Cuaki, Alyanna N.

Cholecystectomy

Definition:
Laparoscopic cholecystectomy is a procedure in which the gallbladder is removed by
laparoscopic techniques. Laparoscopic surgery also referred to as minimally invasive
surgery describes the performance of surgical procedures with the assistance of a video
camera and several thin instruments.
During a laparoscopic surgical procedure, small incisions of up to half an inch are made
and plastic tubes called ports are placed through these incisions. The camera and the
instruments are then introduced through the ports which allow access to the inside of
the patient. The camera transmits an image of the organs inside the abdomen onto a
television monitor.The surgeon is not able to see directly into the patient without the
traditional large incision. The video camera becomes a surgeons eyes in laparoscopy
surgery, since the surgeon uses the image from the video camera positioned inside the
patients body to perform the procedure.

Purpose
Benefits of minimally invasive or laparoscopic procedures include less post operative
discomfort since the incisions are much smaller, quicker recovery times, shorter hospital
stays, earlier return to full activities and much smaller scars. Furthermore, there may be
less internal scarring when the procedures are performed in a minimally invasive
fashion compared to standard open surgery.
Step by Step Procedure

General anesthesia is utilized, so the patient is asleep throughout the procedure.

An incision that is approximately half an inch is made around the umbilicus ( belly
button), three other quarter to half inch incisions are made for a total of four
incisions. Four narrow tubes called laparoscopic ports are placed through the tiny
incisions for the laparoscopic camera and instruments.

A laparoscope (which is a long thin round instrument with a video lens at its tip) is
inserted through the belly button port and connected to a special camera. The
laparoscope provides the surgeon with a magnified view of the patient's internal
organs on a television screen.

Long specially designed instruments are inserted through the other three ports
that allow your surgeon to delicately separate the gallbladder from its
attachments to the liver and the bile duct and then remove it through one of the
ports from the abdomen.

Your surgeon may occasionally perform an X-ray, called a cholangiogram, to

exam for stones in the bile duct.

After the gallbladder is removed from the abdomen then the small incisions are
closed

Equipment
Equipment typically required for laparoscopic cholecystectomy includes the following:

Light source with two video monitors (for the surgeon and the assistant)

Laparoscope, 0 or 30

Standard gas insufflation equipment

Hasson trocar

Trocars, 5 mm (2)

Subxiphoid trocar, 11 mm (this can be replaced with another 5-mm trocar if a 5mm laparoscopic clip applier is available)

Blunt graspers

Maryland dissector and L-hook cautery

Electrocautery equipment
Laparoscopic suction irrigator
Laparoscopic clip applier
Endoscopic ligature loop (eg, Endoloop; Ethicon Endo-Surgery, Blue Ash, OH)
Cotton swab affixed to a 5-mm shaft (eg, Endo Peanut; Covidien, Mansfield, MA)
Endoscopic retrieval pouch (eg, Endo Catch; Covidien, Mansfield, MA