Day case laparoscopic cholecystectomy (NHS)
What is a Laparoscopic Cholecystectomy?
The term cholecystectomy simply means removal of the gallbladder. Although gallblladders were traditionally removed through a fairly big cut in the tummy, Bristol Laparoscopic Associates have been removing gallbladders by keyhole techniques (laparoscopic) since 1989. This involves making 4 small incisions (½cm) in your abdomen. The operation is performed under general anaesthesia.
My operation is planned as a ‘day-case’, what does that involve?
This means that you will come to hospital in the morning of the operation day, have the operation and once you have recovered, allowed home on the same evening.
Suitability for day-case surgery is based on your medical fitness, distance of your home from the hospital, social circumstances. Motivated patients do much better. The assessment of your day case suitability is made at first in the clinic and subsequently at a pre-admission clinic (see below) and only after you have agreed to it.
There are lots of benefits having the surgery performed as a day case; the surgeon and anaesthetist will be consultants, the risks of infection are reduced and you can take the pain killers without having to wait for a nurse.
What can I expect to happen before I come to hospital?
You will receive a letter from the hospital asking you to come up to the hospital for a few hours where a nurse and doctor will examine you at a pre-admission clinic. At the clinic you will be asked questions about your general health and you will also have some tests and investigations, which may include blood tests, chest X-ray and a heart trace (ECG). These are routine investigations that are required for most patients before a general anaesthetic.
You will also be given details about your proposed admission. You will also be given the opportunity to ask any questions about your condition, the operation and the intended future admission. You will be asked to sign a consent form (if not already done so) to give permission to the doctors to carry out the operation.
What will happen when I come into hospital?
We will ask you to ring the ward on the morning of your planned admission to make sure that there is a bed available. However, if your admission is scheduled to the Day Surgery Unit, you will be asked to attend the DCU at 7:30 am. We will ask you to fasted for 6hrs prior to the operation i.e., have nothing to eat or drink from midnight.
You will be admitted by the nursing staff. The surgeon and anaesthetist will see you before your operation.
After the operation you will be allowed to drink and will be given something light to eat. Your surgeon will come to see you about four hours after you have returned to the ward.
If the surgeon is satisfied with your recovery you will be allowed home that same evening provided that you have someone to look after you for the first night. As there is always a small possibility that you may need to stay in hospital overnight it is advisable that you bring some nightwear and toiletries with you.
What will happen when I am discharged home?
Because you will have had a general anaesthetic it is vital that you make arrangements prior to coming into hospital for somebody to collect you, preferably by car. If you had a day-case operation, it is also requested that you have somebody to stay with you for at least twenty-four hours.
You will be sent home with some painkiller tablets. You will also be given instructions of when you may take them.
You will have small waterproof dressings on you wounds, which we advise that you try and leave on for about five days. You can have a shower or a bath with the dressings on. Peal the dressings off after five days. The stitches are on the inside of your wounds and will dissolve on their own. You may have your wounds closed with special glue, in which case there may be no dressings at all, and you would be able to shower or bath at any time.
What can I eat? and can I drink alcohol?
You may find that you feel a bit sickly for the first day after your operation. Again this is normal and is usually due to the effects of the anaesthetic. During this time make sure that you drink plenty of fluid. After that, you may eat and drink as you wish.
Alcohol is not advised in the first 48 hours after your surgery.
When can I drive?
We recommend that you do not drive a car for at least a week. It is also advisable that you contact your insurance company to ensure you are covered in the event of an accident.
When can I return to work?
The following time absent from work is recommended:
Office or sedentary work: 1-2 weeks
Manual Work: 3-4 weeks
You will know when you feel ready to return to work. You will be given a sick note to cover the time you have been in hospital but you will then need to get sick notes from your GP to cover any further time you need off work.
Will I need to come back to the hospital for follow up?
Your GP will be fully informed of your progress regarding your hospital admission, surgery. If there are any problems we will see you as soon as possible. Otherwise we do not routinely make a follow up appointment.
Who and how do I contact anyone if I need to?
You will be given a list of the people you should contact anytime if you are concerned about anything following your operation. You can contact the ward of admission, your GP or if you feel realy poorly and have tummy pain you may call back to the casualty department (A&E) of the hospital.