Instead of a single large incision, laparoscopic cholecystectomy uses four small incisions to allow the insertion of surgical instruments and a small video camera. Guided by a video monitor, the surgeon carefully separates the gallbladder from the liver and the common bile duct. Small metallic clips are used to secure the cut ends of the cystic duct and the artery to the gallbladder. An X-ray of the bile duct may be performed during the operation in selected patients to assist with proper identification of the common bile duct and to look for stones in the common bile duct. Postoperative discomfort after laparoscopic cholecystectomy is much less than after the open operation.
Healing is quicker, and cosmetic results are superior.
Most patients go home after only a few hours in recovery, or occasionally, after a single night in hospital. Recuperation is shorter, usually only several days to a week. The National Institutes of Health endorsed laparoscopic cholecystectomy in 1992 as a safe treatment equivalent to open surgery. Complications are uncommon. The most important risk is the potential for injury to the common bile duct.