Laparoscopy cholecystecyomy

Laparoscopic Cholecystectomy 


Laparoscopic cholecystecyomy is a minimally invasive surgery and this is very common  in laparoscopic surgery in this procedure surgeon remove gallbladder due to gallstone in the gallbladder and infection in the gallbladder.

The gallbladder— a sac located near the liver that serves as a storage space for bile — can be stricken with various problems, such as gallbladder cancer or inflammation (called cholecystitis).

gallstones are also a common gallbladder problem, and infection can occur if the gallbladder remains blocked by a gallstone or continues to be inflamed.

Anatomy of abdominal organs
Anatomy: gallbladder, liver, pancreas


What Causes Gallbladder Problems?

Gallstones in the gallbladder 

Gallstones in the bile duct

Gallbladder inflammation 

Large  gallbladder poylps

Pancreas inflammation due to gallstones 

Blood sugar imbalancs

Low stomach acid production 

Obesity 

Rapid weight loss 

Chronic stress

What are the symptoms of gallbladder problems?

severe pain in the right upper abdomen and sometimes the right chest or back

Pain after eating, particularly high-fat foods, or at night

Fever, with shaking and chills, especially if occurring with, or after, abdominal pain

Nausea and vomiting

Heartburn and indigestion

Feeling of fullness in the abdomen, or excess gas.

Fatty and greasy stool

Light colored stool 

Chronic gas bloating 

Yellow of the skin due to jaundice 

Headache and migraine 

Constipation and diarrhoea 

Bitter test in mouth

Constant runny nose

Weight loss resistance 

Over the counter drug use

Pre-operative instruction for the patient: 

If patient taking blood thinners like aspirin, plavix, coudamin discuss with surgeon whether patient should continue or stop medication before surgery. 

If patient smoke its stop before the surgery because its increasing the risk of complications. 

Don't eat or drink anything after midnight or night before come to the hospital. 

Leaves valuable or costly items and accessories at home but come with medical insurance card and identity card

Before the surgery, patient undergo ultrasound sonography and imaging procedure, such as computed tomography (CT) and blood test, urine test and an assessment of cardiovascular fitness patient also meet with an anestheologists prior to the procedure. The preoperative blood testing is similar before either an minimally invasive cholecystecyomy  or open procedure.


Laparoscopic cholecystecyomy  done under the full  general anesthesia General anesthesia for pain relief during surgery and comfort to patient.
Fentanyl citrate and muscle relaxtant given to the patient and Endotracheal intubation will given and hypnotic agent like propofol given. 
Than anesthesist continue watching monitor and watch vital signs including pulse, spo2(saturation ), E.C.G,  body temperature and blood until the  patient  will not shifted from operation theatre to general ward


What are the advantages of laparoscopic gallbladder surgery

Reduce blood loss and transfusion. 

Reduce pain

Shorter hospital stay

Improved cosmesis

Fast recovery as compared to open surgery 

How is Laparoscopic Gallbladder Removal Done? 

In this procedure surgeon make four incision on the abdomen which is less than 1cm create pneumoperitoneum by co2 gas for big view field and for working space one port is for telescope and another two port is for working instruments and last port is for gallbladder fundus retractor.When surgery is finished, the surgeon closes your incisions with tiny stitches, staples, surgical tape or glue. These disappear as you heal, so the doctor does not need to remove them later.duration of surgery about 1 hours.

Incisions after minimally invasive (laparoscopic) surgery
Incisions after minimally invasive (laparoscopic) surgery

 After the surgery patient shifted to recovery room from the operations theatre for monitoring, respiratory status and vital signs for 2 to 4 hours then moved to general floor when patient stable , hospital stay of about one to two days benefits of laparoscopic or minimally invasive surgery is decreased length of hospital stay and dimnish pain and deceased respiratory complications.

Post op surgery :

Patient keep in recovery room for monitoring for few hours, then patient comfortable & fully come out from the anesthesia then patient shifted to ward.

Check urine output by nursing staff.urine should be cleared.

Check the vitals signs of the patient every one hour. 

Give antibiotics to prevent infection. 

Patient will feel some pain after surgery. Pain at the incision sites and in your abdomen is common. Patient  might also have pain in shoulders.  This is from the air put into your abdomen during the operation. The shoulder pain should go away in 24 to 48 hours.

Painkiller gives for reduce to pain.

Patient can ambulate (walk) with taking help of nursing staff from next day after the order by surgeon.

If catheter is present Catheter or foley's will removed after the 1 days by the instruction of surgeon. 

Don't take solid food after surgery till five days (also as per doctor advise)


Complications of laparoscopic gallbladder removal (cholecystectomy

-Bile leak

-Bleeding 

-Infection 

-Injury to near by structure  like bile duct, small intestine and liver

After the discharge from the hospital :

If patient experience following 
symptoms or problems then immediately contact the doctor:
-Severe persistent pain not relief by medication and rest.
-Difficulty obtaining medication any new onset of or increased weaknesses numbness or tingling.
-Persistent chills new onset of fever over 101° degree farehnit or night sweat.
-Any redness, swelling drainage, heat or pain around incision. 
-Any new onset of chestpain or shortness of breathing. 
-Any clogging or dislodgement of surgical drain.






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