Cholecystectomy - Laparoscopic Surgery for Gallbladder Removal

What is cholecystectomy?

Cholecystectomy is the term used to refer to the surgical procedure which involves the removal of the gall bladder. The gall bladder is a small organ located under the liver that stores and concentrates the digestive juice known as bile produced by the liver. During the digestion process this juice is released by the gall bladder into the small intestine to aid in the digestion of food.

When is cholecystectomy advised?

Cholecystectomy is often advised to relieve the symptoms of gall stones. Stones in the gall bladder can block the tubes that transfer bile to the small intestines. This can result in severe pain in many cases depending upon the amount of blockage. Additionally inflammation of the cells and tissues and infection may ensue. The removal of the gall bladder stones are often accomplished with conservative approaches that involves the use of medications and changes in diet. This may offer relief to a certain extent. However, the symptoms may not be relieved in many cases ultimately requiring the removal of the gall bladder. Further, the condition usually recurs frequently. The repeated formation of stones, infections, inflammations or obstruction in the gall bladder may ultimately require the removal of this organ if the conservative measures are unable to treat the condition.

How is cholecystectomy performed?

Cholecystectomy may be performed either by the any of the two methods available: open cholecystectomy or laparoscopic cholecystectomy. The open cholecystectomy involves the removal of the gall bladder by placing a single large incision over the abdomen. The procedure is performed under general anesthesia and requires the individual to stay for a period of 5 to 7 days in the hospital after the surgical procedure. Laparoscopic cholecystectomy is considered as a minimal surgical technique which involves the placement of a few small incisions on the abdomen instead of a single large incision.

What is laparoscopic cholecystectomy?

Laparoscopic cholecystectomy involves the use of an instrument known as laparoscope that has a light source and a camera attached to it. Other smaller instruments are used along with the laparoscope to perform the cholecystectomy. Laparoscopic cholecystectomy is the most commonly followed procedure to remove the gall bladder and is considered as a minimal surgical technique. In contrast to open surgery which involves the placement of a single large incision over the abdomen, laparoscopic procedure involves the placement of two to three smaller incisions. This shortens the recovery time and also minimizes the amount of scar left behind after the procedure.

The laparoscope and the other small instruments used in the removal of the gall bladder are introduced into the body through the small multiple incisions placed on the abdomen. This procedure is performed under general anesthesia. The gall bladder is observed through the laparoscope and the instruments are used to incise and separate the gall bladder from its location. The laparoscope has a small light and a camera which transfers the images to a television and the operating surgeon can view a magnified image of the area being operated. Additional imaging procedures may be carried out to locate the additional blockages or presence of stones in the gall bladder tubes and clear them. Following the removal of the gall bladder the incisions are sutured or closed with surgical tapes. The operated individual is generally advised to stay in the hospital for a day to rule out the presence of any associated complications.

What are the post surgery instructions?

The individual undergoing laparoscopic cholecystectomy needs to stay in the hospital for about a day after the surgery. The individual may be required to take medications to relive any pain or other symptoms associated with the surgery. The recovery is usually faster and is generally not associated with any complications. The operated individual can return home a day after the surgery. Resuming normal activities may vary with each individual and the doctors’ instructions must be followed. The individual who has undergone the laparoscopic cholecystectomy may be asked to visit the hospital at regular intervals to monitor the progress. Additional imaging studies may also be advised to evaluate the outcome of the surgical procedure. Medications may be advised as needed.

What are the pros and cons of laparoscopic cholecystectomy?

A number of benefits are noted with the use of laparoscopic technique for the removal of the gall bladder. The open surgery technique involves the placement of a larger incision when compared to the laparoscopic procedure. Thereby with the laparoscopic cholecystectomy, the extent of incision is smaller, the healing is faster and minimal or no scar may be observed after the wound heals. The amount of pain associated with this technique is also less. The operated individual may return home within a day following the surgery. Everyday activities can be resumed from an earlier period when compared to individuals who have undergone the open method.

Laparoscopic cholecystectomy may not be feasible for all individuals. Obese individuals and individuals with a history of any other abdominal surgery that has resulted in the formation of dense scar tissues cannot be operated with laparoscopy. Increased bleeding and inability to view the tissues clearly may affect the completion of the laparoscopy procedure and may create the need for an open technique. Presence of large stones or increased amount of inflammation in the gall bladder may also be impossible to treat with laparoscopy.

What are the risks and complications of laparoscopic cholecystectomy?

Generally the laparoscopic cholecystectomy is associated with a lesser number of complications when compared with the open surgical technique. The complications associated with the laparoscopic procedure noted under rare circumstances have been listed below.

As with any other operation involving the use of anesthesia, adverse reactions to the drugs administered or other associated complications may be noted in some cases of laparoscopic cholecystectomy. Some of the other complications of anesthesia can include breathing difficulty, pneumonia, formation of blood clots in legs or lungs, and heart problems. Accidental damage to the adjacent structures such as the small intestine may also occur in rare cases. Other complications such as bleeding may be noted either immediately following the procedure or during the recovery period. Secondary infections at the surgical site may also be noted in certain individuals. These complications may need additional hospital care.