Cholecystectomy : gallbladder removal surgery
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Find out about CHOLECYSTECTOMY (Removal of the gallbladder)
The gallbladder is a pear-shaped structure that is found attached to the liver. The bile duct is a tube that transports bile from the liver to the small intestine. The gallbladder is attached to the bile duct by a small tube called the cystic duct. Bile is collected in the gallbladder between meals and empties into the bile duct through the cystic duct during a meal.
The bile duct is long tube-like structure that connects the liver to the intestine. The liver makes bile that is required for the digestion of food. The bile from the liver is transported to the intestine by the bile duct.
Cholecystectomy is a procedure in which the gallbladder is removed.
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.
During a laparoscopic surgical procedure, small incisions of up to half an inch are made and plastic tubes called ports are placed through these incisions. The camera and the instruments are then introduced through the ports which allow access to the inside of the patient. The camera transmits an image of the organs inside the abdomen onto a television monitor.The surgeon is not able to see directly into the patient without the traditional large incision. The video camera becomes a surgeon’s eyes in laparoscopy surgery, since the surgeon uses the image from the video camera positioned inside the patient’s body to perform the procedure.
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. The overall complication rate is less than 2%. The complication rate for laparoscopic gallbladder surgery is similar to the complication rate for traditional open gallbladder surgery when performed by a properly trained surgeon.
Many thousands of laparoscopic cholecystectomy have been performed in Tunisia and this operation has an excellent safety record. Some of the important steps in the operation are as follows :
- 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 ( belly button), 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.
- Long specially designed instruments are inserted through the other three ports that allow your 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.
- Your surgeon may occasionally perform an X-ray, called a cholangiogram, to exam for stones in the bile duct.
- After the gallbladder is removed from the abdomen then the small incisions are closed
In a small number of patients if excessive scarring is present or the anatomy of the structures is not clear then for safety reasons the surgeon may decide too convert the operation to an open surgical operation through a traditional large surgical incision. Less than 5% of all laparoscopic cholecystectomy procedures are converted to open procedures.
The decision to convert to an open operation is strictly based on patient safety. Factors that may increase the risk of converting to the "open" procedure include obesity, a history of prior abdominal surgery causing dense scar tissue, acute cholecystitis or bleeding problems during the operation.
Once a diet is tolerated, patients leave the hospital. Most patients go home the next day after a laparoscopic cholecystectomy. Some may even go home the same day the operation is performed. This compares with a five day stay following the open cholecystectomy procedure.
After cholecystectomy procedure, Patients will probably be able to get back to normal activities within a week's time, including driving, walking up stairs, light lifting and work. Activity is dependent on how the patient feels. Walking is encouraged. Patients can remove the dressings and shower the day after the operation. In general, recovery should be progressive, once the patient is at home.
Most patients are fully recovered and may go back to work after seven to ten days.
Often, this depends on the nature of your job since patients who perform manual labor or heavy lifting may require two to four weeks of recovery.
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