Advanced Laparoscopic Cholecystectomy SurgeryDelivering Quicker Recovery with Less Pain
Cholecystectomy is the surgical removal of the gallbladder. It is the most common method for treating symptomatic gallstones. Surgical options include the standard procedure, called laparoscopic cholecystectomy, and an older more invasive procedure, called open cholecystectomy.
A traditional open cholecystectomy is a major abdominal surgery in which the surgeon removes the gallbladder through a 5-7 inch incision. Patients usually remain in the hospital 2 nights and may require several additional weeks to recover at home. This is more often utilized for patients with severe symptoms, acute cholecystitis who present to the emergency room.
Laparoscopic cholecystectomy requires multiple small incisions in the abdomen, none bigger than 1/2 inch. This allows the insertion of operating ports, small cylindrical tubes approximately 5-10 mm in diameter, through which surgical instruments and a video camera are placed into the abdominal cavity. The camera illuminates the surgical field and sends a magnified image from inside the body to a video monitor, giving the surgeon a close-up view of the organs and tissues. The surgeon watches the monitor and performs the operation by manipulating the surgical instruments through the operating ports.
To begin the operation, the patient is anesthetized and placed in the supine position on the operating table. A scalpel is used to make a small incision at the umbilicus. The surgeon inflates the abdominal cavity with carbon dioxide to create a working space. The camera is placed through the umbilical port and the abdominal cavity is inspected. Additional ports are placed in the upper right quadrant of the abdomen. The gallbladder fundus is identified, grasped, and retracted superiorly. The cystic duct and the cystic artery are identified, clipped with tiny titanium clips and cut. Then the gallbladder is dissected away from the liver bed and removed through one of the ports. This type of surgery requires meticulous surgical skill, but in straightforward cases can be done in 30-45minutes. A cholangiogram, an injection of dye into the cystic duct, is very helpful in decreasing serious injuries to the duct. Ask your surgeon if this is something he attempts in all cases.
Laparoscopic cholecystectomy does not require the abdominal muscles to be cut, resulting in less pain, quicker healing, improved cosmetic results, and fewer complications such as infection and adhesions. Most patients can be discharged on the same day as the surgery, and most patients can return to any type of occupation in about a week.
Dr. Liberman has been performing laparoscopic cholecystectomy for over 20 years and has performed over 2000.