Laparoscopic Cholecystectomy Health Feed

Gallbladder removal, termed as cholecystectomy, is regarded as one of the most commonly opted surgical procedures. Laparoscopic surgery for cholecystectomy is the process of removing the gallbladder with laparoscopic techniques. It is a minimally invasive surgery where the surgical procedures are performed with the assistance of different minute instruments and a video camera.

Advantages of Laparoscopic surgery for cholecystectomy
The most commendable reason why people favour laparoscopic surgery is that in place of having to undergo a five to seven-inch incision, this surgical process requires only four small incisions in the abdomen. Moreover, there is minimal post-operative pain and the patients are able to recover faster than patients who have undergone open gallbladder surgery. Most patients can go home the same day as the surgery and can have a quick return to day to day activity.

Determining whether you are a good candidate for laparoscopic surgery
Even though there are numerous benefits of laparoscopic gallbladder surgery, the process may not be suitable for all candidates as it is generally not suggested for patients who suffer from severe and complicated gallbladder disease or have a history of undergoing upper abdominal surgery. A comprehensive medical evaluation by the physician and subsequent consultation with the surgeon is essential in determining whether a patient is a suitable candidate for laparoscopic removal of the gallbladder.

Undergoing the laparoscopic surgery for gallbladder removal
Once you are recommended to undergo laparoscopic gallbladder removal, your doctor will advise you certain preoperative measures that you must follow before the surgery. It is suggested to take a shower the night before the operation and not to eat anything from the night before the operation. Also, drugs such as anticoagulants, arthritis medicines, and Vitamin E medications must also be stopped temporarily for several weeks before the surgery.

The surgery is performed under general anaesthesia. Therefore, the patient is asleep all through the process. The surgeon first inserts the cannula into the abdomen and then a laparoscope is connected to a specific camera through the cannula. Subsequently, other cannulas are also inserted which help the surgeon to separate the gallbladder from the attachments and then remove it completely through one of the apertures. Once the surgeon removes the gallbladder successfully, the small incisions are closed with dissolvable surgical tape or glue.

It is an overall safe procedure, and the rate of complications is much lower which makes it the most effective and popular treatment option.

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 gall bladder 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 Gall Bladder Operation: The gall bladder 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 start to harbor deposits that are hardball like substances, usually known as gall bladder stones. The size of these stones can vary from the size of a grain to the size of a golf ball. 

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

Risk: While the gall bladder 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 gall bladder 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 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.

What is Laparoscopic Gallbladder Removal Surgery (Laparoscopic Cholecystectomy)?

Gallbladder removal is one of the most commonly performed surgical procedures. Gallbladder removal surgery is usually performed with minimally invasive techniques and the medical name for this procedure is Laparoscopic Cholecystectomy or Laparoscopic Gallbladder Removal.

The gallbladder is a pear-shaped organ that rests beneath the right side of the liver. Its main purpose is to collect and concentrate a digestive liquid (bile) produced by the liver. Bile is released from the gallbladder after eating, aiding digestion. Bile travels through narrow tubular channels (bile ducts) into the small intestine. Removal of the gallbladder is not associated with any impairment of digestion in most people.

What Causes Gallbladder Problems?

Gallbladder problems are usually caused by the presence of gallstones which are usually small and hard, consisting primarily of cholesterol and bile salts that form in the gallbladder or in the bile duct.

It is uncertain why some people form gallstones but risk factors include being female, prior pregnancy, age over 40 years and being overweight. Gallstones are also more common as you get older and some people may have a family history of gallstones. There is no known means to prevent gallstones.

These stones may block the flow of bile out of the gallbladder, causing it to swell and resulting in sharp abdominal pain, vomiting, indigestion and, occasionally, fever. If the gallstone blocks the common bile duct, jaundice (a yellowing of the skin) can occur.

Diagnosing 

1. Ultrasound is most commonly used to find gallstones.
2. In a few more complex cases, other X-ray test such as a CT scan or a gallbladder nuclear medicine scan may be used to evaluate gallbladder disease.

Gallstones do not go away on their own. Some can be temporarily managed by making dietary adjustments, such as reducing fat intake. This treatment has a low, short-term success rate. Symptoms will eventually continue unless the gallbladder is removed. Treatments to break up or dissolve gallstones are largely unsuccessful.

Surgical removal of the gallbladder is the time-honored and safest treatment of gallbladder disease.

What are the Advantages of Performing Laparoscopic Gallbladder Removal?

1. Rather than a five to seven inch incision, the operation requires only four small openings in the abdomen.
2. Patients usually have minimal post-operative pain.
3. Patients usually experience faster recovery than open gallbladder surgery patients.
4. Most patients go home the same day of the surgery and enjoy a quicker return to normal activities.

Are you a Candidate?

Although there are many advantages to laparoscopic gallbladder removal (cholecystectomy), the procedure may not be appropriate for some patients who have severe complicated gallbladder disease or previous upper abdominal surgery. A thorough medical evaluation by your personal physician, in consultation with a surgeon trained in laparoscopy, can determine if laparoscopic gallbladder removal (cholecystectomy) is an appropriate procedure for you.
 

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:

1. The surgery involves the 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.
2. 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.
3. Intraoperative cholangiography is the X-ray procedure which shows the anatomy of bile ducts. This is done before the surgeon removes the gallbladder.
4. 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.
5. 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

1. Mixed stones: They are made up of cholesterol and salts. They tend to develop in batches.
2. Cholesterol stones: Mainly made of cholesterol, which is crucial to many metabolic processes. They can grow large enough to block the bile ducts.
3. 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 the 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.

What is gallstone surgery?

It is surgical removal of the gallstone from the gallbladder. It is also known as cholelithotomy.

What are the Statistics of the surgery?
Approximately 90% of patients who seek treatment undergo surgery to remove the stones and the gallbladder.

What is the role of gallstone surgery?
Gallstones which are asymptomatic generally don’t need surgical removal. Treatment depends on the size and location of the gallstones. Surgery to remove the entire gallbladder with all its stones is usually the best treatment, and it is done in patients who can tolerate the procedure.

What are the indications for gallstone surgery?
Indications for gallstone surgery are as follows:

• Stone lodged in the pancreatic duct
• If the stone is causing severe pain, vomiting
• Chronically obliterated cystic duct due to gallstone
• Nonfunctioning gallbladder due to obstruction
• Calculi greater than 3 cm in diameter
• Acute infection of gallbladder (acute cholecystitis) due to gallbladder obstruction
• Chronic infection of gallbladder due to gallbladder obstruction

How is the surgery performed?
The following surgeries are done in patients who are found to have cholelithiasis and choledocholithiasis:

1. Extracorporeal shock wave lithotripsy: A special machine which generates sound waves is used to break the stone. It is only done in the people who are having a small, and soft stone. This procedure doesn’t require any anesthesia, and repeated shock wave therapy is required for complete removal.
2. Laparoscopic cholecystectomy: It is a procedure where a laparoscope (a small, thin tube) is put inside the body through a tiny incision made just below the umbilicus, and another probe is inserted to remove the stone.
3. Open gallbladder surgery: It is done to remove the gallbladder when it is infected, or inflamed, or has large gallstones, or when complications are found during laparoscopic surgery.
4. Percutaneous cholecystostomy guided by computed tomography (CT), or ultrasonography (USG) to remove the gallbladder.
   • Contact dissolution of gallstone can be done where direct catheter of a chemical solvent is introduced by the percutaneous way. It is best for cholesterol stone and, is best at removing any size of the stone.
   • Endoscopic retrograde cholangiopancreatoscopy (ERCP) is used to remove the stones which are in bile duct through the mouth, throat, esophagus, stomach, duodenum, and biliary system without any surgical incisions.

What are the complications of surgery?
Following are the most common complications of surgery:

• Bile leakage leading to biliary peritonitis
• Infection of gallbladder due to improper aseptic precautions
• Abscess formation around the gallbladder, or over adjacent structures
• Death due to rapidly spreading peritonitis causing septicemia
• • Raised liver enzymes, jaundice, and severe pain

Gallbladder removal, termed as cholecystectomy, is regarded as one of the most commonly opted surgical procedures. Laparoscopic surgery for cholecystectomy is the process of removing the gallbladder with laparoscopic techniques. It is a minimally invasive surgery where the surgical procedures are performed with the assistance of different minute instruments and a video camera.

Advantages of Laparoscopic surgery for cholecystectomy
The most commendable reason why people favour laparoscopic surgery is that in place of having to undergo a five to seven-inch incision, this surgical process requires only four small incisions in the abdomen. Moreover, there is minimal post-operative pain and the patients are able to recover faster than patients who have undergone open gallbladder surgery. Most patients can go home the same day as the surgery and can have a quick return to day to day activity.

Determining whether you are a good candidate for laparoscopic surgery
Even though there are numerous benefits of laparoscopic gallbladder surgery, the process may not be suitable for all candidates as it is generally not suggested for patients who suffer from severe and complicated gallbladder disease or have a history of undergoing upper abdominal surgery. A comprehensive medical evaluation by the physician and subsequent consultation with the surgeon is essential in determining whether a patient is a suitable candidate for laparoscopic removal of the gallbladder.

Undergoing the laparoscopic surgery for gallbladder removal
Once you are recommended to undergo laparoscopic gallbladder removal, your doctor will advise you certain preoperative measures that you must follow before the surgery. It is suggested to take a shower the night before the operation and not to eat anything from the night before the operation. Also, drugs such as anticoagulants, arthritis medicines, and Vitamin E medications must also be stopped temporarily for several weeks before the surgery.

The surgery is performed under general anaesthesia. Therefore, the patient is asleep all through the process. The surgeon first inserts the cannula into the abdomen and then a laparoscope is connected to a specific camera through the cannula. Subsequently, other cannulas are also inserted which help the surgeon to separate the gallbladder from the attachments and then remove it completely through one of the apertures. Once the surgeon removes the gallbladder successfully, the small incisions are closed with dissolvable surgical tape or glue.

It is an overall safe procedure, and the rate of complications is much lower which makes it the most effective and popular treatment option.

The gallbladder is responsible for storing and releasing bile. This bile aids in digestion by breaking down fat cells. If the gallbladder does not function optimally, small crystals begin to develop within the gallbladder. These are known as gallstones and can range from being the size of a salt crystal to a golf ball. Gallstones can be extremely painful and do not go away on their own. Since the body can function without a gallbladder, a surgeon may advise removing this organ to treat gallstones. This is known as a cholecystectomy. Today, this surgery is usually performed laparoscopically.

What is a laparoscopic cholecystectomy?
This surgery is also known as keyhole surgery. Unlike open surgery, in this case, the surgeon makes a few small incisions through which instruments may access the gallbladder. The removal of the gallbladder is also done through one of these incisions. A laparoscopic cholecystectomy may also be performed if the gallbladder is inflamed or in the case of pancreatitis. There are a number of advantages to this type of surgery. Most important amongst them is that the patient recovers faster and has less scarring.

Laparoscopic Cholecystectomy Procedure
This surgery is usually performed while the patient is under general anaesthesia. The surgeon begins by making a number of small incisions in the patient’s abdomen. A tube is then inserted into one of the incisions. Carbon dioxide gas is passed through this tube to separate the underlying organs from the abdominal wall. A tiny camera is inserted into another cut. The feed from this camera is displayed on a large monitor. Clips are sued to cut off the arteries and ducts servicing the gallbladder. The gallbladder is them cut free and pulled out of the abdomen through one of the incisions. During the surgery, special x-rays may also be used to check for gallstones lodged in the bile ducts. The incisions will then be stitched and dressed. In most cases, patients may go home on the same day.

Recovery from Laparoscopic Cholecystectomy
This surgery has a high success rate and is considered relatively safe. However, there are some risks associated with the procedure. These include:

1. Allergic reaction to anaesthesia
2. Bleeding or clotting of blood
3. Infections
4. Increased heart rate
5. Injury to the small intestine or bile duct

Recovering from a gallbladder removal surgery usually takes a week. Unless there are any complications, extended hospitalization is not required. In the first few days after the surgery, patients may experience slight diarrhoea. Patients are advised to walk but should avoid lifting weights. Special antibacterial soaps should be used while bathing to avoid the onset of infections.