Laparoscopic Cholecystectomy

Laparoscopic cholecystectomy is a minimally invasive procedure in which the gallbladder is removed via several small incisions instead of one large one, as is used in conventional open surgery.

A laparoscope (a narrow tube with a camera) is inserted through one incision. This allows the surgeon to see the gallbladder via a high definition monitor. Several thin instruments are inserted through additional small incisions in order to remove the gallbladder.

What are the Benefits of Laparoscopic Cholecystectomy?

Laparoscopic cholecystectomy is one of the safest minimally invasive surgical options. The overall complication rate is less than 2%, and is similar to the complication rate for traditional open gallbladder surgery when performed by a properly trained surgeon.

Yet, unlike open gallbladder surgery, laparoscopic cholecystectomy provides many potential advantages, including:

  • Less postoperative pain and scarring
  • Shorter hospital stay
  • Faster recovery, enabling a quicker return to normal activities

Why Choose Hoag for Laparoscopic Cholecystectomy?

When it comes to diagnosing and treating gallbladder cancer, Hoag-USC Surgical Center for Digestive Diseases is a nationally recognized leader, performing the highest volume minimally invasive gallbladder surgeries in Orange County. Being a high-volume lung surgery program enables the lung cancer experts at Hoag to achieve a technical skill level not all facilities can match.

With its exceptional team of physician experts and staff, progressive technology, and state-of-the-art surgical facilities, it’s easy to see why Hoag continues to lead the way in comprehensive gallbladder treatment both locally and nationwide.

Who is a Candidate for Laparoscopic Cholecystectomy?

Laparoscopic surgery is generally a safe and effective option for most patients. Since the goal is a successful surgical result, each patient is evaluated individually to determine if laparoscopic surgery is the best option for the individual patient.

How is Laparoscopic Cholecystectomy Performed?

Many thousands of laparoscopic cholecystectomy have been performed in the USA and this operation has an excellent safety record. Some of the important steps in the operation are as follows:

  • General anesthesia is utilized, so the patient is asleep throughout the procedure.
  • An incision that is approximately half an inch is made around the umbilicus ( belly button), three other quarter to half inch incisions are made for a total of four incisions. Four narrow tubes called laparoscopic ports are placed through the tiny incisions for the laparoscopic camera and instruments.
  • A laparoscope (which is a long thin round instrument with a video lens at its tip) is inserted through the belly button port and connected to a special camera. The laparoscope provides the surgeon with a magnified view of the patient's internal organs on a television screen.
  • Long specially designed instruments are inserted through the other three ports that allow your surgeon to delicately separate the gallbladder from its attachments to the liver and the bile duct and then remove it through one of the ports from the abdomen.
  • Before the surgeon removes the gallbladder, you may have a special X-ray procedure called intraoperative cholangiography, which shows the anatomy of the bile ducts.
  • After the gallbladder is removed from the abdomen then the small incisions are closed

In a small number of patients, the surgeon may decide to convert the laparoscopic procedure to an open surgical operation. It’s important to note that less than 5% of all laparoscopic cholecystectomy procedures are converted to open procedures. The decision to convert to open surgery is strictly based on patient safety. Factors that may increase the risk of converting to an open procedure include obesity, a history of prior abdominal surgery causing dense scar tissue, acute cholecystitis, or bleeding problems during the procedure.

What are the risks of Laparoscopic Cholecystectomy?

Complications of a laparoscopic cholecystectomy are infrequent and the vast majority of laparoscopic gallbladder patients recover and quickly return to normal activities. Some of the complications that can occur include bleeding, infection, leakage of bile in the abdomen, pneumonia, blood clots, or heart problems.

Surgical injury to an adjacent structures such as the common bile duct, duodenum or the small intestine may occur rarely and may require another surgical procedure to repair it. If the gallbladder is accidentally or deliberately opened during the procedure stones may fall out of the gallbladder and in to the abdomen that may give rise to later scarring.

What is the recovery period for Laparoscopic Cholecystectomy?

Recovery is much faster and less painful after laparoscopic surgery than after open surgery. In general:

  • The hospital stay after laparoscopic surgery is shorter with patients usually going home the same day or the next day, compared with 2-4 days or longer for open surgery.
  • Patients can remove the dressings and shower the day after the operation.
  • Patients generally get back to normal activities within 7-10 days (verses 4-6 weeks with open surgery), including driving, walking up stairs and light lifting. Activity is dependent on how the patient feels. Walking is highly encouraged.
  • In addition, most patients are fully recovered and may go back to work after 7-10 days. Often, this depends on the nature of work, since patients who perform manual labor or heavy lifting may require 2-4 weeks of recovery.

What should I be concerned about after going home?

The development of fever, yellow skin or eyes, worsening abdominal pain, distention, persistent nausea or vomiting, or drainage from the incision are indications that a complication may have occurred. You should contact your surgeon, if you are experiencing these symptoms.