Who is a candidate for the laparoscopic approach vs. the open technique?
It is up to the surgeon’s judgment to decide what the best approach would be for each patient. For example, a patient who has never had surgery on the abdomen is a better (and safer) candidate for the laparoscopic approach than someone who has had previous abdominal surgeries and has scar tissue, adhesions, and thus a higher risk of potential injury to the bowel or other organs because of that past surgical history. There are other factors involved as well so it is up to your surgeon to consider these and other factors when planning surgery.
What are the advantages of the laparoscopic approach?
Usually, a procedure done with the laparoscopic approach is considered “minimally invasive” in that multiple tiny incisions are made for the scope and instruments to do the work. In return, the patient experiences less pain, shorter recovery time and faster return to normal activities.
What is Laparoscopic Surgery?
Laparoscopic surgery is a technique which allows the surgeon to look into the abdomen, pelvis or chest by inserting a long thin scope through a one-inch incision, rather than making a larger more painful incision. The scope is attached to a camera which shows the surgeon the operative field on a TV screen in the operating room. This is also referred to as “closed” or “laser” surgery, as opposed to “open” surgery.
What procedures are done with this approach?
Today, many common procedures utilize the laparoscope, including gallbladder removal (cholecystectomy), hiatal and inguinal hernia repairs, splenectomy, and gynecologic surgeries, as well as lung and chest procedures.
What does the gallbladder do, and how would I know if I need mine removed?
Gallbladder removal is one of the most common procedures done today. The gallbladder is a storage bag for bile, a digestive juice, and it can cause pain, nausea, bloating, cramping and other problems when it stops working correctly. You can also form gallstones within the gallbladder if it does not empty its bile stores regularly, and these gallstones can cause additional problems by blocking up the main bile duct from the liver to the small bowel. When the gallbladder starts causing problems, it is time to think about removing it.
How is the gallbladder removed?
Today, almost all gallbladder surgery is done with the laparoscopic, or minimally-invasive, approach, using 3-4 tiny incisions, while under general anesthesia. Patients usually go home the same day and are eating a light diet within a day or two. Full activity and return to regular eating habits take between 5-10 days.
What are the risks of gallbladder surgery?
Laparoscopic cholecystectomy is a very safe procedure. It has many advantages for the patient over the “open” approach, but the potential complications are the same – possible bleeding, possible injury to the main bile duct, and the possibility of leaving some gallstones behind in the bile duct.
(Gallstones within the bile duct can be removed without another operation using a special endoscope that goes down the throat, into the small bowel and up into the bile duct to pull the stones out. If not, then surgery to remove the stones from the bile duct is required.)
Any other risks?
Just like any surgery, there is a small risk of infection and possible injury to other organs or the bowel from the laparoscope or instruments. Overall, however, the risk of any of these problems is less than 1%.