Gallbladder surgery using the keyhole technique

In this article, a consultant upper gastro-intestinal and bariatric surgeon explains when a gallbladder may need surgery, and why the keyhole technique may be the best for it.

What is the gallbladder?

The gallbladder is an organ in the right of the abdomen, beneath the liver, that is used to store and release bile that breaks down fats in the digestive system. When we start eating, the gallbladder contracts in order to release bile into the small intestine where it mixes with the food waiting to be digested.

What gallbladder conditions need surgery?

One of the most common issues of the gallbladder are gallstones, small structures resembling gravel or small pebbles that form within the gallbladder, formed from bile salts or cholesterol. They are usually harmless and many patients with gallstones do not have symptoms. However, they can cause blockages and other issues that require the surgical removal of the gallbladder to treat it, such as:

• Biliary colic occurs when the gallbladder contracts around the stones which can cause debilitating pain which can occur repeatedly after eating and last for hours.
• Cholecystitis is where gallstones cause inflammation of the gallbladder and can lead pain, fever, and possibly sepsis. Typically, it is treated by surgery but may be treated with antibiotics in the first instance.

• Gallstone pancreatitis, which happens when a gallstone passes through the pancreatic duct and can lead to significant inflammation. This usually requires in-hospital treatment and can be extremely serious.
• Obstructive jaundice, where a gallstone becomes lodged within the bile duct and can cause yellow discolouration of the skin. This would usually require removal from the bile duct prior to surgery.
• Biliary dyskinesia, where the gallbladder, does not contract in the usual manner and can lead to symptoms similar to gallstones even if they are not present.

The gallbladder is not a pivotal organ, as the bile it stores is actually made in the liver, so bodily function should still be normal after removal.

What happens during gallbladder surgery?

The surgery to remove the gallbladder is called a cholecystectomy and typically it is performed with the keyhole technique. Keyhole surgery, also known as laparoscopy, is a minimally invasive surgical technique that allows surgeons access into the body through smaller incisions through which they can insert their tools – principally, the laparoscope, which is a long and thin tube with a camera and light at the end that is connected to a screen in the operating theatre. This is what grants the surgeon visualisation inside the body. With the laparoscope, the surgeons can investigate the issues with the gallbladder with less blood loss and a faster recovery time for the patient.

The procedure will begin with putting the patient under a general anaesthetic, and the surgeon will then make four small incisions around the belly button. Through these incisions, the laparoscope and other instruments will be inserted, and they will be used to separate the gallbladder from the liver, bile ducts, and surrounding blood vessels, and then it is extracted through one of the incisions.

Afterwards, the incisions are sealed with sutures, surgical staples, or surgical tape and dressed. A large proportion of patients can return home on the same day as surgery and expect to return to their normal activities within one to two weeks. 

For concerns regarding the gallbladder, consult a specialist on Top Doctors today.