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Of all videosurgeries in the United States today, removal of the gallbladder–or laparoscopic cholecystectomy–is among the most commonly performed. And today, most gallbladders are removed by videosurgery instead of the "open" procedure. A National Institutes of Health study referred to laparoscopic cholecystectomy as the optimal treatment for symptomatic gallbladder disease. Indeed, it is a proven and effective procedure that most often results in less pain, smaller incisions, and quicker recovery time.

Gallbladder Disease

The gallbladder is a small sac located beneath the liver. Its purpose is to store bile produced by the liver. Bile is a substance that helps digest fatty foods. Occasionally, the stored bile begins to crystallize. These crystals can slowly grow into gallstones, much like water crystals become hailstones. Gallstones can remain in the body for years without symptoms, but when they move about, there can be blockage of the gallbladder’s outlet. This can result in indigestion, nausea, sharp abdominal pain, and vomiting–symptoms of the stones and gallbladder disease.

Treatment Options

Gallstones that cause no pain usually can be left alone. Otherwise, ultrasound shockwaves can explode the stones, medication can dissolve them away, or surgery can remove the gallbladder with the stones. However, shockwaves and drug therapies are not ideal, generally doing away with only about two-thirds of the stones. And that’s a temporary solution, because even if some of the stones are destroyed, new ones will take their place, since the stones are the end result of the underlying problem.

Surgical removal of the gallbladder is the permanent solution to gallbladder disease. Fortunately, the body is designed so that the digestive process works equally well without a gallbladder to hold bile. When there is no gallbladder, the bile flows directly into the intestines, where it is processed. Sometimes gallbladder removal results in increased bowel movements, which tend to return to a normal amount in time.

The Benefits of Laparoscopic Cholecystectomy

There are two surgical options for removing the gallbladder: the "open" procedure and videosurgery. The videosurgical technique is referred to as laparoscopic cholecystectomy, and it is the way most people have their gallbladder removed today.

Rather than the large incision that "open" surgery requires, there are only four small incisions ranging from 1/4 inch to 1 inch made in the abdominal region. The videosurgeon inserts a thin, telescope-like instrument attached to a camera, along with specially designed surgical instruments. The camera projects a magnified picture of the gallbladder region onto a television screen. This picture guides the surgeon as he or she moves the instruments that will remove the gallbladder. A large opening is not needed to remove the gallbladder because the organ collapses like a balloon and can be pulled through one of the small incisions.

The main advantages the laparoscopic technique offers are:

1. Less time in the hospital. Most patients are able to leave the hospital the same day as the surgery or the next day. With "open" surgery, a 5 to 8 day stay is anticipated.
   
   
2. Quick recovery time. A patient can return to work or a regular routine within 3 to 7 days, compared to 4 to 6 weeks with open surgery.
   
   
3. Little pain. When the body is "opened" for surgery, the surgeon cuts through layers of muscle and tissue. These heal with time, but for many people, the process can be painful. With only four small incisions needed for videosurgery, the recuperative pain is greatly reduced.
   
   
4. Minimal scarring. There are four small scars instead of a 6- to 9-inch scar.

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