I am a General and Laparoscopic Surgeon practicing in Bandra for the last 24 years. I do all basic and advanced laparoscopic surgeries. I have done a fellowship in Minimally Access Surgery under the guidance of Dr Palanivelu ,Coimbatore. I have also done a fellowship in Laparoscopic surgery in Palmdale and Coney Island ,USA.
I am a Gastrointestinal Surgeon with Holy Family Hospital, since 1986. I am going to talk about the gallbladder and gallstones, in particular. The gallbladder is a pear-shaped cystic organ, situated in the right upper abdomen just below the liver. Gallstones are the commonest cause of upper abdominal pain. Gallstones are of different types. There are cholesterol stones bcoz of high cholesterol, there are pigment stones because of the rapid breakdown of red blood cells and there are stones caused because of infection. In fact, the gallstone has been called the tombstone of the bacteria lying within it. The gallbladder is a vestigial organ, by which it can be dispensed with, without any ill effects to the patient like the appendix. Hence in case of any problem with the gall bladder. The deceased gallbladder is usually removed. The operation is called a colostomy.
Gallstones requires to be treated as soon as they become symptomatic. Except in diabetic patients, where even asymptomatic stones would require to be treated because of the very high incidence of empyema of the gallbladder. Gallstones can present as biliary colic, which is an intimidating, sharp pain which occurs in the upper abdomen in the center and radiates to the back, or as an infection wherein the gallbladder is inflamed and presents with fever, dilating pain, and toxemia. Gallstones could also move down into the bile duct and cause obstructive jaundice or cause pancreatitis. Which is a life-threatening severe inflammation. By convention, the gallbladder used to be removed by a cut in the abdomen about 5 to 6 inches in length, however, with the advance of technology the gallbladder can now be removed by laparoscopy. Wherein there would be 3 to 4 punctures of 5 and 10 millimeters. The use of a video camera, with video enhanced images. The whole gallbladder could be dissected and removed through these punctures. Usually, before starting laparoscopic surgery, we require to create a pneumoperitoneum by which we put a gas commonly carbon dioxide is used because carbon dioxide is very soluble and gets absorbed 200 times faster than air, also it causes less post-operative pain. In a few patients, who are at high risk for surgery and anesthesia it was better to remove the gallbladder by the open technique. However, almost 90% of patients would get the gallbladder removed by laparoscopic surgery.