Laparoscopic cholecystectomy

Welcome

At Mater Health Services we understand that being in hospital can be a very stressful experience. This booklet aims to alleviate some of your concerns in keeping with our Mission to offer compassionate, quality care that promotes dignity while responding to patients’ needs. It explains briefly the events that may occur during your visit and the things to expect when you are discharged from the hospital.

It is, however, only a guideline as each person may require differing treatments.

If you have any questions about your treatment please ask your doctor or nurse. Our pastoral care team offers a caring support network to all patients. The dedicated members of this team will visit you during your stay and are available at your request to discuss any anxieties or problems that you may have.

Laparoscopic cholecystectomy

A laparoscopic cholecystectomy is the surgical removal of the gallbladder through a scope. This operation requires several small incisions into the abdomen to allow the insertion of the surgical instrument and a small videa camera. After the initial incisions, the surgeon will inflate the abdominal cavity with carbon dioxide. The camera sends a  magnified image from inside the body to a video monitor, giving the surgeon a close-up view of the organs and tissues. The surgeon watches the monitor and performs the operation by manipulating the surgical instruments through separate small incisions. This type of surgery requires meticulous surgical skill. Straightforward cases can be done in about an hour.

Expected length of hospital stay

The day following your surgery you will be transferred anytime from 7 am to the Transit Lounge then discharged at the pre-arranged time.

After your operation

• You will stay in the recovery room within the theatre suite after the operation while you waken from the anaesthetic. You will be transferred on your bed to your room in the Day Procedure Unit.
• You will have four to five small dressings on your abdomen. You may have a drain in place which will remove excess fluid from your wound. Your doctor will usually order this drain to be removed the day after your surgery.
• Your nurse will take frequent observations of your vital signs (e.g. pulse) and dressings for several hours after the surgery. These will become less frequent as you recover but remain regular until you leave hospital.
• You will be resting in bed immediately after your surgery.

The following exercises help prevent complications suchas chest infections and blood clots in your legs. You should do these every hour that you are awake while resting in bed.

Breathing exercises: take five long and slow deep breaths. Each breath should be deeper than the previous breath. Think about getting the air to the very bottom of your lungs.

Circulation exercises: firmly move your ankles up and down to stretch and contract your calf muscles.

• When you are ready to get out of bed for the first time following your surgery it is important that you have assistance.
• About four hours after you return to the ward, your nurse will assist you to have a wash.
• You may have small amounts of water or ice to suck, then progress from fluids to a normal diet as tolerated.
• If you have pain or nausea, please tell your nurse as there are medications which can be given to relieve this. It is important to be comfortable.
• The drip (IV) is necessary to maintain your fluid intake. This will be removed when you are tolerating adequate amounts of oral fluids.

In preparation of going home

• Your nurse will discuss your follow-up appointment and any discharge arrangements that have been made with you.
• Discharge information will be given to you and your nurse will discuss this with you. If you have any questions, please do not hesitate to ask.
• A full assessment will be made prior to transferring you to the Transit Lounge in preparation for discharge to ascertain your condition is safe for you to go home.
• You will be transferred to the Transit Lounge anytime from 7 am, the morning following your surgery. This is where you will wait for your transportation home.
• Those picking you up will find the Transit Lounge:
  • on level 4 Mater Hospital Brisbane
  • just inside the ambulance entrance
  • opposite the waiting area for the Emergency Department.
• It is still recommended to perform deep breathing, coughing and leg exercises while you are resting in bed.
• You will recommence your normal medications.
• Please tell the nursing staff if you have any pain so that they may give you medication to help relieve it.
• You may walk as much as you like, short frequent walks are a great way to start.
• You may shower yourself. If your wounds are open, pat them dry with a towel. For dressings still over port sites/wounds, leave them intact for 48 hours and then they can be removed.
• You may have food and fluids as desired.
• Your observations (temperature, pulse) and your wounds will be checked before you are discharged.

Discharge advice following laparoscopic cholecystectomy

What to expect

• You will experience some pain at your wound site. This should be relieved by oral analgesia e.g. Paracetamol however do not take any more than eight tablets within a 24 hour period.
• You may experience shoulder tip pain for two to three days. This should be relieved by simple pain relief (as above). Heat packs may also help.
• The wound may look slightly reddened and raised.
• There should be no discharge from the wounds.
• You can remove the dressings over your wounds 48 hours after your surgery.
• You should be mobilising freely, increase your activity as you feel able.
• You should be able to tolerate a normal diet.
• Post operative lethargy often lasts for a month or more. This is normal.

What to avoid

• high fat foods
• excessive activity/heavy lifting
• over exertion.

Contacts

Please contact either your General Practitioner (GP); the Mater Hospital Brisbane Procedure Unit on 07 3163 8324; or the Mater Hospital Brisbane Emergency Department on telephone 07 3163 8111, IMMEDIATELY if you experience any of the following after discharge:

• you notice discharge from the wound
• you feel feverish
• pain is not relieved with simple analgesia e.g. Panadol/Panadeine—do not take any more than eight tablets within a 24 hour period
• nausea and vomiting which does not settle
• any other concerns.

Mater Hospital Brisbane

Raymond Terrace, South Brisbane Q 4101

Telephone: 07 3163 8111

Acknowledgments

Staff of Mater Hospital Brisbane, Raymond Terrace, South Brisbane, Q 4101

© 2010 Mater Misericordiae Ltd. ACN 096 708 922.

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