Surgeries and Procedures

The gallbladder is a small organ whose function is to store and release bile, which is a digestive fluid secreted by the liver. Bile performs the critical function of breaking down fats so they can be absorbed by the digestive tract.

Gallbladder removal surgery is called for when gallstones have formed, blocking the flow of bile and leading to attacks that can cause severe pain and discomfort.

Traditional Gallbladder Surgery
Gallbladder surgery used to involve a large,open incision, 3-4 days in the hospital, and a slow and painful recovery period of about 4-6 weeks. In traditional surgery, known as “open cholecystectomy”, an incision is made just below the ribs on the right side of the abdomen. The liver is moved to expose the gallbladder. The vessels and ducts to and from the gallbladder are cut and tied off, and the gallbladder is removed. The patient is under general anesthesia for the procedure. Open or traditional gallbladder surgery provides a better view of the anatomy than laparoscopic surgery.

Laparoscopic Gallbladder Surgery
With the invention of the laparoscopic procedure in 1989, the surgery can now be performed through several small openings, can be completed in one to three hours, and has a much shorter recovery time.

During a laparoscopic gallbladder surgery, a tube carrying a video camera is inserted through an incision in the navel. The surgery is then performed under the guidance of this camera. Tiny instruments are used to cut and clip the ducts and arteries attached to the gallbladder and to remove the gallbladder from the body.

The challenge in performing the surgery correctly is for the surgeon to properly identify each duct on the television camera and be sure he or she is cutting and clipping the proper one. Mistakenly cutting, clipping or nicking the common bile duct rather than the cystic duct can lead to dire consequences, as can nicking or cutting adjacent organs.

In a normal procedure, the steps in the process include:

• Administration of general anesthesia to the patient.
• After the patient is anesthetized, the abdomen is inflated with carbon dioxide to create enough space that the surgeon can both see and maneuver inside the abdominal cavity.
• Next, four tiny incisions are made, including one in the naval.
• A laparoscope is then inserted, which is attached to a camera, allowing the doctor to see inside the abdomen and identify the ducts and organs.
• Using the camera and screen as a guide, other instruments are inserted through the other incisions. These instruments are used to close off the ducts and blood vessels with small metal clips.
• The gallbladder is then separated from the liver and from the ducts and arteries running to it.
• The gallbladder is drained of all fluid through the naval opening and is then removed through that incision.
• Finally, the carbon dioxide is removed from the abdomen and a few quick stitches close the incisions.
• The procedure usually lasts about an hour to an hour and half.

Performed properly by a skilled and experienced surgeon, this procedure is safe, effective and cuts hospital time and recovery time significantly.

Improperly performed, this surgery entails serious — and even fatal — risks. Read More>