Laparoscopy is a type of surgical procedure that allows a surgeon to access the inside of the abdomen (tummy) and pelvis without having to make large incisions in the skin. This procedure is also known as keyhole surgery or minimally invasive surgery.
The patient is normally admitted to hospital a day prior to the surgery or on the day of surgery. After admission the patient is examined and investigations reviewed by one of the members of the MAS team, Also a member of the anaesthesia team would conduct the pre anesthetic check-up. Any pre operative investigations are performed if needed. The patient would need to be fasting overnight or for 8 hrs for the surgery but can take his regular dose of medicines with sip of water (Please follow instruction given by the attending staff)
Next morning, the patient is shifted to the operating theatre about an hour or so prior to surgery. After surgery, the patient is shifted to the recovery ward under the care and supervision of our Anaesthesia team. The patient is observed in the recovery ward normally for 2-4 hours after surgery and then shifted back to the room. Hence the patient may come back to the room after about 5 – 8 hours since he/she has left the room.
Oral diet is started with sips of water on return to the room and progresses to drinking all liquids on the same day of surgery. The patent is encouraged to sit up, visit the toilet and removed around the same day. In fact movements are encouraged because this causes dramatic reduction in pain and increases the sense of well being.
The patient is given a normal breakfast next morning and will be discharged from hospital after a visit by one of the MAS team members. On discharge, a discharge summery with a medication advised will be handed over to the patient with date for next appointment.
Slippage of stones in CBD may cause pain or jaundice or both. This situation requires en endoscopy (ERCP) for removing the stones. This should preferably be done before surgery.
Sometimes a stone in the CBD may not show on ultrasound however patient may have symptoms which are suspicious of the same. In this event the patient requires magnetic resonance cholangiopancreatography (MRCP – an MRI scan) which shows the presence of stones in the common bile duct
An incisional hernia happens when a weakness in the muscle of the abdomen allows the tissues of the abdomen to protrude through the muscle. The hernia The surgeon may use endoscopy in removing CBD stones before gallbladder surgery. Once the endoscope is in the small intestine, the surgeon locates the affected bile duct. An instrument on the endoscope is used to cut the duct and the stone is captured in a tiny basket and removed with the endoscope. This two-steps procedure is called ERCP and EPT.