Various diseases of the gallbladder are often accompanied by the formation of solid stones or stones that interfere with the normal circulation of bile and digestion. This condition is called cholecystitis and involves the complete removal of the organ, cholecystectomy. Laparoscopy of the gallbladder is, to date, the most sparing and progressive way of surgical intervention. This operation is both effective and as safe as possible for the patient.
How is the gallbladder removed by laparoscopy?
This type of cholecystectomy is performed under general (endotracheal) anesthesia . Immediately after falling asleep to the patient through the esophagus, a probe is inserted into the stomach. With its help, excess fluid and gases are removed, random vomiting is prevented. Also, a team of doctors connects a person to an artificial lung ventilator, then you can proceed to the operation itself.
First, the surgeon makes 4 small incisions in the abdominal cavity. Through one of them, a special sterile gas is introduced, allowing the tissues to spread quickly and expand the organs, which facilitates subsequent visualization.
In each incision, miniature surgical instruments are inserted that have sufficient hardness for excising the gallbladder, but at the same time are flexible, so when working as a doctor, the risk of damage to neighboring organs is minimal. Also in the abdominal cavity a high-resolution video camera is inserted, equipped with a flashlight, the image of which is broadcast to the surgeon's monitor.
For cholecystectomy, it is necessary to preliminarily cut off the bladder duct (holedoch) and arteries, so they are carefully clipped (clips) made of steel. After this, the specialist performs the incisions and carefully sutures the lumen of large blood vessels. Removal of the gallbladder is slow with simultaneous cauterization (coagulation) of bleeding zones, excision of altered tissues. The organ is removed through a small incision near the navel.
After cholecystectomy, the abdominal cavity is washed with an antiseptic solution, and the punctures are sutured or sealed. Sometimes in one of them for 1-2 days set a small drainage.
Preparation for laparoscopy of the gallbladder
Approximately 10 days before surgery, aspirin and other anticoagulants, vitamin E and its containing complexes, non-steroidal anti-inflammatory drugs are discontinued.
In the evening on the eve of the procedure, a cleansing enema is performed, after which it should be easy to dine, but before 6 pm. From midnight it is forbidden to drink water and take any food. In the morning before the cholecystectomy the enema is repeated.
Postoperative period after removal of the gallbladder by laparoscopy
Immediately after surgery, the patient is moved to the ward, where he wakes up within 1 hour. Over the next 4-6 hours the patient will have to comply with strict bed rest, but after the allotted time you will be able to sit down, walk, drink clean water without gas.
When there is nausea and pain in the postoperative period of gallbladder removal, the method of laparoscopy appoints Cerukal and pain medications, sometimes - a narcotic group. Also, to prevent infection, antibiotics are mandatory.
From the 2nd day after cholecystectomy it is allowed to take light dietary food - a weak chicken broth, chopped white meat, skim cottage cheese or yogurt.
The discharge is made on the 3rd-7th day, depending on the patient's well-being, the fusion of damaged tissues.
Rehabilitation at home after laparoscopy of the gallbladder
Restoration of the patient consists in observance of a diet № 5 on Pevzner, restriction of physical activity. A person after cholecystectomy can not lift weights, perform any complicated work, even around the house.
It is recommended to wear soft underwear with an overstated waist so that the fabric does not irritate and does not rub the puncture zones. Daily it is necessary to process cuts with the preparations appointed by the surgeon, and also to stick them with plaster on a silk basis.
After 8-10 days, the rehabilitation period ends, if the sutures are properly consolidated, and there are no complications.