How Long Does Gallbladder Surgery Take

It is important to understand the procedure you’ll undergo on the day of your gallbladder operation. Gallstones are usually the cause of gallbladder disease. There are also other conditions that can warrant gallbladder removal, including gallbladder cancer or gallbladder inflammation ( cholecystitis).

The most common treatment for gallbladder conditions is a Cholecystectomy. It’s because people can still function normally without the gallbladder. This can be done through minimally invasive surgery or an open procedure.

Before Surgery

Follow your surgeon’s preoperative instructions. Preoperative orders may include:

No eating or drinking
Only take medications approved by your doctor (with a sip of water).
Shower or bathe before visiting the hospital or an outpatient clinic
Avoid applying lotions, deodorants, perfumes, or nail polish.
The surgical site (abdomen), however, should not be shaved.
Remove all jewelry or contact lenses.
Bring your photo ID with you to the hospital or outpatient clinic.
Prepare to answer some questions prior to surgery (such as your full name, the type of surgery that you expect to undergo, and which part of the body will be operated upon).

An IV is placed as part of the admission process to provide fluids and relaxants before the surgery. Combining different medications before and after surgery, including pain management medicine (called anesthesia) to put you to bed, can cause a loss of memory.

Before the day of surgery, the surgeon will usually discuss the options you have for anesthesia (including risks and side effects). If you have any questions about the procedure, do not hesitate to ask your surgeon.

During Surgery

Gallbladder surgeries are classified into two categories: traditional open surgery and minimally-invasive surgery. Ask your doctor about the procedure and confirm it with them.

Minimally invasive surgery is performed through one or more small openings. A thin tube-like instrument equipped with a light, a lens, and a guide is then inserted to guide the procedure. 2 Note that minimally invasive can refer to traditional Laparoscopic surgery, which involves the surgeon manually guiding small instruments, or it can refer to robotic arms, also known as Robotic-Assisted Surgery.
Robotic-assisted surgery is performed by a surgeon sitting at a computer console, where he controls the movements of the robot arms in real time. Robotic-assisted surgeries are advantageous because they provide a magnified 3D image of the surgical area and a greater range and precision of movement during the procedure.
Open surgery is a traditional method that involves cutting the skin with a large incision to allow the surgeon to see the gallbladder.

Tests

Some tests are performed immediately before or even during the surgery.

Intraoperative cholangiogram

A cholangiogram, a type of X-ray used for gallbladder removal surgery, may be performed during the procedure. A dye is injected into the common bile canal. The surgeon then takes an X-ray to check for gallstones. If there are stones, the surgeon will remove them with a special tool during the cholecystectomy.

Laparoscopic ultrasound

Laparoscopic ultrasound is a reliable and simple way to view the common bile canal during laparoscopic surgery.

According to the World Journal of Gastroenterology, “It’s particularly useful in difficult surgical circumstances where the anatomy is obscured”.

The surgeon can detect stones in the bile duct using this procedure. LUS helps the surgeon to see the anatomy and structure of the bile canals. This reduces the risk that the common bile can be damaged accidentally during the procedure.

Gallbladder removal: Steps to follow

Both types of minimally invasive surgery are performed to promote a data-component. The two types of minimally-invasive surgery are done to reduce pain and bleeding after surgery, as well as promote faster recovery times.

The steps involved in laparoscopic cholecystectomy are:

You may be asked to remove any jewelry or other items that might interfere with the surgery.
You will need to remove all your clothes and wear a hospital gown.
On the operating table, you will lie on your back.
You may need to have excess body hair removed if it is near the surgical area.
The skin over the surgical site is cleaned with an antiseptic sterile solution.
You will receive an IV and initial medication for relaxation.
Anesthesia general will be administered.
A tube is inserted in your trachea during the procedure to assist with breathing.
During surgery, the anesthesiologist will monitor your vital signs, including your breathing, blood pressure, and heart rate. He will also check your blood oxygen levels.
After the anesthesia induces sleep, the surgeon inserts a port.
Gas is pumped into the abdomen via a port (to make space for the procedure).
A small camera (which shows the surgery on an operating room screen) is inserted into the port.
Once the surgeon is able to see the gallbladder clearly, he will create more ports.
The additional ports are filled with long, narrow instruments (instruments used for surgery).
Through one of the incisions, the gallbladder will be removed from the body.
The surgeon will close the incisions after the surgery with small staples, tapes, glues, or surgical staples (these don’t need to be removed as they dissolve when the incision heals).

Robotic surgery

More and more, robotic surgery is replacing laparoscopic surgery. Robotic surgery is a minimally invasive type of surgery. It’s similar to laparoscopic surgeries, and the steps are identical. The only difference is that the surgeon controls the robot during robotic-assisted surgeries rather than directly controlling the instruments with their hands.

The minimally invasive cholecystectomy takes between one and two hours.

Cholecystectomy

To ensure optimal safety, your surgeon may have planned an open cholecystectomy or may switch a minimally-invasive cholecystectomy to an open procedure (during surgery). Some of the most common reasons for an open procedure are:

Scars or inflammation from an older surgery
Obesity can make it difficult to see organs through a scope.
Bleeding during surgery

During minimally invasive surgeries, it may be decided that the open method is more safe. It could be due to the anatomy of the gallbladder of a patient (which makes it difficult to see through a scope) or for other reasons.

No matter what type of surgery you have, the steps leading up to the administration of general anesthesia will be identical. The steps that are performed after an open cholecystectomy are:

The incision can be made on the upper abdomen or right side, below the ribs.
The gallbladder, liver, and muscle tissue are exposed by pulling back the muscles and tissues.
The surgeon removes the gallbladder using large, traditional instruments.
In some cases, drainage (or multiple drains) can be placed in the incision in order to allow fluids and pus to drain from the incision.
You are then taken to the recovery area. The incision will be sutured, and a dressing will be placed over it.

Open cholecystectomy takes about one to two hours.

After Surgery

You will wake up in the recovery area after surgery. The recovery room is where patients who have undergone surgery are closely monitored for any possible complications.

The nurse will check your vitals (including your blood pressure, pulse, breathing, and temperature) as well as other signs and symptoms. You should let the nurse know immediately if you’re worried about any symptoms or have questions.

In most cases, patients who have undergone an uncomplicated procedure such as a cholecystectomy stay in the recovery area for an hour or longer.

You can also find out more about pain

You will experience some pain in the area of the abdominal incisions after gallbladder removal surgery. You may feel pain in your shoulder area if you underwent a minimally-invasive procedure. This is due to the carbon dioxide gas injected during the procedure. Shoulder pain usually goes away within 24 to 48 hrs after surgery.

You should follow your surgeon’s instructions for pain medication after surgery. As well as, taking pain relievers and putting ice over the incision can help reduce pain. However, you should always consult your doctor or nurse about the safest way to use ice.

You can take ibuprofen (Motrin, Advil) or other anti-inflammatory pain medications over the counter. Narcotics are sometimes prescribed. Take only pain medication prescribed by your doctor.

Nausea

You should consult your doctor if you experience nausea or vomiting after surgery.

Follow your surgeon’s instructions regarding pain management, wound treatment, and physical activity.

Discharge

The discharge criteria are the standards that a patient must meet in order to be released from a hospital, outpatient clinic, or other facility. The criteria for a patient to be discharged may vary from facility to facility, but the following are common:

Walking and moving around safely
Tolerating a bland diet consisting of liquids or low-fat, bland solids
Stable vital signs include blood pressure, temperature, pulse, and breathing rate.
Absence of pain, nausea, vomiting, or bleeding

Open surgery discharge

Open procedures require a longer hospital stay (usually two to four days). Open procedures require a longer hospital stay (usually two to four weeks).

It’s always a good idea to have someone reliable drive you home following the procedure. Before you leave the hospital, your nurse will review all of your discharge instructions. You may want to ask someone to take down notes on your aftercare instructions, as the medication (given both before and during the surgery) can affect your memory.

Resuming normal activity

You can expect to feel better every day following the procedure. Depending on your job, you could be back to work in a week or two. If you are lifting heavy objects or very active at work, it may take up to one month.

It may take up to four weeks to get back to your daily routine after an open cholecystectomy. Consult your doctor before you drive, resume normal activities, or return to work following your surgery.

Cynthia Vincent