Surgery using a laparoscope is the most common way to remove the gallbladder. A laparoscope is a thin, lighted tube that lets the doctor see inside our belly. It is a minimally invasive surgery in which small incisions and specialized tools are used to remove a diseased or infected gallbladder.

The gallbladder is a small organ that sits right under the liver and is credited with bile storage, which can help the body in breaking down various kinds of fats that enter it. So, what all do you need to know about this operation? read this list.

Reasons for gallbladder operation
The gallbladder is not a very efficient organ. It can lead to blockages and choking as the bile it stores can become very thick and difficult to handle. Also, this bile can harbour deposits that are hard ball like substances, usually known as gallbladder stones. The size of these stones can vary from the size of a grain to the size of a golf ball. 

Further, these gallbladder stones can cause infections, which can lead to symptoms like nausea, vomiting, bloating and more. Another reason can also be the gallbladder disease known as chloelithiasis, which can cause abdominal pain. Inflammation in the pancreas, also known as pancreatitis, can lead to gallbladder open removal surgery.

Risk
While the gallbladder removal surgery is usually considered a safe one, with little or no complications, there are risks attached to this surgery too. These include sudden and excessive bleeding and the creation of blood clots, allergic reactions to the drugs used as well as anaesthesia, blood vessel damage, accelerated heart rate which leads to an increased risk of contracting a heart attack or heart disease, infections, inflammation or swelling in the pancreas, and injuries caused to the bile duct during surgery.

You might also need this type of surgery if you have the following:
1. Biliary dyskinesia, which occurs when the gallbladder doesn't fill or empty correctly due to a defect
2. Choledocholithiasis, which occurs when gallstones move to the bile duct and potentially cause a blockage that prevents the gallbladder from draining
3. Cholecystitis, which is an inflammation of the gallbladder
4. Pancreatitis, which is an inflammation of the pancreas

Laparoscopic surgery is preferred over open cholecystectomy surgery because the smaller incisions that are made reduce your risk of infection, bleeding, and recovery time.

Preparation
To prepare for your gallbladder removal surgery, the doctor may ask you to have a prescription fluid so that your bowels are flushed clean. You may also be asked to fast for at least six hours before the surgery so that there is no hindrance to the same. Also, the use of an antibacterial soap to bathe is usually prescribed so that the risk of contracting infections decreases.

While this surgery can be a simple one, you will have to take due care after the surgery to ensure that the recovery is fast and virtually pain free.

All About Gallbladder Surgery

The gall bladder, which sits just below the rib cage to the right of the stomach, is very tender to touch. It is a little sac or storage compartment for bile, which is produced by the liver. The gallbladder emits bile into the small intestines via a duct referred to as the cystic duct. The entire process is meant to break down foods (namely fatty foods). 
Gallbladder attack symptoms may include one or more of the following:
1.Pain in the back right shoulder blade:
Sometimes, pain radiates through to the back shoulder blade on the right side or in the middle between the shoulder blades. This is pain from the gallbladder affecting the back of the shoulder. This back shoulder blade chest pain is one of the most common yet unknown symptoms of a gallbladder disorder. This can come and go or be constant. It may be sharp, excruciating or dull. It may also occur especially at night. A gallbladder attack will typically last for one to four hours.
2. Pain in the stomach: 
The most common symptom of a gallbladder problem is pain. This pain usually occurs in the mid to upper-right section of your abdomen. It can be mild and intermittent, or it can be quite severe and frequent. In some cases, the pain will begin to radiate to other areas of the body, including the back and chest.
3. Nausea or Vomiting: 
Nausea and vomiting are common symptoms among all types of gallbladder problems. But only a chronic gallbladder disease may cause digestive problems, such as acid reflux, gas, nausea, and vomiting.
4. Diarrhea:
Having more than four bowel movements a day for at least three months may be a sign of chronic gallbladder disease.
5. Fever or Chills:
An unexplained fever may signal that you have a bile duct infection. If you have an infection, you need treatment before it worsens and becomes dangerous. The infection can become life-threatening if it's allowed to spread to other parts of the body.
6. Unusual Stools or Urine: 
Lighter-colored stools and dark urine are possible signs of a common bile duct block.

Recognizing The Symptoms Of A Gall Bladder Attack

These Gallstones don t cause any problems in most cases. But prompt treatment is required if stones block ducts and cause infections and inflammation in the pancreas. This may lead to the removal of the gallbladder through a surgery, known as cholecystectomy, which further includes techniques such as laparoscopic (keyhole) cholecystectomy or open surgery.

Although it is a less vital organ, the body can cope up even after removal.

Procedure of surgery:

The surgery involves removal of gallbladder and gallstones through several incisions in the abdomen. In order to see clearly, the surgeon inflates the abdomen with air or carbon dioxide.
A lighted scope attached to a video camera is inserted into one incision near the belly button. The video monitor is used as a guide for inserting other surgical instruments into the other incisions to remove the gallbladder.
Intraoperative cholangiography is the X-ray procedure which shows the anatomy of bile ducts. This is done before the surgeon removes the gallbladder.
Bile flows from the liver through the common bile duct after the surgery into the small intestine. As the gallbladder has been removed, the gallbladder can no longer store bile between meals but has no effect or little effect on digestion.
In case of open surgery, the surgeon reaches the gallbladder through a large, single incision in the abdominal wall.
Complications after gallbladder surgery:

This surgery carries some degree of risk like any other surgery. Complications such as internal bleeding, infection, injury to nearby digestive organs, injury to the bile duct and injury to blood vessels.

Types of gallstones:

There are three main types of gallstones. They are

Mixed stones: They are made up of cholesterol and salts. They tend to develop in batches.
Cholesterol stones: Mainly made of cholesterol, which is crucial to many metabolic processes. They can grow large enough to block the bile ducts.
Pigment stones: The colour of bile is greenish-brown, due to some particular pigments.
Medical factors to consider before cholecystectomy:

The most important factor is a consideration of your medical history. This is because the pre-existing conditions influence decisions on surgery and anaesthetic and information about any bad reactions or side effects from any medications would be helpful for surgery.

Self-care after the surgery:

Taking rest is the most important thing after surgery. Avoid things such as heavy lifting and physical exertion. The usual recovery period after the surgery is one week.

Know Everything About Gallstone Surgery!

Surgeons perform the Laparoscopic Cholecystectomy Procedure when there is an obstruction to the flow of bile from the gallbladder to the digestive system. This may happen due to the formation of stones in the gallbladder. 

In case there is stone in the gallbladder, it calls for the removal of gallbladder. If the gallbladder is not removed, it may give rise to abdominal pain, nausea, vomiting, pain in the shoulder, arms, etc. It may also lead to jaundice and infection and put the pancreas in difficulty. The gallbladder removal procedure can be carried out through the Laparoscopic Cholecystectomy.

In this procedure, the gallbladder is removed from the abdomen through small incisions using a laparoscope and other surgical instruments. A total of five incisions are made into the abdomen.

Role of Gallbladder and Why Laparoscopic Cholecystectomy is Needed?

The gallbladder is a pear-shaped organ located at the right side of the liver. It helps the digestive system of the body. The gallbladder stores the bile juice made by the liver. This bile juice helps in digesting the fat. If there are stones in the gallbladder, it can block the flow of bile fluid, which affects the functionality of digestive system. This problem is known as Gallstones. A Laparoscopic Cholecystectomy is performed when there is a stone in the gallbladder.

What Is a Laparoscope and How Is It Used?

A laparoscope is a narrow tube-like structure that carries a camera in front of it. This instrument is inserted through a small incision and the doctor manipulates it to view the targeted area clearly. He can view the area clearly on the monitor. Surgical instruments are then inserted through other incisions, and the gallbladder is removed.

The Procedure:

Before the procedure, the patient is administered with general anesthesia. This relaxes the muscles and prevents pain. The patient falls asleep and the doctor carries out the procedure. Carbon dioxide is inserted into the abdomen to inflate it. After this, a small incision is made in the navel and the laparoscope is inserted through it. The surgeon may also perform an X-ray to confirm the existence of stones in the common bile duct. Once he is confirmed about the existence of stones, he inserts surgical instruments through other incisions. The surgeon removes the gallbladder through these incisions.

What Are the Benefits of Laparoscopic Cholecystectomy Procedure?

There are many benefits of Laparoscopic Cholecystectomy over open gallbladder removal:

The patient suffers less discomfort compared to regular surgery.

The patient also needs to stay in the hospital for a lesser number of days as compared to open surgery.

The patient also suffers smaller tears as compared to open surgery.

Risks of Laparoscopic Cholecystectomy:

The risk of complications is low in a laparoscopic procedure. However, there are still some risks, that include:

Infection

Business

Injury to the common bile duct

Shoulder Pain

Leakage of Bile

Conclusion:

Laparoscopic cholecystectomy has become a popular option for patients suffering from gallbladder stone. Surgeons often suggest this procedure so that patients can recover quickly and there is minimal bleeding. However, the laparoscopic surgeon must be experienced to perform this type of surgery. An experienced laparoscopic surgeon can ensure that there are minimal bleeding and little risk of other side effects during the procedure. The patient must be able to recover quickly and get back to his routine.

Laparoscopic Cholecystectomy Procedure!

Gall bladder is a very important digestive gland, which is located on the right side of your abdomen, just beneath your liver. Its main function is to collect, store and release bile, a digestive fluid produced in your liver, essential for metabolizing fats, into your small intestine.

Sometimes, small hard stones comprising of cholesterol, bile pigments and calcium salts in the shape of a pebble, can form in your gall bladder. Gallstones may cause no symptoms but when the gallstone lodges in ducts and blocks the flow of bile, it can cause persistent high-intensity pain which requires gallstone surgery.

Surgery is then prescribed to remove the gall bladder. This surgery is called cholecystectomy. It s done when there are

Gallstones in the gallbladder
Gallstones in the bile duct
Gallbladder inflammation
Inflammation in pancreas
Gallstone surgery or cholecystectomy is a common surgery, and it comes with only a small risk of complications and you can walk out of the hospital on the day of the surgery itself.

Procedure

Minimally invasive or laparoscopic cholecystectomy
During this procedure, the surgeon makes 4 tiny incisions in your abdomen and inserts a tube with a tiny video camera inside it.
Through a video monitor, the surgeon watches while he inserts surgical tools through the other 3 incisions to remove your gallbladder.
After the surgery, the surgeon confirms that there are no gallstones left. Once this is done, he sutures your incisions and you are taken to the recovery area. A laparoscopic cholecystectomy takes just 2 hours or so.
But the problem with this procedure is that it  not appropriate for everyone. Sometimes, what happens is that, the surgeon may start with a laparoscopic surgery and then may decide to go for an open gallstone surgery because of scar tissue or complications.
Traditional or open cholecystectomy
This procedure requires a bigger incision of about 6-inches in your abdomen, below your ribs on the right side. The liver and gallbladder are exposed and the surgeon removes the gallbladder.
An open cholecystectomy takes one or two hours.
Single-incision Laparoscopy Surgery

Traditional laparoscopic surgeries use a telescopic rod attached to a video camera called a laparoscope, which is inserted through a small incision. Apart from this, 3 to 5 additional small cuts are made to insert the other surgical instruments to perform the surgery.

However, single-incision laparoscopy surgery (SILS) is a revolutionary minimally invasive surgical procedure conducted through a single incision. It provides a better cosmetic outcome, as a small incision is made through the patient s navel or belly button, resulting in an almost scarless outcome.

Indications

Most patients who are good candidates for laparoscopic surgery are eligible for single-port procedures. Some of the surgeries that single incision laparoscopy is indicated for include cholecystectomy (removal of gall bladder), appendectomy (removal of appendix), splenectomy (removal of spleen), hepatectomy (removal of liver) and adrenalectomy (removal of adrenal glands). SILS can also be used for diagnostic purposes.

However, patients who have previously undergone multiple major surgeries to the abdominal region and those who are morbidly obese are not considered for SILS.

Procedure

Single Incision Laparoscopy is usually performed as day surgery either in the hospital or outpatient surgery center under general, regional, or occasionally local anesthesia depending on the type of procedure performed and the surgeon s preference.

The patient is made to lie down in a tilted position so that the feet are placed higher than the head. The surgeon makes a single incision of about 3/4th of an inch at the belly button and injects a harmless gas to expand the area and obtain a clear view of the operative site. A tube called a trocar or port is placed through the incision, through which the laparoscope (a narrow telescope having a light source and camera) and tiny surgical instruments are inserted. The laparoscope guides your surgeon with images of the abdominal contents that can be viewed on a large screen. Once the diseased organ is excised, your surgeon removes the instruments, releases the gas, and closes the incision with a small bandage.

Recovery

Common post-operative guidelines following Single Incision laparoscopy include the following:

You will need someone to drive you home after you are released as the anesthesia may make you feel groggy and tired
Do not remove the dressing over the incision for the first two days and keep the area clean and dry.  No showering or bathing during this time.  The incision usually heals in about 5 days
Your surgeon may give you activity restrictions such as no heavy lifting. It is very important that you follow your surgeon s instructions for a successful recovery
You may feel soreness around the incision area. Your surgeon may give you a prescription pain medicine or recommend NSAID s (non-steroidal anti-inflammatory drugs) for the first few days to keep you comfortable
If the abdomen was distended with gas, you may experience discomfort in the abdomen, chest, or shoulder area for a couple days while the excess gas is being absorbed
Diet

You must be very careful with your diet after gallstone removal as your body will not be able to digest fats well. You will of course be sticking to a liquid diet for a week or two and then introduce solids back into your diet. When you do so, you have to stick to a low fat diet. Stay off fried foods and gas-forming foods. Also make sure that you consume no more than 60 gm of fats per meal to avoid discomfort. Stay off spicy foods to avoid bloats and abdominal pains.

Gallbladder Surgery - Aftercare Tips To Help You Recover Better!

Sometimes, when it comes to problems in the abdominal area, an ultrasound is not clear enough for a diagnosis. In such cases, an Endoscopic Retrograde Cholangiopancreatography (ERCP) may be performed. This procedure gives the doctor a clear view of the duodenum, bile duct, pancreatic ducts, gallbladder and papilla of Vater.

This procedure is usually performed under intravenous sedation without general anesthesia. This procedure involves the use of a duodenoscope, which can be described as a thin, long, flexible tube with a camera at one end. It also has a fiber optic bundle that transmits lights to the camera and a chip to transmit video images to a TV screen.

This is inserted through the patient s mouth and sent down the throat through the food pipe to the stomach and duodenum while the patient is lying on his or her back. The air pipe is left undisturbed so as to not interfere with the patient s breathing. Since the patient is not under general anesthesia, he or she can move and turn according to the doctor s needs. The papilla of Vater is a small nipple like structure with an opening to the bile duct and pancreatic duct. Once this has been identified, a small plastic catheter is passed through the duodenoscope into the bile duct or pancreatic duct through the papilla. Dye is then injected into the area and X-rays are taken of the bile ducts and pancreatic duct. In cases where a biopsy is needed, other instruments can also be passed through the endoscope. Plastic or metal stents can also be passed through this to relieve obstructions in the bile ducts and pancreatic ducts.

ERCP can be used to diagnose and treat a number of conditions in the liver, bile ducts, gall bladder, pancreas and papilla of Vater. These include:

  Blockage of the bile duct by gallstones, cancer, scars, tumors or compression from adjacent organs.

  Jaundice due to an obstructed bile duct. This can also cause light stools and dark urine.

  Persistent upper abdominal pain

  Unexplained weight loss and loss of appetite

  Diagnosing a Dysfunctioning Sphincter of Oddi within the Papilla of Vater

ERCP can also be used to confirm pancreatic cancer and cancer of the bile duct. Once the diagnosis is confirmed, the doctors can customize treatment according to the patient s needs.

Endoscopic Retrograde Cholangiopancreatography - Procedure and Results

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