Laparoscopic Surgery (Laparoscopy) Of The Gallbladder

Author: Dr Slobodan Jovanovic, surgeon

The gallbladder is a part of the bile ducts, which is located under the liver, with a pear-shaped appearance which functions as a reservoir for bile. Under physiological conditions, the secretion of bile is 600 – 1000 ml per day.

The main components of bile:
– water
– bile acids
– cholesterol
– phospholipids
– gall colors
– proteins

Bile, as a product of the liver, plays an important role in the digestion of food and absorption of fat, protein and carbohydrates.

Many factors lead to the formation of plaque in the gallbladder:

– gender
– pregnancy
– obesity
– age
– hereditary factors
– particular diseases
– eating habits …

Today, gallbladder surgery is the most commonly performed surgical procedure in the world

The plaques will not disappear by themselves. The symptoms can be temporarily eliminated by diet and certain drugs, but they will reappear with more severe clinical manifestations. Therefore, the surgical removal of the gallbladder is the quickest and safest treatment of a diseased gallbladder, whether it is acute or chronic, with or without calculi or gallbladder polyps.

The first gallbladder surgery was done in Berlin in 1882. Since then, the surgical technique has been improving, but the idea remains the same: “the gall bladder should not be removed because it contains plaques, but because it creates them.”

Today, in the developed world, more than 95% of the operations performed are using the laparoscopic gall bladder removal technique. Instead of a traditional incision of about 15 – 20cm, laparoscopic cholecystectomy is performed through 3 of 4 incisions each of a diameter of 0.5 to 1 cm, without cutting the anterior abdominal wall. These entry points are for advanced surgical imaging tools. To perform this technologically dependent procedure it is necessary to have laparoscopic equipment that consists of a laparoscopic column and laparoscopic instruments. The components of the pillars are: monitor for the operator and the assistant, camera, electrosurgical unit, gas insufflator with a bottle of central power, pump for irrigation and insufflation, and a tripod on which all parts of laparoscopic column are placed.

After surgery, the patient can get up after a couple of hours and begin the intake of fluids and light food, and leave the hospital the same day or the next day. Activities of each individual patient depend on how they feel. A quick return to physical activity and walking is recommended. The day after the surgery the bandage can be removed and you can take a shower. A follow-up is scheduled for seven days after the surgery.

Significantly shorter recovery period in comparison to the standard procedure

After laparoscopic gallbladder surgery the patient returns to work after 7 days, unlike after the traditional operation, where the period is 4 to 6 weeks. After laparoscopic surgery minimal postoperative pain is present, the recovery is faster and the aesthetic effect is favorable, because of the dramatically smaller scars. Operational risk is lower than with the traditional surgery. Numerous studies have shown that the number of complications is extremely low, and if complications do occur, they are easily manageable.

Due to the aforementioned reasons, laparoscopic cholecystectomy is the “gold standard” in the surgical treatment of gallbladder diseases.