Of all surgical procedures for which laparoscopy is an option,
cholecystectomy - gallbladder removal - is the most widely
recognised and accepted.
A cholecystectomy is the surgical removal of the gallbladder.
Using advanced laparoscopic technology, it is now possible to remove
the gallbladder through a tiny incisions in front of the abdomen.
A specialist trained in laparoscopic procedure will recognise any
adjunct problems encountered, and be in a position to deal with them.
Indications for laparoscopic gall bladder removal (Cholecystectomy)
- If an attack hasn't settled after 12 hours
- If there are complications such as jaundice, pancreatitis
- If patient suffers recurrent pain or vomiting
- If patient suffers cholangitis
What are the benefits?
The main benefit of this procedure is that it is minimally invasive
surgery. Minimally invasive surgery means "Lesser Pain" and "Faster
There is no incision pain as occurs with standard abdominal surgery.
So the recovery time is much quicker. Also, there is no scar on the
Is laparoscopy always advised?
There are very few instances when laparoscopic surgery is not
preferable to conventional surgery for cholecystectomy. This is
especially true when the surgical
and nursing team is well experienced in the procedures and
The only real contraindication is if the anaesthetic risk is too
high. Other, lesser contraindications - such as during the first
trimester of pregnancy - need not pose a problem to the experienced
- Obesity - there are fewer post-operative complications with
- Previous surgery - adhesions can be dealt with successfully
- Common bile duct stones can be removed by laparoscopy, or by ERCP
- Severe cholecystitis is best dealt with acutely - one operation
and recovery period - and can be done safely with laparoscopic
Risks & complications
Like any abdominal surgery, laparoscopic cholecystectomy carries some
risks. Even though infrequent, it still carries the same risks as
general surgery. Current medical reports indicate that the low
complication rate is about the same for this procedure as for standard
Complications are rare and may include:
- Bleeding & infection may occur but is rare with experienced
- In a few cases, the gallbladder cannot be safely removed by
laparoscopy. Standard open abdominal surgery is then immediately
- Nausea and vomiting may occur after the surgery
- Injury to the bile ducts, blood vessels, or intestine can occur,
requiring corrective surgery
The disposable instruments - used are more expensive but carry no
risk of hepatitis or AIDS. There are hidden costs to using
non-disposable instruments, in cleaning and handling.
Surgical skill speeds procedures and lessens time-related theatre and
Fewer complications occur, a saving because they add to the expense,
requiring more time off work, more medications and more time in
Routine use of X-ray adds costs to theatre time, also to equipment,
radiographer, radiologists and chemicals.
An experienced laparoscopic nursing team - when staff are familiar
with the equipment and procedures there will not be problems of
inappropriate or unnecessary use of antibiotics or catheters.