Laparoscopic cholecystectomy is also known as gall bladder 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 bile produced by the liver. 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. Gallstones do not go away on their own. Some can be temporarily managed by making dietary adjustments, such as reducing fat intake. Surgical removal of the gallbladder is the time-honored and safest treatment of gallbladder disease.
Laparoscopic cholecystectomy is a procedure in which the gallbladder is removed by laparoscopic techniques. Laparoscopic surgery also referred to as minimally invasive surgery describes the performance of surgical procedures with the assistance of a video camera and several thin instruments.
The standard surgery to remove the gallbladder is called a cholecystectomy. In this kind of surgery, the gallbladder is removed openly via an incision made in the abdomen. A less invasive way to remove the gallbladder is called laparoscopic cholecystectomy. This surgery uses an instrument called the laparoscope to remove the gallbladder, and the surgery is performed through several small incisions rather than through one large incision.
Benefits of minimally invasive or laparoscopic procedures include less post-operative discomfort since the incisions are much smaller, quicker recovery times, shorter hospital stays, earlier return to full activities and much smaller scars. Furthermore, there may be less internal scarring when the procedures are performed in a minimally invasive fashion compared to standard open surgery.
Laparoscopic cholecystectomy is a very safe operation. There are a few important steps involved in the operation. General anesthesia is utilized, so the patient is asleep throughout the procedure. An incision that is approximately half an inch is made around the umbilicus, and three other quarter to half inch incisions are made for a total of four incisions. Four narrow tubes called laparoscopic ports are placed through the tiny incisions for the laparoscopic camera and instruments.
A laparoscope (which is a long thin round instrument with a video lens at its tip) is inserted through the belly button port and connected to a special camera. The laparoscope provides the surgeon with a magnified view of the patient's internal organs on a television screen. After that, long specially designed instruments are inserted through the other three ports that allow the surgeon to delicately separate the gallbladder from its attachments to the liver and the bile duct and then remove it through one of the ports from the abdomen.
Once the gallbladder has been removed from the abdomen, then the small incisions with absorbable stitches or with surgical tape or glue.
Anyone who has a gallbladder disease is eligible for a laparoscopic cholecystectomy, provided their doctor has recommended it.
Not all gallbladder diseases require a removal of the gallbladder. It depends on the results of certain tests that the patient has to take. If the doctor thinks that the disease can be treated without involving surgery, then there is no need for a laparoscopic cholecystectomy.
Generally, if a laparoscopic cholecystectomy has been performed successfully, then there are no side effects involved. The development of fever, yellow skin or eyes, worsening abdominal pain, distention, persistent nausea or vomiting, or drainage from the incision are indications that a complication may have occurred. If any of these occur, then you should contact your healthcare provider at the earliest.
Gallbladder removal is a major abdominal operation and a certain amount of postoperative pain occurs. Transient or temporary nausea and vomiting may occur as a side effect of both the surgery and the medications used for anesthesia. This tends to be limited to 1-2 days after surgery. Most patients who have a laparoscopic gallbladder removal go home from the hospital the day of surgery once liquids are tolerated. Some patients remain in the hospital overnight and go home the next morning.
Activity is dependent on how the patient feels. Walking is encouraged and patients can go up and down stairs the day of surgery. Patients can remove the dressings and shower the day after the operation. Patients will probably be able to return to normal activities within a week’s time, including driving, light lifting and working. In general, recovery should be progressive, once the patient is at home.
Following a laparoscopic cholecystectomy, most patients can return to work within seven days following the laparoscopic procedure. Patients with administrative or desk jobs usually return in a few days while those involved in manual labor or heavy lifting may require a bit more time.
In India, a laparoscopic cholecystectomy costs between Rs. 50,000 to Rs. 70,000.
Laparoscopic cholecystectomy is a procedure that treats gallbladder diseases by removing the gallbladder itself, so once the surgery has been done, the results are permanent.