A cholecystectomy is a surgical procedure to remove your gallbladder — a pear-shaped organ that sits just below your liver on the upper right side of your abdomen. Your gallbladder collects, concentrates, and stores approximately 3-5 cups of bile daily — a digestive fluid composed of salts, enzymes, bilirubin, cholesterol, and other substances, produced in your liver, and released into the small intestines via the gallbladder.
Bile helps to break down fats into fatty acids for absorption during small intestinal digestion. Via several ducts, the gallbladder is also connected to the Pancreas, Liver, and Small Intestines. It is in these ducts that gallstones, if formed in the gallbladder, can leave the gallbladder and get trapped, blocking the flow of bile through the ducts. This common reason for a cholecystectomy causes severe pain and swelling of the gallbladder or the other surrounding organs. Gallstones are hardened digestive fluids that can form in the gallbladder, from the size of a grain of rice to as big as a golf ball. Gallstones and the associated inflammation in the gallbladder, liver, pancreas, or ducts can happen suddenly (acute) or over a longer period (chronic). Other gallbladder issues such as a tumor, duct dysfunction, or defects in the gallbladder organ itself may necessitate a cholecystectomy.
Dr. David W. Ford may recommend a cholecystectomy if you have:
Most adults with gallstones do not have symptoms. Eighty percent (80%) of people with gallstones go 20 years without symptoms.
Gallstones are often the cause of gallbladder problems, but what causes gallstones? There are many factors or combinations of factors that can contribute to gallstone formation, specific to each individual. You are more likely to get gallstones if you:
Doctors do not have a consistent way of preventing gallstones, however, a healthy lifestyle is always recommended as a standard to prevent or reduce conditions in combination with other surgical and non-surgical treatments. This includes a healthy monitored weight loss, daily exercise, and eating high-fiber foods such as beans, whole grains, peas, figs, apricots, dates, raspberries, blackberries, strawberries, corn, broccoli, plums, pears, apples, greens, and nuts.
Gallbladder problems may cause pain occurring usually on the right side or middle of your upper belly, and can last from 30 minutes to 24 hours. This pain, also known as Biliary Colic, may be constant or may get worse after a heavy meal, or it may sometimes feel more like fullness than pain. The location of the pain may be felt in your back and the tip of your right shoulder blade. Acute Cholecystitis pain lasts longer than 6 hours, with abdominal tenderness and fever.
Other symptoms in addition to the sharp pain in your abdomen may include:
Treatment of gallbladder problems and gallstones begin with an evaluation from Dr. David W. Ford using an Ultrasound test and exam, to confirm gallbladder issues or gallstones and eliminate the possibility of ulcers, liver problems and heart conditions that could contribute to pain.
If additional tests are required, a combination of one or more of the following examinations may be ordered by Dr. Ford:
If gallstones or other gallbladder problems show significant impediment to a healthy lifestyle, Dr. David W. Ford may recommend a surgical treatment using either Open surgery or the da Vinci Robotically assisted Surgical System. This may include an Endoscopic retrieval of the stones or a Cholecystectomy, a removal of your gallbladder. The cholecystectomy, along with intravenous (IV) fluids and pain medication is the standard treatment of acute cholecystitis.
A cholecystectomy can relieve the pain and discomfort of gallstones. Conservative treatments, such as dietary modifications, usually can't stop gallstones from recurring, however it is common for a cholecystectomy to prevent gallstones from coming back. A cholecystectomy is a common surgery, and it carries only a small risk of complications. In most cases, you can go home the same day of your cholecystectomy.
Cholecystectomies are most commonly performed using laparoscopic or robotically assisted laparoscopic surgical systems. In more complicated cases, one large incision is necessary to remove the gallbladder. This is called an open cholecystectomy. Dr. David W. Ford uses both open and the da Vinci Robotic Surgical System depending on the needs of his patients. In some cases, Dr. David W. Ford will begin with the da Vinci surgical system and find it necessary to make a larger incision because of scar tissue from previous operations or other complications in the gallbladder itself, bleeding problems or severe obesity. Both surgical methods, open and the da Vinci robotically assisted laparoscopy will require general anesthesia and may require a specialized X-ray of your gallbladder and bile duct during surgery. This X-ray can find gallstones in the common bile duct. If found, Dr. David W. Ford may need to do additional procedures during the surgery, or you might need another procedure to remove them later.
The da Vinci Surgical System allows Dr. David W. Ford to perform minimally invasive Cholecystectomies with clinically supported precision and accuracy. During the robotically assisted cholecystectomy, Dr. David W. Ford makes four small ports or incisions, each less than 1 inch long, in your abdomen. A laparoscope (a tube with a tiny video camera) is inserted into your abdomen through one of the incisions.
Dr. David W. Ford who is seated in the operating room, operates via the Surgeon Console that controls the Patient Cart’s robotic devices, including various surgical instruments and the camera. The images gathered from the laparoscope’s camera are high-definition 3D, which are sent to a monitor that Dr. David W. Ford uses to guide the surgical system during the gallbladder removal. If needed, the abdomen can be inflated with a harmless gas (carbon dioxide), which creates space to allow Dr. Ford to view the inside of the body. After the gallbladder is removed, your incisions are sutured, glued or surgically clipped, and you're taken to a recovery area. A cholecystectomy using the da Vinci robotically assisted surgical system takes one or two hours.
There are many robotically-assisted surgical systems that are FDA approved and in use today. However, many are specially designed for specific organs, procedures or conditions, such as lung or pulmonary surgeries or knee and other extremity replacement surgeries. The da Vinci Robotic Surgical System is the premier system specialized in cholecystectomies. Dr. David W. Ford is not only an expert board certified surgeon, but also certified in the use of this leading-edge technology.
This robotic platform offers Dr. David W. Ford fully wristed instruments and a 3D high-definition camera with 10x magnification. As a result, the gallbladder removal can be done with more precision, and complex situations can be fixed with small incisions. Furthermore, the robot doesn’t get tired and Dr. Ford sits during surgery, so there is less surgeon fatigue. For the patient, this translates into quicker recovery, less pain and less complications.
Other benefits of robotic cholecystectomies include:
In 2000, Intuitive’s da Vinci Surgical System was the first robotic surgery device to gain FDA clearance for use in general laparoscopic surgeries, including minimally invasive cardiac, colorectal, gynecology, head and neck, thoracic, urology, and general surgeries. Over 1,700 da Vinci Systems are currently installed in hospitals internationally, and more than 775,000 patients have received procedures from this robotic surgical system. With roughly 75 percent of all prostate cancer operations in the U.S. being performed using da Vinci devices, this robotic platform has established itself as an effective and reliable tool.
Should the robotically assisted surgical laparoscopic surgery be recommended as part of treatment for your gallbladder and/or cholecystectomy, Dr. David W. Ford and his team will have the best state-of-the-art technology at their disposal to usher in your recovery.
Da Vinci surgical systems are comprised of three components: surgeon console, patient-side cart, and vision cart.
The patient-side cart is positioned near the patient on the operating table. It is where the instruments used during the operation move in real time in response to your surgeon’s hand movements at the surgeon console.
A camera provides a high-definition, 3D magnified view inside your body. Every hand movement your surgeon makes is translated by the da Vinci system in real time to bend and rotate the instruments with precision.
The vision cart makes communication possible between the components of the system possible, and supports the 3D High Definition vision system.
"The da Vinci Surgical System allows me to make smaller incisions, resulting in reduced risk of infection, minimize scarring, reduce pain, and accelerate recovery time, allowing my patients to return to normal activities more quickly."
People are often able to go home the same day as their surgery, though sometimes a one-night stay in the hospital is needed. In general, you can expect to go home once you are able to eat and drink without pain and are able to walk unaided. It takes about a week to fully recover.
As follow up, the gallbladder is sent to various labs for several tests, depending on the situation or severity, and you yourself may undergo additional imaging tests, such as an X-ray or ultrasound if Dr. Ford is concerned about possible gallstones in other areas, or other problems in your bile duct.
You may also have 1 or more drains in the incision if an open procedure was done. The drains will be removed in a day or so. You might be discharged with the drain still in and covered with a dressing.
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Other alternative recommendations, as needed – Use at least one if have not had a BM for 2 days: