What is a Laparoscopic Cholecystectomy?
A laparoscopic cholecystectomy is a surgical procedure in which the doctor removes the gallbladder using a tool called a laparoscope and other minimally invasive surgical instruments. A laparoscope is a long, narrow tube with lenses and fiber-optic cables inside that is attached to a camera and light source. The surgeon can see the internal organs on a monitor using this scope and then use the tools through small incisions in the skin to remove the gallbladder.
When is it Performed?
This procedure is performed when there are stones (small, hard masses) in the gallbladder, which is attached to the liver. The gallbladder is shaped like a small balloon or pear and holds bile, which is produced in the liver. Bile helps with digestion of food in the intestinal tract. Bile can form sediment in the bottom of the gallbladder, which may form gallstones. There is no known means to prevent gallstones.
These stones may remain loose in your gallbladder, block the gallbladder, plug the common bile duct or pass into your intestine. When the stones block the gallbladder neck, the flow of bile is partially blocked. This can cause abdominal pain when the gallbladder contracts. It may become swollen, infected and/or start to decompose. Other symptoms may include vomiting, indigestion and occasionally fever. If you experience symptoms, you need to consult with your doctor to see if laparoscopic cholecystectomy is right for you.
How is it Diagnosed and Treated?
Ultrasound tests are most commonly used to find gallstones. Gallstones do not go away on their own. They can sometimes be managed for a time with medicine or dietary adjustments, but symptoms usually persist until the gallbladder is removed. Surgically removing the gallbladder is the safest, most effective treatment.
What Happens During the Procedure?
You will be brought into the operating room. A heart monitor and blood pressure cuff will be attached to you. You will be given a general anesthetic that will cause you to fall into a deep sleep. During this time, the anesthesiologist will give you muscle relaxants and pain medications and will remain with you throughout the entire procedure.
The surgeon will insert a small needle through your bellybutton and insert carbon dioxide gas into your abdomen. When your abdomen is inflated, the surgeon will then place the trocars (small metal or plastic tubes) through small incisions in your skin. This will allow the scope and instruments to move in and out of your abdomen without losing the gas. The surgeon will then remove the gallbladder using electrical cautery to separate it from the liver bed. Clips or ties will be placed on the duct and blood supply to the gallbladder, then the gallbladder will be removed through your bellybutton.
In about 5 percent of patients, the laparoscopic method is not feasible. For patient safety, the surgeon may need to perform "open" surgery to remove the gallbladder.
Be sure to discuss risks and possible complications with your surgeon.
What Happens After the Procedure?
The anesthesiologist will accompany you to the recovery room (PACU) where you will stay until you are awake enough to be sent to your room or home. Your doctor will discuss any needs for pain medications or antibiotics with you as well as when you will need to schedule a follow-up appointment.
What are the Benefits of this Procedure?
You will be rid of the painful gallbladder with less discomfort than an open abdominal procedure. Your hospital stay will be shorter, and your return to normal activities will be quicker than if you had the open abdominal procedure.
There are usually no activity restrictions following your surgery. In fact, you're encouraged to do light activity a few days after your surgery. Activity will help alleviate soreness. You'll be given some narcotic pain medicine. Most people don't require a refill. You can usually return to work or your usual activities within a week. Your surgeon's office will provide you with a list of possible problems, such as fever or nausea, to watch for. You'll see your surgeon for a follow-up visit one or two weeks after the surgery.
