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Cholecystectomy

Surgery to remove the gallbladder is the most common way to treat symptomatic gallstones. The most common operation is called laparoscopic cholecystectomy. For this operation, the surgeon makes several tiny incisions in the abdomen and inserts surgical instruments and a miniature video camera into the abdomen. 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. While watching the monitor, the surgeon uses the instruments to carefully separate the gallbladder from the liver, ducts, and other structures.

If gallstones are in the bile ducts, the physician (usually a gastroenterologist) may use endoscopic retrograde cholangiopancreatography (ERCP) to locate and remove them before or during the gallbladder surgery.

What are the Benefits?

The main benefit of Single Incision Laparoscopic Surgery (SILS) is that it is a minimally invasive surgical procedure that causes "Lesser Pain" and ensures "Faster Recovery".

There is no incision pain as occurs with standard abdominal surgery. So the recovery time is much quicker. Also, there is no scar on the abdomen.

Is laparoscopy always advised?

There are very few instances when laparoscopic surgery is not preferable over conventional surgery. This is especially true when the surgical and nursing team is well experienced in the procedures and post-operative care.

The only real contraindication is if the anesthetic risk is too high. Other, lesser contraindications - such as during the first trimester of pregnancy - need not pose a problem to the experienced laparoscopic surgeon. 

  • Obesity - there are fewer post-operative complications with laparoscopic surgery
  • Previous surgery - adhesions can be dealt with successfully

Risks & Complications

Like any abdominal surgery, laparoscopic surgery carries some risks. Even though infrequent, it still carries the same risks as general surgery. Current medical reports indicate that the low complication rate is about the same for this procedure as for standard or conventional surgery.

Complications are rare and may include bleeding, and vascular injuries because of the trocars and needles used in surgery.

Summary

The disposable instruments used are more expensive but carry no risk of infections. There are hidden costs to using non-disposable instruments, in cleaning and handling.

Surgical skill speeds procedures and lessens time-related theatre and anesthetic charges.

Fewer complications occur, a saving because they add to the expense, requiring more time off work, more medications and more time in hospital.

An experienced laparoscopic nursing team - when staff are familiar with the equipment and procedures there will not be problems of inappropriate or unnecessary use of antibiotics or catheters.

For more information on Single incision laparascopic surgery please visit www.facs.org

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