Laparoscopic Gallbladder Removal

Laparoscopic cholecystectomy is a minimally invasive procedure to remove the gallbladder using small incisions, specialised surgical instruments, and a camera (laparoscope). It is commonly performed to treat gallbladder conditions such as gallstones and inflammation, helping to alleviate pain and prevent complications. This approach typically allows for quicker recovery and less post-operative discomfort compared to traditional open surgery.

Dr. Chok Aik Yong

Colorectal Surgeon & General Surgeon

MBBS | MRCS (UK) | MMed (Surgery) | FRCS (UK)

Indications Benefits Techniques Preparation Procedure Recovery Risks FAQ

Indications for Laparoscopic Cholecystectomy

Gallbladder removal may be recommended for various conditions affecting its function and health.

Symptomatic Gallstones: Gallstones can cause recurring pain, especially after meals. If they block the bile ducts, they may lead to complications requiring urgent treatment.
Cholecystitis: Inflammation of the gallbladder can result in severe pain and infection. Acute cases often require prompt surgical removal to prevent further complications.
Biliary Dyskinesia: A dysfunction in gallbladder emptying can cause pain and digestive discomfort. This condition affects bile release and may necessitate removal if symptoms persist.
Gallbladder Polyps: Growths on the gallbladder wall can indicate pre-cancerous changes. Polyps larger than 1 cm are often removed due to the increased risk of malignancy.
Pancreatitis: Gallstones can trigger inflammation of the pancreas, leading to severe pain and complications. Removing the gallbladder helps prevent recurrent attacks and reduces the risk of long-term pancreatic damage.

Benefits of Laparoscopic Cholecystectomy

Laparoscopic surgery offers several advantages over traditional open cholecystectomy.

Smaller Incisions

Uses small incisions instead of a single large cut, leading to less post-operative pain and minimal scarring.
Shorter Hospital Stay

Most patients are discharged the same day, whereas open surgery typically requires a 2–3 day hospital stay.
Faster Recovery

Patients usually resume normal activities within 1–2 weeks, compared to 4–6 weeks for open surgery.
Reduced Post-operative Pain

Smaller incisions cause less tissue trauma, reducing discomfort and lowering the need for pain medication.
Lower Infection Risk

Smaller incisions and minimal tissue handling reduce the risk of surgical site infections.

Surgical Techniques

Traditional Laparoscopic Cholecystectomy

Performed through four small abdominal incisions, this technique allows our surgeon to insert specialised instruments and a high-definition camera. The camera projects detailed images onto monitors, ensuring precise visualisation during the procedure.

Single-Incision Laparoscopic Cholecystectomy

This variation is performed through a single incision at the navel, using specially designed instruments. It may offer improved cosmetic outcomes but requires additional surgical expertise and is suitable only for select patients.

Robotic-Assisted Laparoscopic Cholecystectomy

In this approach, our surgeon operates robotic arms from a console, benefiting from enhanced 3D visualisation and improved instrument control. This technique allows for greater precision, particularly in complex cases, although it may require longer operating times.

Preparing for Surgery

Medical Evaluation: Blood tests are used to assess liver function and clotting ability, while imaging studies, such as ultrasound, confirm gallbladder disease and anatomy. The patient’s medical history and previous abdominal surgeries are reviewed to determine the best surgical approach.
Medication Adjustments: Blood thinners must be stopped before surgery, typically 5–7 days for aspirin and longer for certain anticoagulants. Specific instructions are provided for managing patients with diabetes medications and other regular prescriptions.
Fasting Guidelines: To reduce the risk of complications during anaesthesia, patients must avoid eating or drinking for 6–8 hours prior to surgery, ensuring an empty stomach. Instructions on when to stop eating and drinking will be provided according to the scheduled surgery time.

Step-by-Step Procedure

Anaesthesia Administration

General anaesthesia is delivered through an intravenous line, keeping the patient unconscious throughout the procedure. Once anaesthesia takes effect, a breathing tube is inserted, and vital signs are continuously monitored for safety.

Port Placement

A small incision near the navel allows for camera insertion, while carbon dioxide inflation creates space for improved visibility. Three additional small incisions are made for surgical instruments.

Gallbladder Identification

The laparoscope provides a magnified view of the gallbladder and surrounding structures, including the bile duct and blood vessels, to ensure precise dissection.

Dissection and Removal

Specialised instruments separate the gallbladder from the liver bed. Blood vessels and the bile duct are clipped and divided before placing the gallbladder in a retrieval bag for removal through one of the ports.

Incision Closure

Surgical instruments are removed, and the incisions are closed using dissolvable stitches, then covered with dressings for protection.

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Post-Surgical Care and Recovery

Immediate Recovery

Patients remain in the recovery area for 2–4 hours, where regular checks on pain levels, vital signs, and nausea are monitored. Oral fluids are introduced once fully awake, and pain relief or anti-nausea medication is provided as needed.

Early Recovery

Showering is allowed 24 hours after surgery, with care taken to keep incisions clean and dry. Light activity, such as walking, is encouraged to help prevent blood clots. Most individuals return to desk-based work within 3–5 days but should avoid heavy lifting.

Long-Term Recovery

Full recovery generally takes 2–3 weeks, with activity levels increasing as comfort allows. A follow-up appointment within 1–2 weeks is scheduled to assess wound healing and review any pathology results.

Potential Risks and Complications

While uncommon, complications can occur. Bile duct injury is rare but requires prompt treatment. Bleeding, infection, or organ injury may arise in some cases. Temporary digestive changes, such as diarrhoea, typically resolve within weeks. Blood clots are rare and can be minimised with early movement and compression stockings.

Frequently Asked Questions (FAQ)

How will my digestion change after gallbladder removal?

The liver continues to produce bile, which flows directly into the small intestine instead of being stored. Most people adapt within a few weeks. Some may initially experience looser stools, which usually settle with dietary adjustments.

What dietary changes are recommended after surgery?

For the first few weeks, eat small, low-fat meals to ease digestion. Most people return to their normal diet within a month, though some may need to limit fatty foods to avoid discomfort.

Can gallstones return after surgery?

Once the gallbladder is removed, new gallstones cannot form inside it. However, in rare cases, stones can still develop in the bile ducts. Maintaining a balanced diet and staying hydrated can help reduce this risk and support healthy digestion.

Dr. Chok Aik Yong

Colorectal Surgeon & General Surgeon

MBBS|MRCS (UK)|MMed (Surgery)|FRCS (UK)

Expertise lies in managing colorectal diseases, particularly advanced colorectal cancer and inflammatory bowel disease.

Dr Chok graduated with degrees in Bachelor of Medicine and Surgery from the National University of Singapore. He was conferred the Master of Medicine (Surgery) in Edinburgh (UK) and a member of the Royal College of Surgeons, UK. He subsequently completed his specialist training in colorectal surgery and became a Fellow of the royal college of Surgeons in Edinburgh in 2016.
Dr Chok was awarded the Health Manpower Development Plan (HMDP) award in 2019 to further advance his colorectal training at Royal Marsden Hospital, one of the top 5 cancer centres in the world. While in London, Dr Chok trained with pioneers in the surgical management of advanced colorectal cancer and inflammatory bowel disease (IBD) and gained extensive experience while appraising the latest clinical and research evidence.

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