The gallbladder, located under the right lobe of the liver, is meant to store bile synthesized by the liver. When we eat, the gallbladder contracts, and then sends bile to the small intestine in order to digest and dissolve proteins, oils, and fats. For most people, gallbladder problems are not associated with digestion impairment.
Problems with the Gallbladder
Most problems with the gallbladder are due to the formation of “gallstones” and too much cholesterol in our diet. Gallstones are hard masses mainly composed of cholesterol and bile salts which can block the flow of bile out of the gallbladder. Symptoms of gallstones can include swelling of the gallbladder resulting in sharp pains in the abdomen, indigestion, vomiting, and fever in some cases. Jaundice, or yellowing of the skin, can also occur if the common bile duct is blocked by gallstones.
Diagnosis and Treatment
Doctors typically use ultrasound or other x-ray tests to diagnose gallstones or gallbladder disease. While dietary changes and/or medications can sometimes temporarily help in managing symptoms of gallstones, they will not eradicate them completely, and the symptoms will continue until the gallbladder is removed. Gallbladder removal surgery is often the safest treatment of gallbladder disease.
Laparoscopic Gallbladder Removal
One of our surgeons will meet with you in an initial consultation to discuss your candidacy for laparoscopic gallbladder removal and help determine if this technique is the best option for your needs. With laparoscopic gallbladder removal surgery, Dr. Leong will use small instruments to remove the gallbladder. This technique requires only four very small incisions in the abdomen, which typically leads to a minimized recovery process, less post-operative pain, less visible scarring, and discharge from the hospital within one day.
Laparoscopic gallbladder removal is performed under general anesthesia. A small, narrow tube-like instrument called a cannula is inserted through a tiny incision made in the area of the belly button. A laparoscope connected to a special camera is pushed through the cannula, relaying images to a television monitor to give our surgeon a clear view of the internal surgical area. Then, other cannulas are inserted through small incision in the abdomen to allow the surgeon to delicately separate the gallbladder and remove it. If gallstones are found in the bile duct, your surgeon may remove them with a special scope, or he/she may decide it will be better to remove them in a second surgical procedure. It may also be decided that the laparoscopic procedure will need to be converted to an open procedure in order to eliminate all stones that are found during surgery.
Once the gallbladder has been removed, the small incisions are either stitched up (usually only one or two stitches is necessary), or closed with surgical tape.
Other Surgical Options
In a small number of cases, the laparoscopic technique may not be the best option for gallbladder removal, and an “open” surgery may be necessary. Your surgeon will choose or convert to open gallbladder removal surgery for one or more of the following reasons:
- Dense scar tissue caused by previous abdominal surgery
- The presence of stones in other areas surrounding the gallbladder
- Inability to visualize organs
- Bleeding problems
If the surgeon feels that it’s necessary to convert from a laparoscopic procedure to an open one, it’s important to know that this is typically not a complication, but rather a decision based on sound surgical judgment and a commitment to your safety.
Laparoscopic gallbladder removal typically lasts about one hour and can often be performed as an outpatient. You will be given detailed post-operative instructions and a medication prescription for any discomfort you may feel. Your diet will be as tolerated from liquids to regular foods (fatty foods should be avoided during recovery). You should avoid heavy lifting for several weeks after the procedure. Most patients can resume working within a week after the procedure, if they are not engaging in manual labor or heavy lifting.
As with any surgical procedure, laparoscopic gallbladder removal surgery is not without risks. Our experienced surgeons take every precaution to minimize risks and complications. All risks and benefits from this procedure will be explained to you at your initial consultation before your surgery is scheduled, and you will be given detailed information about what you can expect before, during, and after surgery.
If you have any questions regarding laparoscopic gallbladder removal, please contact Dr. Leong today. He will be happy to talk with you about all aspects of this procedure, and address any concerns you may have.