The most common technique used for gallbladder surgery is the laparoscopic approach, which uses a camera to visualize the surgery instead of a large incision. The laparoscopic method has become the “gold standard,” however, the surgery can be converted to the “open” procedure quickly if the surgeon deems it necessary or if complications arise.
The surgeon begins with four small incisions, approximately half an inch long, in the upper right side of the abdomen. Two of these incisions allow the surgeon to place surgical instruments in the abdominal cavity. The third incision is used to insert the laparoscope, an instrument that has a light and a video camera that allows the surgeon to view the surgery on a monitor while working. The fourth incision is used to insert a port that releases carbon dioxide gas, inflating the abdomen to allow better visualization and more room to work.
The gallbladder is separated from the healthy tissue and is placed in a sterile bag and crushed, to allow it to pass through one of the small incisions. If the gallbladder is enlarged or hardened, and cannot fit through the laparoscopic incisions, the surgery is converted to an open procedure to allow removal of the organ.
The surgeon then inspects the area where the gallbladder was removed and the closes the ducts that were connected to it. If there are no signs of leaking or infection, the port that blows carbon dioxide into the abdomen is removed and the remaining gas leaks out of the incisions as the instruments are removed. The incisions are then closed with staples, stitches or adhesive bandages.
