Until recent decades, many surgeries involved surgical wounds, lengthy recovery times, and unsightly scars. When less invasive laparoscopic surgery became practical, gallbladder removal and repair became easier, safer, and less fear inducing for patients.
During a laparoscopy, a small incision is made in the body, making room for a minute camera attached to a tube-like device that is used to view the internal organs. The camera transmits the image of organs onto a monitor, substituting the view a surgeon may have in more invasive, traditional incisions.
The gallbladder is a small, pear-shaped organ situated beneath the right side of the liver. It is responsible for collecting and storing bile juice before it is transferred into the small intestine. Sometimes, due to unknown reasons, the gallbladder develops obstructions called stones. Gallstones are hard masses of cholesterol and bile salts that occupy either the gallbladder or the bile duct and prevent the flow of bile juice into the small intestine.
Presence of bile juice in the gallbladder may cause it to swell, resulting in vomiting, abdominal pain, indigestion, and fever. If the bile duct is blocked by gallstones, it can also result in jaundice (yellowing of the skin). Under such conditions, a laparoscopy of the gallbladder, also known as a laparoscopic cholecystectomy, may be recommended.
Laparoscopic removal of the gallbladder is performed under general anesthesia. The surgeon begins by making a small incision on the right side of the belly button and inserts a small, tube-like instrument that transfers pictures of internal organs onto a television monitor.
Carbon dioxide gas may be pumped into the belly to inflate it and create more space for the surgeon to work. The gallbladder is then separated from blood vessels, and the bile duct is removed through one of the openings.
Sometimes, a special X-ray known as a cholangiogram is performed during the surgery to check for the presence of gallstones outside of the gallbladder. After laparoscopic surgery, the incisions are closed with stitches or surgical tapes.
The laparoscopy procedure offers a number of health benefits.
Instead of having a five to seven inch cut in the abdomen (the size typical in a traditional open surgery), individuals who undergo a laparoscopy are left with three or four small incisions in the abdominal region. These incisions are associated with minimal postoperative pain and less obvious scars.
Patients tend to recover faster after a laparoscopic surgery, many leaving the surgical center within a day and quickly resuming normal activities.
Complications from a laparoscopic cholecystectomy are uncommon, but they can occur. Problems may include:
Loose bowel movements for several weeks
Internal bleeding around the surgical area
Infection in the belly region
Accidental injury to adjacent structures such as the bile duct and small intestine
Risks from anesthesia including difficulty breathing, pneumonia, blood clots, and heart problems
Inflammation of the pancreas
Laparoscopy is Not for All
Although there are many advantages of a laparoscopic cholecystectomy, the procedure is not safe for everyone. It is recommended that patients who have experienced previous upper abdominal surgery, are suffering from cardiopulmonary disease, have an allergy to anesthesia, or bleed excessively do not undergo laparoscopic cholecystectomy.
Pregnant women can also be at greater risk of complications and may want to reconsider the surgery, as the effects of carbon dioxide on the fetus are unclear.
The invention and refinement of laparoscopic procedures allows physicians to diagnose and treat many health problems on an outpatient basis. Laparoscopic cholecystectomies have become effective diagnostic tools and treatment option that makes surgical procedures safer and more practical than ever.