If you are having gallbladder surgery, it is most likely because you have gallstones, or you are having bouts of cholecystitis (inflammation of the gallbladder). When you sign the consent for your gallbladder procedure, the consent may have the word cholecystectomy in it. This is the medical term for having your gallbladder removed. About 95% of all gallbladder surgeries are performed laparoscopically by use of a laparoscope and very small incisions. This is a minimally invasive procedure, therefore most people having this procedure can have it done at a same-day surgery center. If you have had several abdominal surgeries in the past and your surgeon feels that you may not be able to have your gallbladder surgery done laparoscopically, you will probably have your surgery done at a hospital.
Once you arrive in the operating room, the circulating nurse will have you transfer onto the operating room bed. The nurse should keep you covered with warm blankets as the operating room can be rather cold. The anesthesiologist or the CRNA will begin placing monitors on you – EKG leads, oxygen saturation probe, and blood pressure cuff. The circulating nurse may place SCD’s (sequential compression device) on your legs or feet. The nurse may check your armband and have you recite your name, your birthdate, and what surgery you are having done. The anesthesiologist/CRNA will then place an oxygen mask over your nose and mouth. This is to make sure you are well oxygenated before receiving the IV anesthesia medication. You will then start receiving the anesthesia medication through your IV. This medication can sometimes sting or burn, this is normal and will go away very shortly. Only a few seconds after receiving the IV anesthesia, you will become unconscious.
After you are unconscious, the anesthesiologist or CRNA will place a breathing tube through your mouth and down into your trachea. Once the tube is secured in place, the nurse will start positioning and prepping you for the procedure. If you went to the bathroom while you were in the pre-op area, then you most likely will not have a urinary catheter placed. Your abdominal area (and your abdominal area ONLY) will then be exposed. If you are a male, your abdomen will most likely be shaved. The circulating nurse will “prep” your abdomen with a betadine solution or similar antibacterial solution. After your belly has been cleaned with the solution, the sterile surgical team will begin placing sterile drapes on you. You will be completely covered with the sterile drapes except for your abdominal area where they will be making the incisions. The circulating nurse will hook up the equipment to specific machines that have been passed to her/him from the sterile surgical team. Once all equipment has been hooked up and operational, your surgery will begin.
The surgeon will start by making four small incisions and then place narrow tubes called ports into each of the incisions. These ports are used to place the laparoscopic camera and instruments through. CO2 gas is pumped into your abdomen to create more space inside your belly, this makes it much easier for the surgeon to see. The laparoscopic camera is placed in one of the ports (the belly button port) and other laparoscopic instruments are placed through the other ports. The surgeon will be viewing a video monitor in which video from the laparoscopic camera is sent. The surgeon will use the laparoscopic instruments to place surgical clips on the cystic artery and the cystic duct. The cystic artery and cystic duct are attached to your gallbladder, the clips are placed in order to seal them off from the gallbladder. Once the clips are in place and the artery and duct have been divided from the gallbladder, the surgeon will begin to delicately separate your gallbladder from your liver.
Once the gallbladder is free, it is removed through one of the ports. Your gallbladder is passed to the circulating nurse who will place it in “formalin” (a formaldehyde solution) and send it to pathology. All of the ports are removed, the CO2 gas is released from within your abdomen and the small incisions are closed with either staples or suture. At this point, the anesthesiologist/CRNA will start waking you up. Once you are breathing on your own, the breathing tube will be removed.
The surgical team will transfer you from the operating room bed onto a stretcher and you will be wheeled to the recovery room or PACU (post anesthesia care unit). You will still be very sleepy, so you probably will not remember being wheeled to the recovery room. Once in PACU, a PACU nurse will be there to take care of you until you are discharged. The average time spent in the recovery room is around an hour.