How is a laparoscopic cholecystectomy performed?
Your laparoscopic cholecystectomy will be performed in a hospital. Your surgeon will make four small incisions in your upper abdomen and insert tiny instruments and a laparoscope through the incisions. A laparoscope is a long, thin camera that transmits pictures of the inside of your body to a video screen. Your surgeon sees the surgical area on the video screen while performing the surgery.
Dye may be injected via a catheter into the bile duct to confirm the anatomy and to ensure that no stones are in the common bile duct. After the dye injection and X-ray, the gallbladder duct is clipped and the gallbladder removed from one of the small openings.
Surgeons sometimes combine laparoscopic cholecystectomy with open surgery. Open surgery involves making a larger incision to directly view and treat the surgical area.
Your doctor may decide after beginning your laparoscopic cholecystectomy that you require an open surgery to safely and most effectively complete your surgery.
Types of anesthesia that may be used
Your surgeon will perform laparoscopy using general anesthesia. General anesthesia is a combination of intravenous (IV) medications and gases that put you in a deep sleep. You are unaware of the procedure and will not feel any pain.
What to expect the day of your laparoscopic cholecystectomy
The day of your surgery, you can generally expect to:
- Talk with a preoperative nurse. The nurse will perform an exam and ensure that all needed tests are in order. The nurse can also answer questions and will make sure you understand and sign the surgical consent form.
- Remove all clothing and jewelry and dress in a hospital gown. It is a good idea to leave all jewelry and valuables at home or with a family member. Your care team will give you blankets for modesty and warmth.
- Talk with the anesthesiologist or nurse anesthetist about your medical history and the type of anesthesia you will receive.
- A surgical team member will start an IV.
- The anesthesiologist or nurse anesthetist will start your anesthesia.
- A tube will be placed in your windpipe to protect and control breathing during general anesthesia. You will not feel or remember this or the surgery as they happen.
- The surgical team will monitor your vital signs and other critical body functions. This occurs throughout the procedure and your recovery until you are alert, breathing effectively, and your vital signs are stable.
What are the risks and potential complications of a laparoscopic cholecystectomy?
Laparoscopic cholecystectomy generally involves a faster recovery and less pain than open surgery to remove the gallbladder. This is because it causes less trauma to tissues and organs. Your doctor will make small incisions instead of a larger one used in open surgery. He or she can thread the surgical tools around muscles and organs instead of cutting through or displacing them as in open surgery.
Despite this, laparoscopic surgery involves risks and possible complications. Complications may become serious and life threatening in some cases. Complications can develop during surgery or recovery.
Conditions that increase your risk of complications include severe gallbladder inflammation from gallstones, severe obesity, and abdominal adhesions (scar tissue) from prior surgeries.
General risks of surgery
The general risks of surgery include:
- Anesthesia reaction, such as an allergic reaction and problems with breathing
- Bleeding, which can lead to shock
- Blood clot, in particular a deep vein thrombosis that develops in the leg or pelvis. A blood clot can travel to your lungs, heart or brain and cause a pulmonary embolism, heart attack, or stroke.
- Infection and septicemia, which is the spread of a local infection to the blood
- Pneumonia, which is a lung infection
Potential complications of laparoscopic cholecystectomy
Complications of laparoscopic cholecystectomy include:
- Abdominal adhesions, which is a formation of scar tissue in the abdomen
- Damage to nearby organs, such as the common bile duct and small intestine
- Leakage of bile into the abdomen
- Gallstones left in the bile duct