Chelsea Williamson
Dr. Hays
BIO 398 – ELMC internship
6 April 2010
LAPAROSCOPIC CHOLECYSTECTOMY
On Monday April 6, a laparoscopic cholecysectomy was performed on a 70 year-old female, and I was lucky enough to be able to observe the operation. This paper will give an overview of the gallbladder and it’s function, the specific symptoms the patient was experiencing, the tests done prior to the operation, and describe the operation that was observed, discussing possible after-effects of the operation.
The gallbladder is connected to, and sits just under, the kidney; it is also connected to the small intestine via the common bile duct. The function of this organ is to hold bile produced by the kidney and secrete it into the small intestine after the consumption of food. Bile helps to break down fats so the intestines can absorb them. “ Bile is a bitter, yellow fluid. It can consist of cholesterol, lecithin, calcium, bile salts, acids and waste materials among other things.”(1).
Before the operation, I was able to hangout with the patient, her daughter, and her mother, because the operation was delayed by 2 hours. She told me that she was experiencing symptoms such as pain under her right rib that went all the way to her back, and her right shoulder was very sore as well. This, and the fact that both of her daughters had already undergone chlolecysectomies, led the doctors to believe that she had gallstones in her gallbladder that were blocking the passage of bile. “ The usual center of gallstones is a mixture of cholesterol, bilirubin and calcium. These stones can be black, red, white, green, or tan-colored.”(1). To confirm that the gallstones were present and to assess their size and location, the doctors ordered an abdominal ultrasound scan for a visual image.
Once it was confirmed by the ultrasound that gallstones were in fact present, and were the cause of the symptoms the patient was having, a laparoscopic cholecysectomy was performed. The operation only took about an hour once everyone was set-up in the operating room. The first thing the surgeon did was to perforate a hole through the bellybutton into the peritoneal cavity of the patient. Once he was able to access the cavity, he filled it up like a balloon with carbon dioxide gas. The purpose of the carbon dioxide was to create space within the cavity for better visibility with the camera. Once a sufficient amount of gas filled the abdomen, the camera was inserted through the bellybutton and three more small incisions were made in various locations around the gallbladder, also penetrating the peritoneal cavity. With the camera focused on the gallbladder the whole time, the surgeon used various tools to cut and eventually remove the organ.
The gallbladder is considered a non-essential organ. The removal of the organ does not mean that the patient will stop producing bile; the only difference is that they cannot store the substance, so the amount excreted into the small intestine will be smaller and less controlled. Patients who undergo this surgery should be cautious about the fat content of their diet. Of course every person is different, through trial and error each post-operative patient will come to understand how their body reacts to fat consumption and the amount they can eat.
This was a great experience. I really enjoyed being around the medical staff in the OR (operating room). It seemed like a great environment for the patients and the staff alike, and if I could be a volunteer there, I would do it in a heartbeat.
Work cited
Graefer, Deborah. “Gallbladder Attack.” Untitled . 2007. Web. 06 Apr. 2010. <http://www.gallbladderattack.com/gallbladder.shtml>.
“How Are Gallstones Diagnosed?” EhealthMD.com . Ed. Guy Slowik. Sept. 2009. Web. 06 Apr. 2010. <http://www.ehealthmd.com/library/gallstones/GS_diagnosis.html>