What is minimally invasive gallbladder surgery?

  Laparoscopic cholecystectomy is indicated for gallbladder stones, gallbladder polyps, acute and chronic cholecystitis, etc. With its minimally invasive advantages such as small trauma, light pain, quick recovery, almost no scar on the abdominal wall and short hospital stay (discharged in 3 days after surgery), it has been rapidly promoted and applied in China in the past 20 years and has become the treatment of choice for gallbladder diseases. It accounts for about 91% of all gallbladder surgeries in China. However, many hospitals still use 6 metal titanium clips to clamp the gallbladder duct and gallbladder artery during surgical operation, and at least 4 metal titanium clips are left in the abdominal cavity for a long time after surgery.  (1) Titanium clips produce artifacts that affect future ultrasound, CT, MRI and other examinations and diagnoses.  (2) The “U” shaped structure of the metal titanium clip itself makes it difficult to tighten the tissue, especially in inflamed and edematous bile ducts, which are prone to loosening.  Recent loosening and slipping from the biliary artery or bile duct can lead to bleeding or biliary fistula; distant dislodgement and wandering into the common bile duct can form catarrh in the common bile duct and even lead to obstructive jaundice. If detached and implanted in the abdominal aorta, uterus, right ovary, bladder, etc. can lead to serious complications. It is often reported in domestic and foreign medical journals.  (3) Titanium clips have an irritating and longer-term stimulating effect on adjacent liver tissue cells.  The use of silk ligation of the gallbladder duct and gallbladder artery requires multiple knots, which is tedious and time-consuming to operate. Hem-o-lok ligature clips, which are non-absorbable multi-polymer plastic material, are used and remain in the abdominal cavity as a foreign body. We apply electrocoagulation to close the gallbladder artery and clip only one Tyco bioclip, which is made of polyglycolic acid and polyglycolic carbonic acid and is completely absorbed in about 2-3 months, respectively, after which no foreign body remains in the abdominal cavity. We have been using it clinically for more than ten years after research trials. It is well proven that it not only simplifies the operation process, shortens the operation time, reduces the operation consumables and medical expenses, but also after 3 months of operation, the abdominal cavity can be drawn up by the biological Tyco clip after the dissection, and the gallbladder duct and blood vessels are closed intact, and no foreign body is left in the abdominal cavity. Moreover, all complications arising from the use of titanium clips were avoided. The results are satisfactory. It has been applied in more than ten hospitals in China. Several papers were published in the Journal of Laparoscopy, Chinese Class Medical Journal and SCI International Issue X around 2010. In 2014, he was awarded the third prize of scientific and technological achievements of the whole army. We hope to benefit the society widely.