da Vinci® Single-Site® Gallbladder Surgery

About

If you have severe gallbladder symptoms, your doctor may recommend surgery to remove your gallbladder. It’s an organ you can live without. Gallbladder removal is known as a cholecystectomy. It can be performed using open surgery through a large incision or with minimally invasive surgery (laparoscopy).

With traditional laparoscopy and multi-port da Vinci Surgery, surgeons operate through a few small incisions. With single incision traditional laparoscopy and da Vinci Single-Site Surgery, your surgeon operates through one small incision in the navel (belly button).



 

Our Team

Areas of Focus:
Colorectal Cancer, Gall Bladder, Hernia Repair, Thyroid
Areas of Focus:
Burn Surgery, Cholecystectomy (Gallbladder Removal Surgery), Colon and Small Bowel Surgery, Hernia Surgery, Minimally Invasive Surgery
Areas of Focus:
Acute Care Surgery, Hernia Surgery, Minimally Invasive and Open Repairs, Treatment of Breast Disease including Cancer, Surgical Treatment of Skin and Soft Tissue Disorders including Cancers, Minimally Invasive Adrenal, Spleen, Gallbladder and Gastointestinal Surgery
Areas of Focus:
Thyroid & Parathyroid Surgery, Minimally Invasive Hernia Surgery, Minimally Invasive Adrenal Surgery, Gallbladder Surgery, Varicose Vein Treatment

What to Expect

This procedure is performed using the da Vinci Surgical System – offering the latest in surgical and robotics technologies. The da Vinci System is beneficial for performing complex surgery. Your surgeon is 100% in control of the da Vinci System, which translates his or her hand movements into smaller, more precise movements of tiny instruments inside your body. da Vinci – taking surgery beyond the limits of the human hand.

Before Your Surgery

Receiving excellent care in a safe and comfortable environment is important to every patient facing surgery. It may be helpful to read the information provided so that you will arrive at the hospital prepared and know what to expect. You may also want a loved one to read this information so they will also know what to expect.

Knowing what to expect before, during and after gallbladder surgery may help you to feel more confident about the surgical experience.

In the days or hours leading up to surgery, medical tests are done by your doctor or nursing staff. The main goal is to make sure you are ready for surgery. The tests and health checks may include:

  • Blood tests: Checks your blood count, liver function and blood coagulation (how quickly your blood clots).
  • Abdominal ultrasound: A common test that checks for gallstones.
  • Health check: Your surgeon will ask questions about your health history. He/she will also ask about medications you may be taking and explain pain control options you may be offered after surgery. Your doctor or nursing staff will give you pre-surgery instructions to follow closely, such as not eating or drinking anything 4-8 hours before surgery.

    The day before or morning of surgery, your anesthesiologist will meet with you by phone or in person. The anesthesiologist is the doctor who sedates you - puts you to sleep - during surgery. He/she will review any allergies you have or medicine you may be taking, and explain what happens when you are put to sleep during surgery.

Day of Surgery

Receiving excellent care in a safe and comfortable environment is important to every patient facing surgery. It may be helpful to read the information provided so that you will arrive at the hospital prepared and know what to expect. You may also want a loved one to read this information so they will also know what to expect.

Knowing what to expect before, during and after gallbladder surgery may help you to feel more confident about the surgical experience.

The day before and day of surgery, your doctors and nurses will give you instructions about what to do to avoid problems with surgery. Common instructions and tips are listed below.

Instructions Before Surgery

  • Don't eat or drink anything the day of surgery
  • Bring your insurance card
  • Wear loose fitting clothes
  • Bring a list of any medications you are taking
  • Leave valuables with a loved one or at home
  • Make sure you have someone to drive you to and from the hospital

What Happens Next

Once you are at the hospital, a wristband will be placed on your arm with your name and other identifying information on it. A nurse will start an intravenous line (IV) in your arm. The IV sends fluids into your body through a thin tube. One of the liquids may be a medicine to help you relax before surgery.

Medical staff will wheel you into the operating room and you will then receive general anesthesia. The anesthesia puts you to sleep and allows you to stay asleep through surgery. Your surgeon will then remove your gallbladder.

FAQ

Everyone reacts to surgery and pain differently. Doctors and nurses often use a scale of 0 to 10 to measure pain (10 = worst pain, 0 = no pain at all). After surgery, you will be asked about your pain level often. Be completely honest about your pain and any other symptoms. Some patients may not have much pain at all, while others feel a lot of pain – everyone is different.

Narcotic Pain Medicine

Narcotics or opioids are often given to people in severe pain. Common side effects can include: sleepiness, lowered blood pressure, nausea and constipation.

Non-Narcotic Pain Medicine

Your doctor or nurse may also offer you non-narcotic pain medicine. These may include ibuprofen or naproxen. Non-narcotic pain medicine can also have side effects. Common side effects may include: upset stomach, bleeding in the stomach and retaining fluid.

Your doctor or nurse will let you know which foods to eat and which exercises to try after surgery, and which ones to avoid.

Diet

When you wake up from surgery and are alert, you will be given a small amount of liquid to drink. If your stomach doesn't get upset, your nurse will offer you some food to eat. Based on your post-surgery instructions, you should be able to eat and drink a normal and healthy diet within 1-2 days after surgery.1

Activity

While in the hospital, a nurse will help you to walk and get in and out of bed after surgery. Once you’re back home, you will also be asked to:

  • Slowly increase your activity, if you have no complications from surgery
  • Avoid strenuous activity
  • Avoid driving while/if on narcotic pain medicine
  • Avoid sex until your stitches, if any, are removed
  • Rest and sleep as you feel the need
  • Return to work when you feel you can, but consult with your doctor first

Recovery and getting back to your normal activities will depend on whether you had open surgery or minimally invasive surgery.

Your medical team will give you information on how to increase the chances of making your recovery a full success. You will also receive information about how to care for your incision(s).

Receiving excellent care in a safe and comfortable environment is important to every patient facing surgery. It may be helpful to read the information provided so that you will arrive at the hospital prepared and know what to expect. You may also want a loved one to read this information so they will also know what to expect.

Knowing what to expect before, during and after gallbladder surgery may help you to feel more confident about the surgical experience.

The day before and day of surgery, your doctors and nurses will give you instructions about what to do to avoid problems with surgery. Common instructions and tips are listed below.

Instructions Before Surgery

  • Don't eat or drink anything the day of surgery
  • Bring your insurance card
  • Wear loose fitting clothes
  • Bring a list of any medications you are taking
  • Leave valuables with a loved one or at home
  • Make sure you have someone to drive you to and from the hospital

What Happens Next

Once you are at the hospital, a wristband will be placed on your arm with your name and other identifying information on it. A nurse will start an intravenous line (IV) in your arm. The IV sends fluids into your body through a thin tube. One of the liquids may be a medicine to help you relax before surgery.

Medical staff will wheel you into the operating room and you will then receive general anesthesia. The anesthesia puts you to sleep and allows you to stay asleep through surgery. Your surgeon will then remove your gallbladder.

Receiving excellent care in a safe and comfortable environment is important to every patient facing surgery. It may be helpful to read the information provided so that you will arrive at the hospital prepared and know what to expect. You may also want a loved one to read this information so they will also know what to expect.

Knowing what to expect before, during and after gallbladder surgery may help you to feel more confident about the surgical experience.

In the days or hours leading up to surgery, medical tests are done by your doctor or nursing staff. The main goal is to make sure you are ready for surgery. The tests and health checks may include:

  • Blood tests: Checks your blood count, liver function and blood coagulation (how quickly your blood clots).
  • Abdominal ultrasound: A common test that checks for gallstones.
  • Health check: Your surgeon will ask questions about your health history. He/she will also ask about medications you may be taking and explain pain control options you may be offered after surgery. Your doctor or nursing staff will give you pre-surgery instructions to follow closely, such as not eating or drinking anything 4-8 hours before surgery.

    The day before or morning of surgery, your anesthesiologist will meet with you by phone or in person. The anesthesiologist is the doctor who sedates you - puts you to sleep - during surgery. He/she will review any allergies you have or medicine you may be taking, and explain what happens when you are put to sleep during surgery.

If you have gallbladder symptoms, your doctor will examine you and decide what treatment is needed, if any. If your symptoms are severe, your doctor may recommend surgery to remove your gallbladder – known as cholecystectomy. The gallbladder is an organ that you can live without.

Cholecystectomy can be performed using open surgery through a large incision or minimally invasive surgery.

Open Surgery

With open surgery, your surgeon makes a long abdominal cut/incision to reach your gallbladder. The incision must be large enough for your surgeon to fit his or her hands and surgical instruments inside your body. The open incision allows doctors to see and touch your organs while operating.

Minimally Invasive Surgery

The goal of minimally invasive surgery is to reduce your pain, hospital stay and recovery time. However, people who are obese or have a severe infection or inflammation in the gallbladder may not be candidates for minimally invasive surgery.

Traditional Laparoscopic Surgery: With laparoscopic surgery, your surgeon operates through a few small incisions. Long-handled instruments are inserted through the incisions. One of the instruments is a laparoscope – a thin, lighted tube with a tiny camera at the end. The camera takes images inside your body and sends them to a video monitor to guide doctors as they operate.

da Vinci® (Cholecystectomy) Surgery: Using the da Vinci® Surgical System, your surgeon makes just a few small incisions - similar to traditional laparoscopy. Minimally invasive da Vinci Surgery uses the latest in surgical and robotics technologies, and is beneficial for performing complex surgery. Your surgeon is 100% in control of the da Vinci System, which translates his or her hand movements into smaller, more precise movements of tiny instruments inside your body.

Single Incision Laparoscopic Surgery: With single incision laparoscopy, your surgeon operates through one small incision in the navel (belly button). As with traditional laparoscopy, a tiny camera sends images to a video monitor in the operating room to guide doctors as they remove your gallbladder.

da Vinci® Single-Site® Surgery: Another minimally invasive surgical option is da Vinci®Single-Site® Surgery. During da Vinci Single-Site Surgery, surgeons make one small incision in your belly button to remove your gallbladder – similar to single incision laparoscopy. The da Vinci System features a magnified 3D high-definition vision system. As a result, da Vinci enables your doctor to operate with enhanced vision and precision.

While gallstones are often found during tests for other health conditions, some common tests for finding gallstones and gallbladder disease are:1

Ultrasound: A technician glides a hand-held device over your stomach. The device sends sound waves to your gallbladder. The sound waves bounce off your gallbladder, liver, and other organs. The echoes make electrical impulses that create a picture of your gallbladder on a video monitor. If you have gallstones, the sound waves will also bounce off the stones and show their location.

Computerized tomography (CT) scan: An X-ray produces cross-section images of the abdomen. Your doctor reviews the images to find out if you have gallstones.

Cholescintigraphy (HIDA scan): A radioactive chemical or tracer is injected into a vein in your arm. Using imaging, the tracer is followed through your body to detect stones or problems with your gallbladder.

Endoscopic retrograde cholangiopancreatography (ERCP): During ERCP, a thin tube with a camera at the end is inserted down your throat to look for gallstones. If found, the stones can be removed during the test. You will be lightly sedated, so it will not be painful.

Blood tests: Blood tests may be performed to look for infection, obstruction, pancreatitis, or jaundice.

Main Causes

Your gallbladder may cause symptoms if something blocks the flow of bile through your cystic duct. The most common cause of a blockage is a gallstone. Doctors believe stones form when bile has too much cholesterol or not enough bile salts. Stones can also form if the gallbladder does not empty correctly. And, just having gallstones can cause more gallstones to form.

Other Causes & Risk Factors

There are other common causes for gallstones, including:

  • Gender: Women are twice as likely as men to have gallstones. Extra estrogen from pregnancy, hormone replacement therapy, or birth control pills may raise cholesterol levels in bile and decrease gallbladder movement.
  • Genetics: Gallstones often run in families.
  • Weight: Even being slightly overweight raises your risk for gallstones. Obesity is a major risk factor for gallstones.
  • Diet: A diet high in fat and cholesterol and low in fiber can cause gallstones to form.
  • Rapid weight loss: Rapid weight loss, fasting and “crash” dieting can cause your liver to release extra cholesterol, which can cause gallstones.
  • Age: People over age 60 are more likely to develop gallstones.
  • Ethnicity: Native Americans and Latino men have higher rates of gallstones.
  • Cholesterol-lowering drugs: Drugs that lower your cholesterol levels can increase the amount of cholesterol secreted into bile, which increases the risk of gallstones.
  • Diabetes: People with diabetes often have high levels of fatty acids called triglycerides. These fatty acids may increase the risk of gallstones.

The cause of pigment gallstones is not fully understood. These stones tend to form in people who have liver cirrhosis (scarring of the liver), biliary tract infections, or hereditary blood disorders where the liver makes too much bilirubin (a waste product).

Signs and symptoms of gallbladder disease are often caused by gallstones that block your bile ducts. Gallstones occur when bile hardens in your gallbladder.

Gallbladder symptoms are sometimes called "gallbladder attacks" because they can occur without warning. Gallbladder attacks often happen at night or after a high fat meal.

Common Symptoms

  • Steady pain in upper right side of your stomach
  • Pain increases quickly and lasts 30 minutes to several hours
  • Pain between your shoulder blades
  • Pain under your right shoulder

If your symptoms get worse or include a fever, see a doctor immediately. An attack often goes away when gallstones move, but your gallbladder can become infected and rupture if the blockage remains. That's why it is important to let your doctor know if you think you had a gallbladder attack.

Severe Symptoms

See a doctor immediately if you have any of the following symptoms or if your symptoms get worse:

  • Pain that lasts more than 4 hours
  • Nausea and vomiting
  • Chills or fever
  • Yellowish discoloration of the skin or whites of the eyes
  • Clay-colored stools

Asymptomatic Stones

If you have gallstones but no symptoms, these gallstones are called "asymptomatic stones". They do not affect how your gallbladder, liver, or pancreas works.

If you are facing gallbladder surgery, you may have a lot of questions, such as:

What is a gallbladder?

Your gallbladder is a small pear-shaped organ under your liver. Your gallbladder and several ducts (tubes) are part of the biliary system.

Cholecystectomy

What does your gallbladder do?

Your gallbladder acts as a storage tank for bile. Bile, also known as gall, is a fluid made by your liver to help digest fat. As your stomach and intestines digest food, your gallbladder releases bile through the common bile duct.

Other parts of your biliary system include:

  • Hepatic Bile Ducts: Carry bile out of the liver
  • Cystic Duct: Takes bile from the liver to store in the gallbladder
  • Common Bile Duct: Takes bile from cystic and hepatic ducts to the small intestines
  • Pancreatic Duct: Carries digestive enzymes out of the pancreas

Can I live without my gallbladder?

You can live without your gallbladder. Similar to your tonsils, it serves a purpose but you can live a normal life without it.

Gallbladder disease is very common, but the symptoms and causes can vary from person to person. It is important to know the common signs of gallstones or gallbladder disease and to see your doctor about any symptoms that worry you. Only a doctor can diagnose these conditions.

If your family doctor or general practitioner believes there is a problem with your gallbladder, you may be referred to a doctor or surgeon who specializes in the digestive system.

If you have gallbladder disease and want to learn more about the symptoms, causes, treatments and surgical options, click on the link below. Hopefully, this detailed information will help you to make the right decision based on your situation.

Potential risks of a cholecystectomy procedure include:

  • Injury to bile ducts, liver, pancreas
  • Injury to small or large intestine
  • Pancreatitis (inflammation of the pancreas)

In addition to the above risks, there are risks related to minimally invasive surgery, including da Vinci Single Site Cholecystectomy, such as multiple incisions, conversion to another surgical technique, urinary retention and hernia (bulging tissue) at the incision site.

da Vinci Surgery with Single-Site® Instruments and accessories is cleared for use in gallbladder removal, and for hysterectomy and ovary removal for benign conditions. Patients who bleed easily, have abnormal blood clotting, are pregnant or morbidly obese are not candidates for minimally invasive surgery, including da Vinci Surgery with Single-Site® Instruments. The safety and effectiveness of this device for use in the performance of general laparoscopic abdominal surgery procedures have not been established.

All surgery presents risk, including da Vinci Surgery. Results, including cosmetic results, may vary.  Serious complications may occur in any surgery, up to and including death. Examples of serious and life-threatening complications, which may require hospitalization, include injury to tissues or organs; bleeding; infection, and internal scarring that can cause long-lasting dysfunction or pain. Temporary pain or nerve injury has been linked to the inverted position often used during abdominal and pelvic surgery. Patients should understand that risks of surgery include potential for human error and potential for equipment failure. Risk specific to minimally invasive surgery may include: a longer operative time; the need to convert the procedure to other surgical techniques; the need for additional or larger incision sites; a longer operation or longer time under anesthesia than your surgeon originally predicts.  Converting the procedure to open could mean a longer operative time, long time under anesthesia, and could lead to increased complications. Research suggests that there may be an increased risk of incision-site hernia with single-incision surgery. Patients who bleed easily, have abnormal blood clotting, are pregnant or morbidly obese are typically not candidates for minimally invasive surgery, including da Vinci Surgery. Other surgical approaches are available. Patients should review the risks associated with all surgical approaches. They should talk to their doctors about their surgical experience and to decide if da Vinci is right for them. For more complete information on surgical risks, safety and indications for use, please refer tohttp://www.davincisurgery.com/da-vinci-surgery/safety-information.php

 

The da Vinci System features a magnified 3D high-definition vision system coupled with flexible Single-Site instruments. These features enable your doctor to operate with enhanced vision and precision.

With da Vinci Single-Site Surgery, your gallbladder is removed through a single small incision in your belly button similar to traditional single-port laparoscopy. Patients who choose da Vinci Single-Site Surgery experience virtually scarless results.1

As a result of da Vinci technology, da Vinci Single-Site Cholecystectomy offers the following potential benefits:

  • Low rate of major complications
  • Low conversion rate to open surgery
  • Virtually scarless results
  • High patient satisfaction
  • Minimal pain

da Vinci Single-Site Cholecystectomy offers the following potential benefits, similar to single-incision laparoscopy:

  • Low rate of major complications
  • Low blood loss
  • Low rate of wound infection
  • Short hospital stay
  • Virtually scarless surgery

When considering surgical options, many patients have concerns about safety. Some patients may question whether da Vinci Surgery is as safe as open surgery or traditional laparoscopic surgery. In fact, the da Vinci System has been used successfully worldwide in approximately 1.5 million various surgical procedures to date.

da Vinci offers multiple redundant safety features. First and foremost, the da Vinci System cannot be programmed, nor can it make decisions on its own. Instead, the da Vinci System requires that every surgical maneuver be performed with direct input from your surgeon.

da Vinci System SI Surgeon Console
The da Vinci System surgeon console

 

With da Vinci Surgery, as with traditional surgical methods, you are under the care of your surgeon and his or her supporting team. Your surgeon requires at least one assistant at your side during surgery. This team-member assists with tasks such as switching between instruments, to provide your surgeon with the optimal da Vinci instrument for the procedure step being performed.

Just a few feet away, your surgeon operates using the console controls. As your surgeon maneuvers the controls, da Vinci scales, filters and translates his or her wrist and finger movements into precise movements of miniaturized instruments at the patient-side cart.

Tremor reduction minimizes unintended movements, which means that da Vinci instruments can move in a more precise manner than a human hand. And because the da Vinci Patient Cart does the work of holding and repositioning the instruments and camera – and because your surgeon operates while seated – surgeons can experience much less fatigue in performing surgery with the da Vinci System.

Finally, during the course of an operation, the da Vinci System will perform millions of safety self-checks. The System is designed to be fail-safe, which means that in the event of power interruption or a safety-check failure, the System is designed to shut down safely, allowing the surgeon to remain in control of the procedure.

 
da Vinci EndoWrist Instrumentda Vinci® EndoWrist®Instrument

The da Vinci Surgical System is the only commercially available technology that can provide surgeons with the precision, dexterity and control of traditional open surgery, while only requiring 1-2 cm incisions.

da Vinci Surgical System consists of an ergonomically designed surgeon's console, a patient cart with four interactive robotic arms, a high-performance vision system and patented EndoWrist® instruments.

da Vinci System SI Whole System Standing Surgeonda Vinci Surgeon Console and Patient Cart

At the da Vinci console, your surgeon operates while seated comfortably, viewing a highly magnified 3D image of the body’s interior. To operate, the surgeon uses master controls that work like forceps.

As your surgeon manipulates the controls, da Vinci responds to your surgeon’s input in real time, translating his or her hand, wrist and finger movements into precise movements of miniaturized instruments at the patient-side cart.

 

 

da Vinci System SI 3D Vision Intuitive Movement

da Vinci translates and refines your surgeon's hand movements.

da Vinci 's patient cart holds up to three EndoWrist instruments and one 3D camera. To access the target anatomy, your surgeon introduces the precisely controlled EndoWrist®instruments into the body through a series of dime-sized incisions. A broad range of instrument types are available to help your surgeon perform specialized surgical tasks with precision and control.

 

The da Vinci Surgical System is a sophisticated robotic platform designed to expand your surgeon’s capabilities and offer a state-of-the-art minimally invasive option for major surgery.

Instead of a large incision used in open surgery, da Vinci surgeons operate through a few small incisions - similar to traditional laparoscopy. The da Vinci System features a magnified 3D high-definition vision system and tiny wristed instruments that bend and rotate far greater than the human wrist.

da Vinci Surgical System SI Seated Surgeon Nurse at Cart

Although it is often called a “robot”, the da Vinci System cannot move or operate on its own. Your surgeon is 100% in control of the System. The latest robotic and computer technologies scale, filter and seamlessly translate your surgeon's hand movements into precise micro-movements of the da Vinci instruments

The unique features of the da Vinci System enable your surgeon to operate with enhanced vision, precision, dexterity and control.

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If you would like more information about da Vinci® Single-Site® Surgery, gallbladder removal, minimally invasive procedures or other medical information, the links below may be helpful.

The above external resources are provided as an information service only. Information contained herein does not constitute medical advice and is in no way warranted by the provider to be complete or accurate. Intuitive Surgical makes no judgment about the providers of these pages and is not responsible for the accuracy and/or completeness of the information contained herein.