], "out_of_scope": [ "Complete anatomical models of the liver, gallbladder and extrahepatic biliary tree", "Independent models of the cystic artery and hepatic arterial system", "Diagnosis and management of gallbladder or bile duct diseases", "The complete cholecystectomy procedure and selection of operative techniques", "Autonomous authorization to divide, clip or otherwise manipulate anatomical structures" ], "distinguishing_features": [ "Identify a region bounded by the cystic duct, common hepatic duct and inferior liver surface; adjacency to the gallbladder alone is insufficient. [SAGES](https://www.sages.org/safe-cholecystectomy-program/)", "Check the stated superior boundary when a source uses 'Calot's triangle': historical and modern definitions differ, so the label alone does not establish equivalence. [Calot's triangle](https://pubmed.ncbi.nlm.nih.gov/23519829/)", "Represent an anatomical region defined by relationships among structures, rather than a separate organ, duct or vessel.", "Distinguish identification of the triangle from achievement of the critical view of safety, which requires additional observations. [SAGES](https://www.sages.org/safe-cholecystectomy-program/)" ], "characteristics": [ { "name": "Boundary convention", "kind": "category", "unit_or_values": "Liver-bounded hepatocystic convention; historical Calot convention; other explicitly described convention; unspecified", "why_it_matters": "Prevents observations made under different definitions from being silently combined." }, { "name": "Boundary landmark identification", "kind": "relation", "unit_or_values": "Links to the observed cystic duct, common hepatic duct and inferior liver surface, each with an identification status", "why_it_matters": "Makes recognition depend on anatomical evidence rather than an approximate location." }, { "name": "Boundary visibility", "kind": "state", "unit_or_values": "For each boundary: visible; partially visible; obscured; outside the observation; not assessed", "why_it_matters": "Separates an unseen boundary from an absent structure." }, { "name": "Observed structure relationship", "kind": "relation", "unit_or_values": "Within; crossing; bordering; adjacent; relationship unresolved", "why_it_matters": "Records a vessel or duct's position without treating proximity as proof of identity." }, { "name": "Regional distortion", "kind": "state", "unit_or_values": "Not observed; suspected; observed; indeterminate, with the supporting evidence and suspected cause recorded separately", "why_it_matters": "Captures situations in which the expected boundary arrangement cannot be applied confidently." }, { "name": "Observation context", "kind": "category", "unit_or_values": "Operative view; imaging study; anatomical specimen; illustration, with modality or viewpoint specified", "why_it_matters": "Distinguishes patient evidence from teaching representations and makes visibility claims interpretable." }, { "name": "Critical view assessment", "kind": "state", "unit_or_values": "Not assessed; incomplete; documented as achieved by the responsible clinician; indeterminate", "why_it_matters": "Keeps a clinical assessment separate from the agent's recognition of the triangle." } ], "affordances": [ "Annotate the triangle and its separately identified boundary landmarks in a clinical image or anatomical representation.", "Compare source terminology and flag incompatible boundary definitions.", "Map observed vessels and ducts relative to the triangle while retaining unresolved identities.", "Compare observations across viewpoints or time points to expose inconsistent anatomical interpretations.", "Assemble evidence for clinician review of anatomical identification and critical view criteria.", "Flag inadequate evidence and request expert review when boundaries or structures remain uncertain." ], "agent_conduct": { "may": [ "Describe the triangle and its role as a safety landmark in gallbladder surgery.", "Support surgical teams in documenting that structures were identified before division, when authorized." ], "must_not": [ "Direct or perform surgical steps without the operating surgeon in control.", "Label a structure in a live operation with confidence it does not have.", "Share identifiable operative video without consent." ], "requires_human": [ "Any decision to clip or divide a structure in the triangle." ] }, "ethics": { "considerations": [ "Misidentifying ducts here causes bile duct injuries that change patients' lives.", "Patients deserve an honest account when complications occur." ], "affected_parties": [ "Surgical patients", "Surgeons and theatre teams" ] }, "owners": { "steward": "Nobody: part of a person's body; the surgical team answers for care during an operation.", "master_systems": [] }, "visual_identification": [ "Bounded by the cystic duct, the common hepatic duct and the underside of the liver.", "Usually contains the cystic artery." ], "failure_modes_and_hazards": [ "Misidentification of ducts can cause bile duct injury.", "Inflammation and anatomical variation obscure the landmarks." ] }, "sources": [ { "id": "wikidata", "title": "Wikidata item Q604046: Cystohepatic triangle", "url": "https://www.wikidata.org/wiki/Q604046", "url_status": "live", "what_it_supports": "identity and sense of the item", "checked_by": "wikidata-api" }, { "id": "wikipedia-en", "title": "Wikipedia: Cystohepatic triangle", "url": "https://en.wikipedia.org/wiki/Cystohepatic_triangle", "url_status": "live", "what_it_supports": "general description of the item", "checked_by": "wikidata-api sitelink" } ], "structure": { "bundles": [ { "id": "identity-and-boundary-convention", "name": "Identity and boundary convention", "description": "Establish which anatomical region an observation or source intends by cystohepatic triangle.", "rationale": "The region cannot be recognized consistently if overlapping names conceal different boundaries.", "layers": [ { "id": "anatomical-region-identity", "name": "Anatomical region identity", "description": "Connect the registry concept to an explicitly bounded region.", "findings": [ { "id": "three-landmark-definition", "name": "Three-landmark definition", "description": "Use the cystic duct, common hepatic duct and inferior liver surface to define the working region. [SAGES](https://www.sages.org/safe-cholecystectomy-program/)", "questions": [ { "text": "Does the source explicitly define the region using these three landmarks?", "kind": "definition", "id": "three-landmark-definition-q01" }, { "text": "Which boundaries are directly observed and which are inferred?", "kind": "boundary", "id": "three-landmark-definition-q02" } ] } ] }, { "id": "terminology-reconciliation", "name": "Terminology reconciliation", "description": "Preserve the meaning attached to each anatomical name.", "findings": [ { "id": "calot-label-interpretation", "name": "Calot label interpretation", "description": "Record the boundary definition attached to 'Calot's triangle' before mapping it to this entry; published usage distinguishes historical and modern descriptions. [Calot's triangle](https://pubmed.ncbi.nlm.nih.gov/23519829/)", "questions": [ { "text": "What superior boundary does this source assign to Calot's triangle?", "kind": "definition", "id": "calot-label-interpretation-q01" }, { "text": "Which source establishes the intended equivalence or distinction between the names?", "kind": "provenance", "id": "calot-label-interpretation-q02" } ] } ] } ] }, { "id": "boundaries-and-local-relationships", "name": "Boundaries and local relationships", "description": "Record the observed landmarks and the structures related to the region.", "rationale": "Expected anatomy must be distinguished from identification in a particular specimen or patient.", "layers": [ { "id": "boundary-identification", "name": "Boundary identification", "description": "Document evidence for the ductal and hepatic landmarks individually.", "findings": [ { "id": "landmark-continuity", "name": "Landmark continuity", "description": "Record how each proposed boundary is identified, including visible continuity and unresolved segments.", "questions": [ { "text": "What evidence identifies the proposed cystic duct rather than another duct?", "kind": "boundary", "id": "landmark-continuity-q01" }, { "text": "What evidence identifies the common hepatic duct and the inferior liver surface in this observation?", "kind": "boundary", "id": "landmark-continuity-q02" } ] } ] }, { "id": "regional-structure-mapping", "name": "Regional structure mapping", "description": "Describe vessels, ducts and other observed tissues in relation to the boundaries.", "findings": [ { "id": "structure-course-and-identity", "name": "Structure course and identity", "description": "Maintain separate records for an observed structure's course, proposed identity and evidence; location within the triangle alone does not establish identity.", "questions": [ { "text": "Which structures are observed within, crossing or immediately bordering the region?", "kind": "boundary", "id": "structure-course-and-identity-q01" }, { "text": "What observed continuity or other evidence supports each proposed duct or vessel identity?", "kind": "provenance", "id": "structure-course-and-identity-q02" } ] } ] } ] }, { "id": "variation-and-observability", "name": "Variation and observability", "description": "Capture departures from the expected arrangement and limitations of the available view.", "rationale": "A poorly seen triangle, a displaced triangle and a variant anatomical arrangement require different interpretations.", "layers": [ { "id": "anatomical-departures", "name": "Anatomical departures", "description": "Record observed differences without assigning an unsupported explanation.", "findings": [ { "id": "variant-or-distorted-arrangement", "name": "Variant or distorted arrangement", "description": "Describe unexpected boundary or structure relationships and distinguish suspected anatomical variation from suspected acquired or positional distortion.", "questions": [ { "text": "Which specific ductal, arterial or boundary relationship differs from the reference arrangement?", "kind": "boundary", "id": "variant-or-distorted-arrangement-q01" }, { "text": "What evidence supports variation, disease-related distortion or positioning as the explanation?", "kind": "provenance", "id": "variant-or-distorted-arrangement-q02" } ] } ] }, { "id": "view-dependent-evidence", "name": "View-dependent evidence", "description": "Attach visibility judgments to the actual observation conditions.", "findings": [ { "id": "visibility-and-occlusion", "name": "Visibility and occlusion", "description": "Record viewpoint, timing and obscuring material or tissue so that incomplete visualization is not interpreted as anatomical absence.", "questions": [ { "text": "Which boundaries or crossing structures cannot be assessed in this view, and what obscures them?", "kind": "boundary", "id": "visibility-and-occlusion-q01" }, { "text": "Which image, frame or specimen observation supports the visibility judgment?", "kind": "provenance", "id": "visibility-and-occlusion-q02" } ] } ] } ] }, { "id": "clinical-identification-and-review", "name": "Clinical identification and review", "description": "Connect regional observations to clinical review without turning the model into an operative protocol.", "rationale": "Recognition of this triangle has clinical significance, but recognition alone cannot establish readiness for an operative action.", "layers": [ { "id": "critical-view-evidence", "name": "Critical view evidence", "description": "Relate the triangle assessment to the additional observations required for the critical view of safety.", "findings": [ { "id": "independent-critical-view-components", "name": "Independent critical view components", "description": "Record triangle clearance separately from exposure of the cystic plate through separation of the lower gallbladder and demonstration of two structures entering the gallbladder. [SAGES](https://www.sages.org/safe-cholecystectomy-program/)", "questions": [ { "text": "What evidence supports each critical view component independently?", "kind": "provenance", "id": "independent-critical-view-components-q01" }, { "text": "Has the responsible clinician documented the overall assessment, or is only the triangle visible?", "kind": "action", "id": "independent-critical-view-components-q02" } ] } ] }, { "id": "unresolved-anatomy-review", "name": "Unresolved anatomy review", "description": "Make uncertain identification explicit and traceable to subsequent clinical review.", "findings": [ { "id": "identification-discrepancy", "name": "Identification discrepancy", "description": "Preserve competing interpretations of a boundary or traversing structure and record whether expert review resolved them.", "questions": [ { "text": "Which unresolved boundary or structure identity prevents a reliable anatomical interpretation?", "kind": "boundary", "id": "identification-discrepancy-q01" }, { "text": "What additional evidence or clinician review is needed to resolve the discrepancy?", "kind": "action", "id": "identification-discrepancy-q02" } ] } ] } ] }, { "id": "evidence-and-external-alignment", "name": "Evidence and external alignment", "description": "What the world already says about this thing, gathered so the model can be checked against it.", "rationale": "A model that cannot be lined up against existing standards, identifiers and practice cannot be adopted by anyone who already uses them.", "layers": [ { "id": "reported-evidence", "name": "Reported evidence", "description": "Findings from the breadth pass, kept separate from the structural claims.", "findings": [ { "id": "evidence-confidence-notes", "name": "Check these first", "description": "Recalled without web access and unsourced; every item is a lead to verify.", "evidence": [ "This description is based on recall rather than source review.", "Check whether a source uses Calot's triangle in its original sense or as a synonym for the hepatocystic triangle.", "Vascular and biliary contents vary between individuals; no fixed dimensions or invariant arrangement should be assumed." ], "questions": [ { "id": "evidence-confidence-notes-q01", "text": "Which of these check these first hold for the sense of Cystohepatic triangle this model covers, and on what evidence?", "kind": "provenance" } ] }, { "id": "evidence-real-world-use", "name": "Real-world use", "description": "Recalled without web access and unsourced; every item is a lead to verify.", "evidence": [ "Anatomical orientation during cholecystectomy.", "Identification of the cystic artery and recognition of variant vessels and bile ducts.", "Assessment of the critical view of safety before division of structures entering the gallbladder." ], "questions": [ { "id": "evidence-real-world-use-q01", "text": "Which of these real-world use hold for the sense of Cystohepatic triangle this model covers, and on what evidence?", "kind": "provenance" } ] }, { "id": "evidence-failure-modes-and-hazards", "name": "Failure modes and hazards", "description": "Recalled without web access and unsourced; every item is a lead to verify.", "evidence": [ "Misidentification of the common hepatic duct or common bile duct as the cystic duct can cause major bile duct injury.", "Variant right hepatic artery anatomy can increase the risk of arterial injury and bleeding.", "Accessory or aberrant bile ducts may be injured during dissection.", "Inflammation, fibrosis, and adhesions can obscure boundaries and distort anatomical relationships.", "Identifying the triangle alone does not establish the critical view of safety." ], "questions": [ { "id": "evidence-failure-modes-and-hazards-q01", "text": "Which of these failure modes and hazards hold for the sense of Cystohepatic triangle this model covers, and on what evidence?", "kind": "provenance" } ] }, { "id": "evidence-neighbours", "name": "Neighbouring kinds and how to tell them apart", "description": "Recalled without web access and unsourced; every item is a lead to verify.", "evidence": [ { "name": "Calot's triangle", "difference": "In its original definition, the superior boundary is the cystic artery rather than the liver; modern usage often applies the name to the hepatocystic triangle." }, { "name": "Cystic duct", "difference": "A bile-carrying duct forming one boundary of the triangle, rather than the anatomical region itself." }, { "name": "Common hepatic duct", "difference": "The duct carrying bile from the joined right and left hepatic ducts; it forms the medial boundary of the triangle." }, { "name": "Cystic artery", "difference": "An artery supplying the gallbladder that typically traverses the triangle, rather than the triangle itself." }, { "name": "Critical view of safety", "difference": "A surgically established view requiring clearance of the hepatocystic triangle, separation of the lower gallbladder from the liver bed, and demonstration of only two structures entering the gallbladder; it is not an anatomical region." } ], "questions": [ { "id": "evidence-neighbours-q01", "text": "Which of these neighbouring kinds and how to tell them apart hold for the sense of Cystohepatic triangle this model covers, and on what evidence?", "kind": "provenance" } ] } ] } ] } ] }, "openQuestions": [ "Does the registry intend the liver-bounded hepatocystic triangle specifically, and does an existing Vercy world model already own this concept?", "Which authoritative anatomical terminology source should govern equivalence among cystohepatic triangle, hepatocystic triangle and Calot's triangle?", "Which contents and anatomical variants should be represented as expected, optional or exceptional after review of primary anatomical studies?", "What evidence and review criteria should distinguish confirmed landmark identification from a plausible interpretation across imaging, operative views and specimens?", "How should the region be represented after surgery or major distortion when its original boundaries can no longer be identified?" ], "statistics": { "bundles": 5, "layers": 9, "findings": 12, "questions": 20 } }