The main reason for having gallbladder surgery is the presence of gallstones and the complications they cause. Gallbladder removal is one of the most commonly performed surgical procedures. Removal is also a treatment option if the gallbladder becomes diseased, infected or in the rare case of cancer. Normal digestion is possible without a gallbladder.
What is Laparoscopic Gallbladder Surgery?
The removal of the gallbladder is most commonly performed using a minimally invasive technique known medically as “Laparoscopic Cholecystectomy”. Cholecystectomy means ‘surgery to remove the gallbladder’ and laparoscopic describes the slender tube which has a light and a camera that is inserted into the body to allow the doctor to see inside the abdomen. Small incisions and specialized tools including the laparoscope are used to remove a diseased or infected gallbladder. A laparoscopy is also known as keyhole surgery.
Laparoscopic surgery is categorized as a minimally invasive procedure and is preferred over open surgery because the smaller incisions reduce the risk of infection, bleeding, and recovery time. Most people recover more quickly and with fewer complications with laparoscopic surgery than with open surgery. For most people Laparoscopic Cholecystectomy is safe and effective and is the most commonly used surgery option for gallbladder removal when no complicating factors are present.
Options for Laparoscopic Gallbladder Surgery
Laparoscopic Cholecystectomy may be performed in two ways. Firstly a surgeon makes several small incisions to allow instruments, including a miniature camera (a laparoscope) to be placed in the body. When this procedure is used there are typically four small incisions made; three on the right side near the bottom of the rib cage and one slightly above the navel. More commonly now laparoscopic surgery is carried out with just one single incision at the belly button. The images from the laparoscope are projected back to a monitor to allow the surgeon to clearly view the surgical site.
Although there are many advantages to laparoscopic cholecystectomy it may not be recommended for some patients for example in the case of severe complicated gallbladder disease or if the patient has previously had upper abdominal surgery. For these patients their doctor will discuss other options.
Advantages of Minimally Invasive Surgery to Remove Gallbladder
Minimally invasive gallbladder surgery has several advantages over traditional open surgery. Firstly, and most importantly for many people, is a shortened hospital stay. This means less time away from work and other commitments. Patients can generally be discharged the same day or the next day. Following a laparoscopy to remove a gallbladder one can expect to return to usual activities, including work, in about 7 to 10 days. A shorter hospital stay also reduces the risk of exposure to other infections.
Secondly, because the gallbladder is removed through either one or only a few very small incisions as opposed to a large incision of approximately 15 centimeters there is considerably less post-operative pain with many patients reporting minimal levels of pain. Wound care is also simplified when compared to open surgery for gallbladder removal. Reduced pain levels also contribute to a swifter recovery as patients are able to be more mobile more quickly therefore returning sooner to both work and other activities after the surgery. When these reasons are considered it is clear that minimally invasive laparoscopic surgery is a good option for the removal of the gallbladder to relieve the intense pain of gallstones.
Gallbladder Laparoscopic Surgery Procedure
Firstly in preparing for gallbladder surgery an IV drip line is inserted into a vein in the back of the patient’s hand. This allows for fluids and drugs to be administered in careful doses. Once in the operating theatre a general anesthetic is administered so that the patient is asleep and pain free during the surgery. The surgery will usually last for less than two hours.
After the general anesthetic has been effective, the surgeon makes small incisions, often one sometimes four, in the abdomen. The abdomen is inflated with carbon dioxide to allow it expand so the surgeon can see clearly and has more space in which to work. A laparoscope, which is a lighted camera on a tube, is inserted through the incision into the abdomen. Cannulas are inserted and carefully separate the gallbladder from its attachments. The gallbladder is then removed through one of the openings.
A cholangiogram, which is an x-ray taken to show the anatomy of the bile ducts, may be performed during surgery. It allows the surgeon to view the anatomy of the bile ducts and identify gallstones lodged in the bile channels. A dye is injected into the common bile duct which is then x-rayed. The surgeon may choose to remove identified stones immediately or later using an endoscope via the mouth. Occasionally the surgeon may need to opt to complete the gallstone and gallbladder removal through open surgery.