Dr Sameer Mihrshahi

This operation is performed under a general anaesthetic. A small incision is made just below or within the umbilicus (belly-button), a plastic tube called a port is inserted into the abdomen, and the peritoneal cavity is inflated with carbon dioxide gas to create a space for surgery. 2 to 3 small incisions for further ports are made, one about 5cm below the bottom of the breastbone, and others on the right side of the abdomen. The gallbladder is grasped with laparoscopic graspers to elevate it and the liver, scar tissue (adhesions) are divided either with scissors or diathermy (electrical current energy that divides tissue), and then the tube joining the gallbladder to the bile duct, called the cystic duct, and the blood supply going into the gallbladder, the cystic artery, are located and separated from surrounding tissues. A cholangiogram (X-ray test of the bile duct, performed by injected dye through a plastic tube into the cystic duct) is performed looking for bile duct stones or other abnormalities. If this is clear, then titanium metal clips are placed on the cystic duct and artery, that are then cut. The gallbladder is separated from the liver by diathermy, and placed in a plastic retrieval bag. After ensuring the operative site looks good, the plastic bag is removed from the port at the umbilicus, the carbon dioxide gas is removed from the abdomen, and the wounds are closed with sutures. Local anaesthetic is instilled into the port sites during the surgery to try and minimise pain following the procedure.