Operation after operations
The first trocar is inserted in an open manner (according to Hasson) outside the area of old scars, the adhesions of the intestine and omentum with the abdominal wall are separated under visual control, and only then the bubble is released. A typical scenario is elective removal of the bladder 6–8 weeks after cholecystostomy performed for severe acute cholecystitis in a high-risk patient: the drain is removed and the bladder is removed safely during the cold period. This also includes operations after cesarean section, appendectomy, and hernia repair. Recovery is standard.
Indications
- cholelithiasis with attacks of biliary colic - planned removal;
- acute cholecystitis (phlegmonous, gangrenous) - urgent surgery;
- chronic calculous cholecystitis, “porcelain” bladder, polyps more than 10 mm;
- asymptomatic stones in diabetic and pre-bariatric patients (if indicated);
- condition after choledocholithiasis and pancreatitis caused by stones.
Why is the entire bubble removed?
It is impossible to remove “only stones”: the changed bladder forms them again within 1–2 years, so the world standard is cholecystectomy. After surgery, bile enters the intestines directly; digestion in the vast majority of patients completely adapts within a few weeks while following a diet in the first 1–2 months. Postponing planned surgery during repeated attacks is dangerous: each new episode threatens acute cholecystitis, pancreatitis and migration of stones into the duct, which complicates treatment.
Benefits of laparoscopy
Laparoscopic access is the standard of modern abdominal surgery: instead of a 10–20 cm incision, 3–4 punctures are left, the pain after surgery is much less, the patient gets up on the day of surgery and is discharged after 1–2 days, the risk of wound infection, hernias in the scar and adhesions is several times lower, and the enlargement of the camera allows you to operate more accurately. In the clinics below, operations are performed by surgeons with extensive laparoscopic experience; hospital (SKD) is included in the price according to the price list.
