A GUIDE TO KEYHOLE SURGERY IN GALL BLADDER REMOVAL

This guide has been written for people who want to find out more about cholecystectomy, the operation for removal of the gall bladder and, in particular, the use of keyhole surgery in treating this condition. Whilst this guide offers general information about cholecystectomy and keyhole surgery, you should always discuss details of your particular case with your GP or specialist.

Introduction

The gall bladder stores bile which helps the body digest the fats in food. Small stones of varying composition can develop in the gall bladder and these are known as gall stones. Many people in middle age have gall stones without being aware of them. However, if pain or other symptoms result from the gall stones, it may be necessary to perform a cholecystectomy (surgical removal of the gall bladder). The removal of the gall bladder may sound drastic, but the operation is safe and the body can function perfectly well without it. A cholecystectomy is one of the most common operations in the UK.

Surgical procedures for cholecystectomy

The gall bladder can either be removed by traditional open surgery, or by keyhole (laparoscopic) surgery. Open surgery involves a major operation in which the surgeon removes the gall bladder through a single large incision. Ninety per cent of cholecystectomies are now carried out by keyhole surgery.

Keyhole surgery involves one or more small incisions through which special surgical instruments are passed into the body. The surgeon is able to see inside the body using an instrument call a laparoscope. A laparoscope is a form of telescope with a powerful light source. A miniature video camera is connected to the laparoscope and this projects a clear image onto a television screen. Viewing the operation on the monitor, the surgeon is able to manipulate the laparoscope and surgical instruments from outside the patient's body to carry out the surgical operation from within.

Prior to having the operation you will need to have the gall bladder and bile duct examined. This is most often done by ultrasound scanning. You may also have other tests such as urine and blood tests.

To create space around the organs and to allow the surgeon a clear view, carbon dioxide gas is introduced into the abdomen. Two to three small incisions are then made through which the surgeon passes the laparoscope and other instruments needed to free and remove the gall bladder.

Benefits

The main benefits of the keyhole cholecystectomy are:

• minimal scarring
• less pain
• reduced risk of infection
• faster recovery time; patients are usually up and about within 24 hours of the operation
• quicker return to normal activity; most patients are able to return to work within a week

Occasionally, during an operation, the surgeon may discover an additional problem which complicates the procedure. In this situation, the surgeon will need to make a number of decisions, which might include converting from keyhole to open surgery. Ask your surgeon to explain the surgical procedure and any possible complications before your operation.