Listen to Your Gut: Talking Gallbladder Surgery with MUSC Health Florence Surgeon

 

Our gallbladder is located in the upper right part of our abdomen, just below our liver. Its purpose is to store bile, which is made in the liver and dissolves fats for digestion. A significant number of adults develop gallstones, which can form in the gallbladder when the bile contains too much cholesterol or bilirubin or the gallbladder doesn’t empty properly. According to the National Institute of Diabetes, Digestive and Kidney Disease, gallstones are very common, affecting 10 to 15 percent of the U.S. population. Not all gallstones are painful, but when they do cause pain, the recommended treatment is surgical removal of the gallbladder.

We talked with Dr. Aftab H. Jafri, a fellowship-trained surgeon at MUSC Health Florence Medical Center, who specializes in minimally invasive foregut, bariatric and gastrointestinal surgery, to discuss gallbladder removal.

Q. What is a cholecystectomy, and why is the procedure performed?

A. A cholecystectomy is the surgical removal of the gallbladder. Cholecystectomies are performed to alleviate pain caused by intermittent or complete obstruction of the gallbladder by a gallstone, a condition called symptomatic cholelithiasis.

Cholecystectomies also are performed in cases of acute cholecystitis, acute pancreatitis, which occurs when a gallstone obstructs the flow of bile, or other functional issues of the gallbladder.

Q. Is cholecystectomy a major surgery?

A. Yes, removal of the gallbladder is a common but major abdominal surgery. The procedure is intricate because of the gallbladder’s close proximity to important intraabdominal organs, blood vessels and ducts.

Q. How has gallbladder surgery changed in recent years?

A. I tell my patients that the gallbladder can be removed in two ways: open and minimally invasive. The open technique requires big, open incisions in the right upper abdomen, and healing can take longer, about one to two weeks.

Minimally invasive surgery has become the standard of care and can be performed in two ways: Robotic and laparoscopically.

Minimally invasive gallbladder surgery techniques

• Laparoscopic surgery involves the use of a camera (laparoscope) that transmits images to a video screen and provides visualization during the surgery. The laparoscope is inserted through a small incision. Additionally, three small incisions are made for the insertion of long instruments that are handled manually by the surgeon to remove the gallbladder. The first laparoscopic cholecystectomy was done in 1985, and since then, it has become the standard of care.
• Robotic surgery has emerged as the technique for removing the gallbladder and is my preferred method for a cholecystectomy. Unlike a laparoscope, a tiny camera provides a three-dimensional, high-magnification image of the patient’s anatomy while the surgeon, who is sitting at a console, controls the robotic arm(s).

Q. How does robotic surgery benefit the patient?

A. Compared to open surgery, the incision is much smaller, so patients have far less pain and require less pain medication. As a result, patients recover more quickly.

Robotic cholecystectomy, like laparoscopic or open cholecystectomy, is performed under general anesthesia. Most patients can return home the same day, depending on the reason for the surgery, and are able to eat and drink. They also are able to return to daily living activities more quickly than patients who have open surgery.

Q. How does robotic surgery benefit the surgeon?

A. Robotic surgery provides more detailed visualization and very precise motion of the instruments, which is the key advantage of using the robot. I emphasize that throughout the procedure, the surgeon is in complete control of the robotic arms, which provide a wide degree of motion and precision.

Q. Is robotic surgery faster?

A. Laparoscopic and robotic surgery are faster because I don’t have to close a large incision, but the time spent performing the cholecystectomy depends totally on the disease process of the patient.

Q. How does a patient prepare for a cholecystectomy?

A. Patients should do the following to prepare for gallbladder surgery:

• Patients must discontinue blood thinners before surgery. The timing of stopping their thinner depends on what type of blood thinner they are taking.
• They must not drink or eat after midnight the evening before surgery.
• I also urge my patients to do a 30-minute walk every day and do breathing exercises if they can.

Q. What do you want patients and prospective patients to know about cholecystectomy?

A. The most important factors in weighing the outcomes of surgery are the surgeon’s credentials, the quality of the facilities and how patients are treated. MUSC Health excels in all these areas and offers an unmatched standard of care.

At MUSC Health Florence, we treat our patients just like our family, and our patients have all the advantages of a top academic medical center without having to leave the area for treatment and care.

Learn more about the gallbladder and our Digestive Disease Center.

Dr. Jafri sees patients at 805 Pamplico Highway, Florence Medical Pavilion A, Suite 230. Make an appointment or call 843-669-1220.