What is Laparoscopic Cholecystectomy?
Laparoscopic Cholecystectomy is the complete removal of the gallbladder via a laparoscope due to a painful case of gallstones.
When no other treatments work, or the pain is extremely severe, gallbladder removal surgery may be the patient’s last option to relieve the problem.
During the surgery the patient will undergo general anesthesia. Making several small incisions on the patient’s abdomen, the surgeon will then inflate the abdomen for easy viewing and insert the laparoscope through one of the incisions along with other surgical tools needed to properly remove the gallbladder.
The laparoscope is a lighted instrument with a video camera attached so the surgeon can having a magnified view of the patient’s internal organs during the procedure.
During the removal, the surgeon may look into the common bile duct to detect any gallstones that may have been lodged there. Using a special scope, the surgeon will then remove those gallstones.
The entire surgery usually lasts about 2 hours. Although complications may arise increasing the patient’s stay at the hospital, most patients are expected to go home the day of the surgery. Normal activities can be resumed approximately 7 to 10 after the surgery and no special diet is normally required once the gallbladder is removed.
Open Gallbladder Surgery versus Laparoscopic Cholecystectomy
Open Gallbladder Surgery
Open gallbladder surgery requires the surgeon to make a large (5 to 7 inch) incision in the patient’s abdomen in order to remove the entire gallbladder effectively.
This surgery option is not ideal as it requires a much larger incision increasing the risk for infection and complications, requires a 2-4 day (or longer) stay at the hospital after the surgery, and a 6-8 week recovery time.
There can also be excessive bleeding, increased risk of damage to surrounding organs, and bile leakage into the abdominal cavity.
With laparoscopic cholecystectomy the patient has minimal scarring, less risk for infection or complications, a single day stay at the hospital as it is performed as an outpatient procedure, and a week’s recovery time period.
The patient should experience very little, if any, post-operative pain and simply recover much better overall with this gallbladder removal surgery.
Some reasons a surgeon might forego a laparoscopic cholecystectomy include:
- A severe case of bile duct inflammation
- Inflammation of the abdominal lining (also known as peritonitis)
- A blood disorder preventing proper blood clotting
- Abnormal abdominal anatomy
In a small number of patients laparoscopic cholecystectomy cannot be performed and an open gallbladder surgery is the only option left. Sometimes, a laparoscopic cholecystectomy surgery converts to an open gallbladder surgery during a laparoscopic one due to unforeseen complications. This is a judgment call that only your surgeon is able to make mid-surgery.
Dr. Fraiman is considered an expert in treating gallbladder disease in Baltimore. With over 20 years of both experience and training, you can be assured Dr. Fraiman can provide the best treatment options for you should you experience any type of gallbladder disease.
Laparoscopic Cholecystectomy Procedure Steps
Laparoscopic surgery to remove the gallbladder is now used for almost 85% of cases. The typical procedure is conducted as follows:
- Step 1: Creation of several small incisions on the abdomen
- Step 2: Inflation of the abdomen for easy access
- Step 3: Insertion of the laparoscope (small camera) and tiny surgical instruments through the incision
- Step 4: Separation of muscles around the surrounding liver to expose the gallbladder
- Step 5: Dissection and extraction of the gallbladder
- Step 6: Closure of incisions
Laparoscopic Cholecystectomy Recovery
Recovery for a patient who has undergone laparoscopic cholecystectomy is the same as for those who have undergone any major surgery. It involves monitoring pulse rate, blood pressure and temperature. Breathing also tends to be shallow because of anesthesia, but this should diminish quickly.
It is possible to experience minor postoperative pain in the shoulder due to carbon dioxide in the laparoscopic tubes. The pain can be relieved by lying on your left side with your thigh drawn up toward your chest.
The best thing about laparoscopic surgery is that there is minimal scarring, minimal blood loss and quick recovery times. Patients are usually discharged a day after surgery and can shower the next day. You can resume normal activities within three days post-operation, but you should avoid lifting heavy objects for at least ten days.
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