One of the most often asked questions of people who develop gallstones is, "Why should my gallbladder be removed when technology exists to eliminate just the stones?" To be blunt, once you begin to produce stones in your gallbladder, it's only a matter of time before more stones will form, and the discomfort of the first episode will return.
There are two pieces of good news for those people. First, you can do without your gallbladder if you have to. Second, laparoscopic techniques are available that eliminate much of the pain and lengthy recovery generally associated with traditional gallbladder surgery.
Most gallstones are crystallized cholesterol that accumulates in the gallbladder. They can remain there and cause no problems, but stones can also block important openings, causing jaundice and pain.
The gallbladder is a sac that holds surplus bile produced by the liver to digest food. During times when digestion isn't taking place, the bile retreats to the gallbladder for use later. Over time, if the mixture of compounds that keep the gallbladder's cholesterol soluble isn't present in sufficient quantity, the cholesterol forms crystals, and eventually stones.
The body adapts to the removal of the gallbladder by storing bile in the liver.
Traditional gallbladder surgery involves a single long cut that makes it possible to view the organ and take it out. That approach requires cutting muscles to reach the gallbladder, thereby increasing postoperative pain and recovery time.
Laparoscopy uses a different, less damaging method to achieve the same objective. Instead of one long, deep cut, there are three small incisions about one-half inch each. Through each of these slits instruments are inserted, including a high resolution camera and other small devices the surgeon uses to perform the procedure. A small amount of carbon dioxide is introduced into the abdomen to help the surgeon acquire a better view of the gallbladder.
Once detached, the gallbladder deflates like a small balloon and is removed through one of the four small incisions. The operation usually lasts less than one hour.
The advantages laparoscopic cholecystectomy represents are significant for patients.
- Less pain; therefore less pain medication.
- Shorter hospital stays. Usually one day.
- Quicker recovery. Most people return to work within one week.
- Reduced scarring.
With all its positives, laparoscopic cholecystectomy has become the procedure of choice for gallbladder removal. Philip L. Leggett, M.D. has performed more than 1,280 of them since 1990.