- Shorter Hospital Stay: Most patients return home within 24 hours after surgery, compared to 3-5 days with open surgery.
- Reduced Post-operative Pain: The small incisions result in less tissue trauma and reduced pain during recovery.
- Faster Recovery Time: Patients typically resume normal activities within 1-2 weeks, rather than 4-6 weeks with open surgery.
- Minimal Scarring: The procedure leaves 3-4 small scars rather than one large surgical scar.
- Lower Risk of Infection: Smaller incisions reduce exposure to potential sources of infection during and after surgery.
Laparoscopic Gallbladder Removal in Singapore
Dr Chong Choon Seng
MBBS | MRCS | Masters in Medicine (Surgery) | FRCS (Edinburgh)
Laparoscopic gallbladder removal, or laparoscopic cholecystectomy, is a minimally invasive surgical procedure to remove the gallbladder using small incisions and specialised instruments. The surgeon makes 3-4 small cuts in the abdomen to insert a tiny camera and surgical tools, allowing them to view and remove the gallbladder. Compared to traditional open surgery, this approach typically offers faster recovery and less postoperative discomfort for most patients.
Indications for Gallbladder Removal
Your surgeon may recommend gallbladder removal when certain conditions affect your gallbladder function or cause persistent symptoms.
- Gallstones (Cholelithiasis): Small, hard deposits form in the gallbladder, causing pain and potential blockage of bile ducts. These stones can range from tiny crystals to several centimetres in size.
- Gallbladder Inflammation (Cholecystitis): The gallbladder becomes inflamed, often due to gallstones blocking bile flow. This condition may cause severe abdominal pain and fever.
- Biliary Colic: Recurring pain occurs when gallstones temporarily block bile ducts. The pain typically appears after meals and can last several hours.
- Gallbladder Polyps: These tissue growths on the gallbladder wall may increase the risk of gallbladder cancer if they exceed a certain size.
- Pancreatitis: Gallstones can block the pancreatic duct, leading to inflammation of the pancreas that requires gallbladder removal to prevent recurrence. In some cases, gallstones may also contribute to bowel obstruction, requiring specialized bowel obstruction treatment to restore normal digestive function.
Benefits of Gallbladder Removal
Laparoscopic gallbladder removal in Singapore offers several advantages compared to traditional open surgery techniques.
Surgical Techniques
The removal of the gallbladder can be performed through different surgical approaches, each selected based on the patient’s specific condition and anatomical considerations.
Traditional Laparoscopic Cholecystectomy
This standard approach uses four small incisions in the abdomen. The surgeon inserts a camera and surgical instruments through these ports to remove the gallbladder. The procedure typically takes 60-90 minutes and allows for clear visualization of the surgical area through high-definition video equipment.
Single-Incision Laparoscopic Surgery (SILS)
This technique involves one incision through the navel rather than multiple cuts. The surgeon uses specialized instruments through this single port to complete the procedure. While this method may result in less visible scarring, it requires additional surgical expertise and may not suit all patients.
Robotic-Assisted Laparoscopic Surgery
The surgeon controls robotic arms from a console while viewing a 3D image of the surgical site. The robotic system provides enhanced precision and dexterity. The setup requires additional operating time but may offer advantages for complex cases.
Surgery Preparation
Medical Evaluation
The surgical team conducts blood tests, imaging studies, and heart function tests. These assessments help identify any underlying conditions that might affect surgery. The evaluation typically includes a complete blood count, liver function tests, and coagulation studies.
Medication Review
Patients must provide a complete list of current medications. Blood thinners, certain supplements, and some medications may need adjustment or discontinuation before surgery. The surgical team will typically provide specific instructions about medication timing and dosage changes.
Fasting Guidelines
No food or drink is allowed for 8-12 hours before surgery. This reduces the risk of aspiration during anaesthesia. Clear liquids might be permitted up to 2-4 hours before the procedure, following the anaesthesiologist’s instructions.
Pre-operative Tests
Additional imaging such as ultrasound or CT scan may be performed to confirm gallbladder condition and anatomy. These scans help the surgeon plan the precise surgical approach and identify any anatomical variations.
Step-by-Step Procedure
Here are the typical steps involved in a laparoscopic gallbladder removal procedure. While these steps provide an overview of the process, the exact approach may vary based on the surgeon’s technique and the patient’s specific needs.
Anaesthesia Administration
The anaesthesiologist administers general anaesthesia through an IV line. Monitoring devices track vital signs throughout the procedure. The team positions the patient appropriately on the operating table.
Port Placement
The surgeon creates small incisions in the abdomen and inserts ports (trocars). Carbon dioxide gas inflates the abdomen to create space for visualization. The camera and instruments enter through these ports.
Gallbladder Identification
The surgical team locates the gallbladder using the laparoscopic camera. They carefully identify surrounding structures including the common bile duct and hepatic artery. This step prevents inadvertent injury to nearby organs.
Dissection
The surgeon separates the gallbladder from surrounding tissue. They clip and cut the cystic duct and artery supplying the gallbladder. This dissection follows a standardized approach to ensure safety.
Removal
The freed gallbladder exits through one of the small incisions. The surgeon removes all surgical instruments and releases the carbon dioxide from the abdomen. They close the incisions with sutures or surgical glue.
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Post-Surgical Care
- Immediate Post-operative Care: Patients typically spend 2-4 hours in the recovery room for monitoring of vital signs and pain control. Healthcare staff assess wound sites and watch for signs of complications. Most patients can drink small amounts of clear fluids once fully awake.
- Pain Management: The medical team provides appropriate pain medication through IV or oral routes. Patients typically experience shoulder pain from residual carbon dioxide gas, which resolves within 24-48 hours. The team adjusts pain medication based on individual needs.
Potential Risks and Complications
While laparoscopic gallbladder removal is generally safe, complications can occur.
- Bile Duct Injury: Occurs in less than 1% of cases but requires immediate attention.
- Bleeding or Infection at Incision Sites: Affects approximately 1-2% of patients.
- Temporary Digestive Changes: Some patients may experience these as their body adapts after surgery.
Frequently Asked Questions
Will I need to follow a special diet after gallbladder removal?
Your body can digest food normally without a gallbladder. The liver continues to produce bile for fat digestion. Some patients find that gradually increasing dietary fat intake helps prevent digestive discomfort during the initial recovery period.
How long does the surgery take?
The procedure typically takes 60-90 minutes, though time varies based on individual anatomy and surgical findings. Total time in the operating room, including anaesthesia and preparation, spans about two hours.
Can gallstones return after surgery?
Since the entire gallbladder is removed, new gallstones cannot form. However, in rare cases, stones might develop in the bile ducts if any predisposing factors exist.
What are the alternatives to surgery for gallbladder removal?
Non-surgical options include medication to dissolve gallstones and lifestyle changes, such as dietary adjustments. These methods usually provide temporary relief but may not address the underlying issue, leaving a risk of future complications.
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Dr Chong Choon Seng
MBBS (NUS)
MRCS (Edinburgh)
Masters in Medicine (Surgery)(NUS)
FRCS (Edinburgh)
Dr Chong is the former Program Director of General Surgery Residency at NUHS, and has more than 20 years of experience in clinical practice.
As an esteemed professional in minimally invasive surgery, Dr. Chong remains committed to achieving optimal outcomes for all surgical conditions, from piles to cancer treatment.
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Singapore 228510
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Ark Surgical Practice – Mount Alvernia Hospital
820 Thomson Road,
Mount Alvernia Hospital, #06-52,
Medical Centre D, Singapore 574623
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