Laparoscopic Gallbladder Removal (Cholecystectomy)

Dr. Sulaiman Bin Yusof

MbChB (Sheffield) M.Med (Surg) FRCSEd (Gen Surg)
蘇萊曼·尤索夫博士

What is Laparoscopic Gallbladder Removal?

Laparoscopic gallbladder removal, or laparoscopic cholecystectomy, is a minimally invasive surgical procedure that removes the gallbladder.

The gallbladder is a small organ under the liver that stores bile, a digestive fluid produced by the liver. This procedure is typically performed to treat gallbladder issues such as gallstones, inflammation, or infections that cause pain and digestive problems. The primary goals are to relieve pain and prevent further complications.

Indications for Laparoscopic Gallbladder Removal

Laparoscopic gallbladder removal is typically performed when gallbladder problems cannot be treated with medication or other methods. The most common reasons for this procedure are:

Gallstones

These are solid particles in the gallbladder and can block bile flow, causing pain, infection, or inflammation. This condition is known as cholelithiasis.

Cholecystitis

This is an inflammation of the gallbladder caused by gallstones that block the cystic duct, resulting in severe pain and infection that requires surgical removal of the gallbladder.

Biliary Dyskinesia

This is a condition in which the gallbladder does not function properly, resulting in pain and digestive issues even in the absence of gallstones.

Gallbladder Polyps

These are growths inside the gallbladder wall that can be precancerous. If the polyps are large or symptomatic, gallbladder removal may be recommended.

Benefits of Laparoscopic Gallbladder Removal

Laparoscopic gallbladder removal offers several advantages over open surgery, including:

Faster Recovery

The shorter recovery time allows patients to resume normal activities, such as work and exercise, much sooner than with open surgery. Many patients can return home the same day or after an overnight stay in the hospital.

Smaller Scars

The small incisions used in laparoscopic surgery result in less visible scarring that heals faster than the larger incision required for open surgery.

Less Postoperative Pain

Patients typically experience less pain after surgery, which can be managed with over-the-counter pain relievers.

Preparing for Surgery

Proper preparation is necessary prior to laparoscopic gallbladder removal to ensure a successful procedure, which includes:

Medical Evaluation: A thorough medical evaluation, including a physical examination, blood tests, and imaging studies such as an ultrasound or MRI, is conducted to assess the condition of the gallbladder and surrounding organs.

Fasting: Patients are usually required to fast before surgery, beginning the night before and abstaining from all food and drink to ensure an empty stomach for the procedure.

Medication Adjustment: Certain medications may need to be adjusted or temporarily discontinued, such as blood thinners, nonsteroidal anti-inflammatory drugs, and certain supplements that can increase the risk of bleeding.

Step-by-Step Procedure

A laparoscopic gallbladder removal procedure involves several steps:

Anaesthesia Administration

Administration of general anaesthesia ensures that the patient is asleep and pain-free throughout the surgery. The surgeon monitors the patient’s vital signs and adjusts the anaesthesia as needed.

Making Incisions

Four small incisions are made in the abdominal wall, each between 0.5 cm and 1 cm in size, which serve as entry points for the laparoscopic instruments and the camera. The precise placement of the incisions allows optimal access to the gallbladder while minimising tissue damage.

Insertion of Trocars and Laparoscope

Trocars are hollow tubes that are inserted through the incisions. A laparoscope, a thin tube containing a light and a camera, is inserted through one of the trocars. The camera provides a high-definition view of the abdomen on a monitor, guiding the surgeon throughout the procedure.

Identification and Detachment of the Gallbladder

The surgeon identifies the gallbladder and its associated structures, such as the cystic duct and cystic artery. Using specialised instruments, the surgeon carefully clips and cuts the cystic duct and artery, disconnecting the gallbladder from the liver and its blood supply.

Removal of the Gallbladder

The gallbladder is carefully isolated and placed in a small bag for extraction. It is removed through one of the small incisions and may be broken into smaller pieces for easier removal.

Closing the Incisions

After the gallbladder is removed, carbon dioxide gas is released from the abdomen. The incisions are closed with sutures or surgical staples, and sterile dressings are applied to each site.

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Post-Surgical Care

Proper care after a laparoscopic gallbladder removal ensures a smooth recovery.

Immediate Recovery: Patients are monitored in a recovery area until they are fully awake and stable. Vital signs are checked regularly, and pain is managed with medication. Most patients can return home the same day or after an overnight stay.

Pain Management: Mild pain and discomfort are common after the procedure. Over-the-counter pain relievers, such as acetaminophen or ibuprofen, are usually sufficient, but prescription pain medications may be provided if needed.

Activity Restrictions: Patients should rest for the first few days and gradually resume normal activities. Light activities, such as walking, can aid recovery, but strenuous activities like swimming, cycling, or running should be avoided for about a week.

Wound Care: Keep the surgical incisions clean and dry. Showering is allowed within a day or two, but avoid soaking in baths until the incisions have fully healed. Apply sterile dressings to the wounds and change them as instructed by your surgeon.

Healthy Diet: Initially, follow a healthy diet and gradually return to regular eating habits. Avoid fatty, greasy, or spicy foods that can irritate the digestive system and stay hydrated by drinking plenty of fluids.

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Dr. Sulaiman Bin Yusof

MbChB (Sheffield)

M.Med (Surgery)

FRCSEd (General Surgery)

蘇萊曼·尤索夫博士

Dr. Sulaiman Yusof is a distinguished Senior Consultant in colorectal and general surgery, boasting over 15 years of expertise. His passion lies in minimally invasive techniques, particularly robotic surgery, where he has achieved remarkable success using the Da Vinci Xi system. Dr. Sulaiman is dedicated to delivering high-quality, personalized, and empathetic care, always striving for the best outcomes for his patients.

Education & Specialist Training
  • MbChB(Sheffield)
  • M.Med(Surgery)
  • FRCSEd(General Surgery)

Dr. Sulaiman’s journey began at the University of Sheffield, where he graduated in 2002. He honed his skills during his house officer and basic surgical training in the UK before returning to Singapore. There, he completed his Advanced Surgical Training at Changi General Hospital and earned the Joint Speciality Fellowship in General Surgery in 2013.

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    Frequently Asked Questions

    How do I know if laparoscopic gallbladder removal is right for me?

    Consult your surgeon to discuss your symptoms, medical history, and treatment options. They will help determine if laparoscopic gallbladder removal is the most appropriate approach for your condition.

    Can gallstones recur after the gallbladder is removed?

    Gallstones cannot recur in the gallbladder once it is removed. However, stones may still form in the bile ducts, though this is uncommon. Maintaining a healthy diet and weight can help reduce this risk.

    Will removing the gallbladder affect my digestion?

    Without a gallbladder, bile flows directly from the liver into the small intestine, which can affect digestion. Some patients may experience temporary changes such as diarrhoea, bloating, or gas, but these usually improve as the body adjusts.

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