Laparoscopic Cholecystectomy
The Gall bladder is a small, pear shaped sac located below your liver in the right upper abdomen. The liquid stored in the gallbladder is called bile. Bile is made in the liver and stored in the gallbladder until the body needs it. The Gallbladder contracts and pushes the bile into the common bile duct that carries it to the small intestine, where it helps the digestion.
Gallstones are due to cholesterol imbalance in the bile.
Gallstones need treatment in persons if they are Symptomatic, Complicated or in some conditions in Silent Gallstones.
Symptomatic Stones
There is transient right upper quadrant abdominal pain. The pain may be severe and colicky and generally felt after meals. You feel better on an empty stomach.
Sometimes there may be symptoms of only dyspepsia, abdominal fullness, or epigastric burning.
Complicated Stones
Swelling and infection of the gallbladder may lead to fever, sustained pain and vomiting.
There may be jaundice when the stone passes into the common bile duct.
It may complicate to Pancreatitis due to inflammation of pancreas due to stone in the common bile duct.
Lastly it may complicate to Pus, Gangrene & Perforation of the gallbladder.
Silent Gallstones
They are detected because of Ultrasonography (USG) and cause no problems. Such stones can be left alone.
Surgery in such cases is done if you are diabetic, If the stone is larger than 2 cm, or if you have some other incidental abdominal surgery planned.
Surgical removal of the entire gallbladder is the treatment of choice. This may be done Laparoscopically or Open conventional method.
Laparoscopic 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 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 now 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. This helps to have a better and magnified view of the organs inside the abdomen.
At our center at Gopi Krishna Laser Stone Center we are world class imaging device STRYKER1588 AIM camera system.
This High-definition camera system is designed to help distinguish critical anatomy with 9 dedicated surgical camera specialty settings and 5 advanced imaging modalities: ENV, IRIS, Clarity, DRE, and DESAT.
1588 ENV: Endoscopic Near Infrared Visualization
ENV enhances visualization of anatomy in real-time during minimally invasive surgery. When ENV mode is activated, it provides visual assessment of blood flow, tissue perfusion, and biliary ducts by using fluorescent light. ENV is used with a fluorescent indocyanine green (ICG) dye.
Benefits of minimally invasive or laparoscopic procedures include less post operative discomfort since the incisions are much smaller and no muscle is cut, 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.
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.
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. In general, recovery should be progressive, once the patient is at home.
Most patients are fully recovered and may go back to work after four to five 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.