Exploring Laparoscopic Cholecystectomy: Procedure, Risks, and Benefits

This essay provides a comprehensive overview of laparoscopic cholecystectomy, a common surgical procedure for gallbladder removal. It begins with an introduction to the procedure, explaining its purpose and the conditions it addresses, such as gallstones and cholecystitis. The main body delve...Read More

Discuss and explore a common
surgical procedure

Table of Contents
INTRODUCTION...........................................................................................................................1
MAIN BODY...................................................................................................................................1
The type of procedure.............................................................................................................1
The purpose of the procedure.................................................................................................2
Risk factor of surgical procedure...........................................................................................2
Patient positioning and potential risk.....................................................................................3
Diagnosis before surgery........................................................................................................4
Alternative ways to perform surgery......................................................................................6
Complications of surgery.......................................................................................................8
Risk to perform surgery..........................................................................................................9
Advantages of surgical procedure..........................................................................................9
CONCLUSION..............................................................................................................................10
REFERENCES..............................................................................................................................11

INTRODUCTION
Laparoscopic cholecystectomy refers to surgical process in order to remove gallbladder
including small cut to insert laparoscope through incision. It includes the narrow tube with
camera called as laparoscope that is inserted via an incision to conduct process of surgery by
making small cut instead of large one (Bansal and et. al., 2014). However, the laparoscopic
cholecystectomy is carried out when gall stones formed in gall bladder and block the flow of bile
in digestive system which results into bloating, nausea, vomiting and pain in abdomen, shoulder,
back or chest. It includes the condition when gallbladder get infected due to formation of gall
stones the surgical process of cholecystectomy is conducted to remove it. In context of this
essay, it will focus on the topic of “Discuss and explore a common surgical procedure’. It will
include the surgical procedure of laparoscopic cholecystectomy which is used to remove
gallbladder in problematic medical situation. The description about laparoscopic
cholecystectomy including its process to remove gallbladder is given below.
MAIN BODY
The type of procedure
Laparoscopic cholecystectomy is commonly occur due to the problem of infected gallbladder
due to presence of gallstones. It includes the procedure of small cut to make incision instead of
large one to insert laparoscope to complete the surgery. However, it is observed that problem of
gallstones is commonly occurs among human beings because of their unhealthy lifestyle and
eating habits. It involves the use of an instrument called as laparoscope that can be considered as
narrow tube with a camera which in inserted through incision. This equipment is helpful to
surgeon as it allows them to view the gallbladder on a screen by inserted camera and carry out
the operation in proper manner (Dawe and et. al., 2014). However, it has been analysed that
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laparoscopic cholecystectomy is mostly prefer to use when the gallstones are present in
gallbladder of an individual.
The purpose of the procedure
The laparoscopic cholecystectomy is mainly used for removing the gall bladder with stones in it
because they have started infecting the entire gall bladder which develops symptoms like
bloating, nausea, vomiting etc. Meanwhile, it has been evaluated that gallbladder is an organ
which has a function to store the bile which provide support in respect of digesting fats in food
intake by human beings. When gallstones formed then they are responsible for making blockage
that can cause problem of nausea, vomiting and pain in abdomen, chest, back or shoulder.
The problems of gall bladder indicate about number of problems through which physicians can
understand about actual condition of an ill person to treat their health problem. It includes some
of symptoms which are considered as warning signs that facilitate to conduct the appropriate
clinical procedures for making an individual wellbeing. Basically, it consist the condition of
bouts of severe pain in right upper abdomen and sometimes the right chest or back. It consist the
another critical sign of pain after eating, specifically high fat foods or at night and condition of
fever with shaking & chills especially if occurring with or after abdominal pain. However, it
involves the symptoms of nausea and perhaps vomiting along with heartburn as well as
indigestion (Staehr-Rye and et. al., 2014). Moreover, it includes the feeling of fullness in
abdomen or excess gas which indicates about warning condition related to gallbladder health
problem.
Risk factor of surgical procedure
It is very important for physician to analyse the actual condition because abdominal pain is also
occurs in some of other cases due to which they should remain careful and conduct accurate
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diagnosis. Additionally, it involves other similar medical conditions such as irritable bowel
syndrome (IBS), Crohn’s disease or ulcerative colitis, inflammation or cancer of pancreas,
urinary tract infections or kidney stones, pneumonia when it engages lower part of right lung
then it can be confused with gallbladder discomfort, viral hepatitis, appendicitis,
gastroesophageal reflux or ulcers in the stomach and diverticulitis or diverticulosis.
In addition to this, it is observed that gallstones are also block ducts that are considered as
channel from which bile get transferred from liver or gallbladder to the intestine. It includes the
problem of gallstones that they infect the gallbladder and blockage in common bile duct is
accountable to develop the health problem of jaundice or irritate the pancreas. Basically, the
gallbladder problem has number of symptoms such as sharp pain, indigestion, fever, yellow skin,
nausea and vomiting through which physicians can understand the situation and need of
conducting cholecystectomy (Pucher and et. al., 2015). It is known to be beneficial due to
making small incision that can be easily healed and have less risk of post-operative wound
infection. There is an effective procedure by which doctors prepare to conduct the surgical
procedure in terms of removing infected gallbladder. It includes the primary action of physical
examination of patient and conduct required pathological tests to make sure that an individual is
healthy enough for the surgery.
Patient positioning and potential risk
On the other hand, the surgeon is required to analyse the entire situation and communicate the
same with patient or their family members to take written permission of the operation. It is
necessary to explain about risk and their possibilities to them and make signed form from patient
that they know about risk and agree to the operation. Meanwhile, it is necessary to convey all the
instructions to patient and make sure they follow it before the surgery. Initially, it is required to
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take a shower the night before surgery or the same morning by using antibiotic soap. The
physician should instruct the individual to not shave the belly area. Secondly, it involves the
important criterion to stop eating and drinking at specific duration of time before the surgery
conducted. Thirdly, it involves few of medications are required to taken before the surgery that
morning as per direction of surgeon (Chang and et. al., 2015). It is necessary to take these
medications with just a sip of water and avoid drinking more water. However, some of medicines
are stop taking before surgery that consist blood thinners, supplements and medicines which is
responsible for affecting immune system of an individual. It is very important for surgeon to talk
with patient just before the operation to make them easy and comfortable.
Diagnosis before surgery
There are number of diagnosing methods that should be conducted for treating the problem of
infected gallbladder or relevant blockage. It includes the physical examination by evaluating
blood pressure, temperature, heart rate, breathing rate etc. to make sure an individual to healthy
enough to have a surgery as a treatment (Comajuncosas and et. al., 2014). However, another
important method to conduct blood tests in order to examine blood components in required
amount and presence if other harmful substances that indicates about current health problem. It
involves the process of taking blood samples in respect of testing to analyse about symptoms of
specific infection or signs of gallbladder problems that indicates need of laparoscopic
cholecystectomy. Meanwhile, it includes another method of imaging test that involves various
methods such as abdominal ultrasound, endoscopic ultrasound, computerised tomography or
magnetic resonance imaging. These procedures are much effective as well as efficient in terms of
clearly make visible the sign of cholecystitis or stones in bile ducts or gallbladder. It is
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favourable for doctor to make an appropriate decision making treatment process which is more
suitable for wellness of patient.
The important method is to carry out scan of human body in terms of evaluating the flow of bile
throughout the human body. It includes the use of HIDA (hipatobiliary iminodiacetic acid) scan
which function as for tracking the production as well as flow bile from the liver to small intestine
along with indicating all the related blockages clearly (Cao, Eslick and Cox, 2016). This process
takes some time because it consists to inject a radioactive dye into human body which attaches to
bile producing cells. It will facilitate to make visible the areas from where bile travels through
the body with the help of flowing in bile ducts respectively. However, it is necessary for surgeon
to conduct all the desired tests to make sure actual condition of patient before conduct the
laparoscopic removal of gallbladder for making them disease free. It involves the different stages
of gallstones according to which other treatment options are available but surgery is last option
when it becomes severe (Hua and et. al., 2014). Moreover, it has been identified that surgeons
used to carry out laparoscopic surgery because it requires small incisions which has less risk of
wound infection and other problems and it is safer techniques of operation for patient. The
doctors are required to focus on person centred care while providing treatment by surgical
process by following ethical as well as legal aspects properly. It will helps to reduce chance of
complications and facilitate to gain better outcomes.
The treatment methods are available for patient according to their low mild or chronic condition
according to which desired treatment services is delivered to patient. It includes fasting in which
a person is not permitted to eat or drink at initial level that facilitates to take stress off the
inflamed gallbladder to improve the condition. However, it consist he clinical method of fluids
through a vein in arm of patient which is favourable in respect if preventing dehydration (Halbert
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and et. al., 2016). It includes antibiotics to fight the infection present in gallbladder to make an
individual disease free. It consist the procedure of providing pain medications which provide
support to control the pain until the inflammation in gallbladder is relieved. However, some
times, it has been analysed that clinical procedures of removing stones are also used to clear the
blockage of bile ducts or cystic ducts in human body. It involves the utilisation of endoscopic
retrograde cholangiopancreatography in order to remove the gall stones that are responsible for
blocking bile ducts or cystic ducts.
In context of laparoscopic cholecystectomy, it has been analysed that patient or their family
should ask number of questions to their doctors that are mentioned here (Yajima and et. al.,
2014). Is cholecystitis the likely cause of abdominal pain? What are other possible causes for my
symptoms? What tests do I need? Do I need gallbladder removal surgery? How soon do I need
surgery? What are the risks of surgery? How long does it take to recover from gallbladder
surgery? Are there other treatment options for cholecystitis? Should I see a specialist? Are there
brochures or other printed material that I can take with me? What websites do you recommend?
In addition to this, patients are expected to provide clear answers for some of questions that are
given here. When did your symptoms begin? Have you had pain like this before? Are your
symptoms constant or do they come and go? How severe are your symptoms? What, if anything,
seems to improve your symptoms? What, if anything, appears to worsen your symptoms? These
questions are mandatory to be answered because physician can gain important information about
an individual by this which is favourable to deliver more effective as well as efficient treatment
facilities for making them disease free (Nijssen and et. al., 2015).
Alternative ways to perform surgery
The laparoscopic gallbladder removal has an appropriate procedure in order to conduct the
operation to make it successful. It involves the initial step of general anaesthesia to carry out
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entire surgical process to remove gallbladder. Meanwhile, anaesthesia is required during surgery
till the end and patient should remain asleep when the operation is finished. After giving the
anaesthesia, it has been analysed that surgeon make small incision near belly button and insert
device known as a port. The port has a function to develop openings through which surgeon can
fill the abdomen with gas which creates space to do the operation (Gillen and et. al., 2014).
However, surgeon insert a camera through the port which helps to indicate the area of operation
visible in screen on the basis of which entire surgery to remove gallbladder can be carried out.
Surgeon should make sure that everything is visible in clear manner then they put in more ports
to insert long and narrow instruments. Then, they put efforts to gently disconnect the gallbladder
and take out through one of the incisions. It has been evaluated that most of the laparoscopic
cholecystectomy required 3 to 4 incisions whereas few of surgeries have more. It is favourable to
treatment the problem of infected gallbladder by removing them in order to make patient
wellbeing. The laparoscopic surgery is beneficial because of reducing wound infection and this
can be healed easily.
In contrary to this, surgeon can use robot to carry out the entire surgical process and the entire
operation will be conducted in the same way as explained above. It includes the criterion that
doctor guides the robot to carry out surgery instead of guiding the instruments by their hands
which generally known as robotic surgery (Tian and et. al., 2015). Basically, it is required to
have specialised X-ray of gall balder and bile duct during the surgery according to which
surgeon is required to conduct other additional processes at the time of surgery. In some cases, it
may require to carry out another procedure in order to remove them later. In addition to this, it is
very important to make sure about training and experience of surgeon who is going to execute
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the surgical procedure to ensure about better outcomes. It is very important to gain treatment of
cholecystectomy otherwise it may results into several problems.
If the laparoscopic procedure of removing gallbladder has not carried out then it has number of
reasons behind it. It includes the condition that gallbladder has a lot of damage such as
inflammation and scars. Basically, it is observed that there is a scar tissue in the abdomen from
earlier surgery due to which gallbladder is not able to remove from the body through
cholecystectomy (Halbert and et. al., 2016). Meanwhile, it has been analysed that the cases in
which a person is suffering from obesity or overweight condition then also removal of
gallbladder cannot be removed. If surgeon is not able to clearly view the inside area that is
required to be operated then the gallbladder cannot be removed from human body. If a person
has excess problem of bleeding then also it is not possible to conduct surgery to remove desired
organ.
Complications of surgery
The laparoscopic cholecystectomy is generally occurs with patient of gaining problem of
gallstones and infected gallbladder. It includes the number of complications which are required
to be analysed by surgeon in terms of avoiding them. Meanwhile, it is observed that the
laparoscopic cholecystectomy is take place in successful manner but in some cases,
complications may have chances to occur. It is necessary for surgeon and their team to remain
prepared for such complications so that immediate medical procedures can be taken for
overcoming with such situations (Bhatia and et. al., 2014). However, it has been analysed that
this surgical process is not having much chances to occur complications but sometimes it
happens to create clinical complexities. The complications of laparoscopic gallbladder removal
do not happen often but some severe cases are responsible to acquire complexities. It includes
the complications such as bleeding, infection in the surgery area, hernias, blood clots and heart
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problems. Moreover, it has been evaluated that hernia is when a small amount of intestine or
other tissue bulges via muscles that functions to cover it.
Risk to perform surgery
In addition to this, it has been observed that surgical procedure is accountable to have a risk of
harming other body parts which may develop extreme complicated situation. It is necessary for
surgeons and their team to remain careful while making incision and carry out entire surgery for
without harming other body tissues to complete it in proper manner (Liu and et. al., 2014).
Basically, may times it is noticed that surgical instrument harm other body part which creates
complication for patient due to which other surgery is required to be conducted to heal that
injury. It includes the criterion of using sterilised equipment in order to avoid relevant infection
risk and ensure safe delivery of service for making an individual disease free. However, gall
bladder surgery has risk that it mat injures nearby areas such as common bile duct, large intestine
or small intestine. It can be considered as a risk of developing medical problem severely so that
operation should be carried out carefully and in gentle manner. Another risk includes that bile
may also starts to leak into abdomen after surgery which create risky situation (Sanford and
Strasberg, 2014). Overall, it has been identified that mots of complications related to gallbladder
surgery is rare that means it never happens. But if patient or their family members have some
concern or doubt then they have right ask relevant questions to the surgeon to ensure about
conducting of an individual.
Advantages of surgical procedure
The treatment of laparoscopic cholecystectomy has an advantage of reducing postoperative pain
and decrease the requirement of postoperative analgesia. It includes another benefit of reducing
hospital stay after conducting the surgery. However, the most important benefit is that
postoperative wound infection risk is lower and the incision site can be easily healed in limited
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duration of time (Mizrahi and et. al., 2015). This clinical treatment is favourable because patient
recovers in short duration of time as compared to their operations. A person can return to their
regular routine work and activity within period of one week. The laparoscopic surgery is suitable
for providing improved cosmesis as well as enhanced patient satisfaction as compared to other
procedures.
CONCLUSION
From the above essay, it has been concluded that laparoscopic cholecystectomy can be described
as an effective method of removing infected gallbladder which includes the procedure of small
cut to make incision instead of large one to insert laparoscope to complete the surgery. It
includes utilise of desired diagnosing method such blood test, Ct scan MRI etc. in order to make
sure about appropriate condition of patient to perform surgery. However, it is essential to
conduct different diagnosing procedures including physical examination to make decision of
conducting surgery in specific time that is suitable for patient.
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REFERENCES
Books and journals
Bansal, V.K. and et. al., 2014. Single-stage laparoscopic common bile duct exploration and
cholecystectomy versus two-stage endoscopic stone extraction followed by laparoscopic
cholecystectomy for patients with concomitant gallbladder stones and common bile duct stones:
a randomized controlled trial. Surgical endoscopy, 28(3), pp.875-885.
Dawe, S.R. and et. al., 2014. A systematic review of surgical skills transfer after simulation-
based training: laparoscopic cholecystectomy and endoscopy. Annals of surgery, 259(2), pp.236-
248.
Staehr-Rye, A.K. and et. al., 2014. Surgical space conditions during low-pressure laparoscopic
cholecystectomy with deep versus moderate neuromuscular blockade: a randomized clinical
study. Anesthesia & Analgesia, 119(5), pp.1084-1092.
Pucher, P.H. and et. al., 2015. SAGES expert Delphi consensus: critical factors for safe surgical
practice in laparoscopic cholecystectomy. Surgical endoscopy, 29(11), pp.3074-3085.
Chang, S.K.Y. and et. al., 2015. A randomized controlled trial comparing post-operative pain in
single-incision laparoscopic cholecystectomy versus conventional laparoscopic
cholecystectomy. World journal of surgery, 39(4), pp.897-904.
Comajuncosas, J. and et. al., 2014. Risk factors for umbilical trocar site incisional hernia in
laparoscopic cholecystectomy: a prospective 3-year follow-up study. The American Journal of
Surgery, 207(1), pp.1-6.
Cao, A.M., Eslick, G.D. and Cox, M.R., 2016. Early laparoscopic cholecystectomy is superior to
delayed acute cholecystitis: a meta-analysis of case–control studies. Surgical endoscopy, 30(3),
pp.1172-1182.
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Hua, J. and et. al., 2014. Low-pressure versus standard-pressure pneumoperitoneum for
laparoscopic cholecystectomy: a systematic review and meta-analysis. The American Journal of
Surgery, 208(1), pp.143-150.
Halbert, C. and et. al., 2016. Beyond the learning curve: incidence of bile duct injuries following
laparoscopic cholecystectomy normalize to open in the modern era. Surgical endoscopy, 30(6),
pp.2239-2243.
Yajima, H. and et. al., 2014. Reasons and risk factors for intraoperative conversion from
laparoscopic to open cholecystectomy. Surgery today, 44(1), pp.80-83.
Nijssen, M.A.J. and et. al., 2015. Complications after laparoscopic cholecystectomy: a video
evaluation study of whether the critical view of safety was reached. World journal of
surgery, 39(7), pp.1798-1803.
Gillen, S. and et. al., 2014. Solo-surgical laparoscopic cholecystectomy with a joystick-guided
camera device: a case–control study. Surgical endoscopy, 28(1), pp.164-170.
Tian, Y.H. and et. al., 2015. Surgical treatment of incidental gallbladder cancer discovered
during or following laparoscopic cholecystectomy. World journal of surgery, 39(3), pp.746-752.
Halbert, C. and et. al., 2016. Long-term outcomes of patients with common bile duct injury
following laparoscopic cholecystectomy. Surgical endoscopy, 30(10), pp.4294-4299.
Bhatia, N. and et. al., 2014. Comparison of posterior and subcostal approaches to ultrasound-
guided transverse abdominis plane block for postoperative analgesia in laparoscopic
cholecystectomy. Journal of clinical anesthesia, 26(4), pp.294-299.
Liu, J.G. and et. al., 2014. Laparoscopic versus endoscopic management of choledocholithiasis
in patients undergoing laparoscopic cholecystectomy: a meta-analysis. Journal of
Laparoendoscopic & Advanced Surgical Techniques, 24(5), pp.287-294.
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Sanford, D.E. and Strasberg, S.M., 2014. A simple effective method for generation of a
permanent record of the critical view of safety during laparoscopic cholecystectomy by
intraoperative “doublet” photography. Journal of the American College of Surgeons, 218(2),
pp.170-178.
Mizrahi, I. and et. al., 2015. Perioperative outcomes of delayed laparoscopic cholecystectomy for
acute calculous cholecystitis with and without percutaneous cholecystostomy. Surgery, 158(3),
pp.728-735.
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