Laparoscopic Cholecystectomy as seen through laparoscope

X-Ray during Laparoscopic Cholecystectomy

Cholecystectomy (/ˌkɔləsɪsˈtɛktəmi/, plural: cholecystectomies,) is the surgical removal of the gallbladder. Despite the development of non-surgical techniques, it is the most common method for treating symptomatic gallstones, although there are other reasons for having this surgery done. Each year more than 500,000 Americans have gallbladder surgery. Surgery options include the standard procedure, called laparoscopic cholecystectomy, and an older more invasive procedure, called open cholecystectomy. A cholecystectomy is performed when attempts to treat gallstones with ultrasound to shatter the stones (lithotripsy) or medications to dissolve them have not proved feasible. Download high resolution version (744x690, 93 KB)Pictures of my cholecystectomy in progress taken through the laprascope. ... Download high resolution version (744x690, 93 KB)Pictures of my cholecystectomy in progress taken through the laprascope. ... Image File history File links Download high resolution version (800x696, 67 KB) Summary X-ray of some of my organs during a laprasopic cholecystectomy. ... Image File history File links Download high resolution version (800x696, 67 KB) Summary X-ray of some of my organs during a laprasopic cholecystectomy. ... The gallbladder (or cholecyst, sometimes gall bladder) is a pear-shaped organ that can accomodate up to 60 ml of bile (or gall) until the body needs it for digestion. ... This article does not cite any references or sources. ... Laparoscopic surgery, also called keyhole surgery (when natural body openings are not used), bandaid surgery, or minimally invasive surgery (MIS), is a surgical technique. ... A lithotriptor with integrated fluoroscope (upper head) and ultrasound generator (lower head) A lithotriptor is a medical device used in the non-invasive treatment of kidney stones (urinary calculosis) and gallstones (stones in the gallbladder in the liver). ...

Open surgery

Traditional open cholecystectomy is a major abdominal surgery in which the surgeon removes the gallbladder through a 4- to 7-inch (10 to 18 cm) incision. Patients usually remain in the hospital over night and may require several additional weeks to recover at home. Up to 4 weeks recovery time. The abdomen (from the Latin word meaning belly) is the part of the body between the pelvis and the thorax. ...

Laparoscopic surgery

Laparoscopic cholecystectomy has now replaced open cholecystectomy as the first-choice of treatment for gallstones unless there are contraindications to the laparoscopic approach. Sometimes a laparoscopic cholecystectomy will be converted to an open cholecystectomy for technical reasons or safety. This article does not cite any references or sources. ...

Laparoscopic cholecystectomy requires several small incisions in the abdomen to allow the insertion of surgical instruments and a small video camera. After the initial incisions, the surgeon will inflate the abdominal cavity with carbon dioxide. The camera sends a magnified image from inside the body to a video monitor, giving the surgeon a close-up view of the organs and tissues. The surgeon watches the monitor and performs the operation by manipulating the surgical instruments through separate small incisions. The gallbladder is identified and carefully Calot's Triangle (the area bound by the inferior wall of the liver, cystic duct, and hepatic duct) is cleared. The cystic duct and the cystic artery are identified, clipped with tiny titanium clips and cut.Then the gallbladder is separated from the liver bed and removed through one of the small incisions. This type of surgery requires meticulous surgical skill, but in straightforward cases can be done in about an hour. The cystic duct is the short (usually around a centimetre or so) duct that joins the gall bladder to the common bile duct. ... ... The cystic duct is the short (usually around a centimetre or so) duct that joins the gall bladder to the common bile duct. ... The cystic artery supplies oxygenated blood to the gallbladder and cystic duct. ...

Recently, this procedure is performed through a single incision in the patient's belly-button. This advanced technique is called as Single Port Access Surgery.

Laparoscopic cholecystectomy does not require the abdominal muscles to be cut, resulting in less pain, quicker healing, improved cosmetic results, and fewer complications such as infection. Most patients can be discharged on the same or following day as the surgery, and most patients can return to any type of occupation in about a week. However, 20% of patients experience chronic diarrhea following surgery, which may persist for weeks or sometimes Months. [1] For other uses of Muscle, see Muscle (disambiguation). ... An infection is the detrimental colonization of a host organism by a foreign species. ...

Complications

An uncommon but potentially serious complication with the new procedure is injury to the common bile duct, which connects the gallbladder and liver. An injured bile duct can leak bile and cause a painful and potentially dangerous infection. Many cases of minor injury to the common bile duct can be managed non-surgically. Major injury to the bile duct, however, is a very serious problem and may require corrective surgery. Bile, which is synthesized in the liver, is carried to the right and left hepatic ducts, which converge to form the common hepatic duct. ...

Abdominal peritoneal adhesions, gangrenous gallbladders, and other problems that obscure vision are discovered during about 5% of laparoscopic surgeries, forcing surgeons to switch to the standard cholecystectomy for safe removal of the gallbladder. Converting to open surgery does not equate to a complication.

A Consensus Development Conference panel, convened by the National Institutes of Health in September 1992, endorsed laparoscopic cholecystectomy as a safe and effective surgical treatment for gallbladder removal, equal in efficacy to the traditional open surgery. The panel noted, however, that laparoscopic cholecystectomy should be performed only by experienced surgeons and only on patients who have symptoms of gallstones. National Institutes of Health Building 50 at NIH Clinical Center - Building 10 The National Institutes of Health (NIH) is an agency of the United States Ministry of Health and Human Services and is the primary agency of the United States government responsible for biomedical and health-related research. ...

In addition, the panel noted that the outcome of laparoscopic cholecystectomy is greatly influenced by the training, experience, skill, and judgment of the surgeon performing the procedure. Therefore, the panel recommended that strict guidelines be developed for training and granting credentials in laparoscopic surgery, determining competence, and monitoring quality. According to the panel, efforts should continue toward developing a noninvasive approach to gallstone treatment that will not only eliminate existing stones, but also prevent their formation or recurrence.

One common complication of Cholecystectomy is an anomaly known as Ducts of Luschka, occurring in 33% of the population. It is non-problematic until the gall bladder is removed, and the tiny supravesicular ducts may be incompletely cauterized or remain unobserved, leading to biliary leak post operatively. The patient will develop biliary peritonitis within 5 to 7 days following surgery, and will require a temporary biliary stent. It is important that the clinician recognize the possibility of bile peritonitis early and confirm diagnosis via HIDA scan to lower morbidity rate. Aggressive pain management and antibiotic therapy should be initiated as soon as diagnosed. The ducts of Luschka (also called supravesicular ducts) are small bile ducts in the posterior wall of the gallbladder (the gallbladder bed), some connected to a subsegmental area of the liver with bile ducts but none connected with the lumen of the gallbladder; they may be aberrant bile ducts. ...