Laparoscopic cholecystectomy (removal of the gallbladder)
Cholecystitis (gallbladder inflammation) and gallstones are among the most common diseases in the Western world. Only a diseased and nonfunctional gallbladder will form stones that in the further course cause the typical symptoms including intolerance to fatty foods, flatulence, nausea and colic. In rare cases, biliary sludge rather than stones can cause the same complaints. Fine, sandy grit that usually goes undetected on an ultrasound scan can thicken the bile, obstructing the bile duct and preventing bile outflow.
The diseased gallbladder is removed by keyhole surgery (laparoscopy), which is now the method of choice for this operation, even in complicated cases. Previous surgeries and adhesions can complicate surgery, but are not a serious obstacle for laparoscopy. Overweight also does not rule out the minimally invasive approach, which in fact is especially advantageous for obese patients.
Today the gallbladder can be removed with very slender instruments (2mm in diameter) that leave nearly invisible scars.
In spite of these advances, not every laparoscopic gallbladder operation can be concluded as a minimally invasive procedure. Very severe gallbladder disease and an unclear anatomical situation can require conversion to open technique. This does not mean that laparoscopy has failed, but that the surgical method had to be adapted to suit the particular situation. This is the case in about 5% of laparoscopic gallbladder surgeries.
Drei Wochen nach einer minilaparoskopischen Gallenblasenentfernung. Im Vergleich zur Blinddarmoperationsnarbe im rechten Unterbauch sind die Narben der Gallenblasenoperation bis auf einen kleinen Strich in der Nabelgrube nicht mehr erkennbar.
Akut entzündete Gallenblase mit multiplen facettierten Steinen.