Laparoscopic Cholecystectomy (Nursing)

by Rhonda Lawes, PhD, RN

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      Slides Gallbladder Cholecystectomy.pdf
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      Reference List Medical Surgical Nursing and Pathophysiology Nursing.pdf
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    00:00 So, let's start with the kinder, gentler version.

    00:04 We're gonna look at the laparoscopic cholecystectomy.

    00:06 So, a laparoscopic camera, that's what you see in this first one, is inserted into the abdomen, so right near the belly button or the umbilicus, if you prefer the professional term.

    00:18 But right here, we're gonna put in a laparoscopic camera.

    00:22 Now, you do have to break the skin, obviously, to get underneath there, but it's a very small incision compared to an open chole.

    00:30 Now, next we have three other instruments so we'll put them through 2-3 other small holes.

    00:35 So, at the most, your patient will likely have four incisions in a laparoscopic cholecystectomy.

    00:42 Now, in order to do this, they place these clips on the cystic artery.

    00:46 That's a good thing. We're getting ready to clip and remove.

    00:51 So, they put clips with these special tools.

    00:54 They place these clips on the cystic artery to stop any bleeding when it's removed.

    00:59 So, they've got the artery clipped and the cystic duct.

    01:02 Okay, so you're originally plumbed to get blood supply and to dump bile out through the cystic duct.

    01:08 That's why they have to put clips on both of them.

    01:11 They're a little more sophisticated, but the same concept as a chip clip that you use on your snacks.

    01:17 Now, the gallbladder is cut away from the duct, so they're gonna sever that.

    01:22 That's relatively simple, but then sometimes, they really have to almost peel away the gallbladder from the liver.

    01:30 So, they'll likely have to use some electrocautery.

    01:32 That gallbladder and that liver had been best friends your whole life.

    01:37 That's why it's sometimes a delicate procedure to remove that gallbladder from the liver.

    01:43 Okay, now, the gallbladder's put in a holder and they remove it through the same incision right near the belly button.

    01:50 I mean, this is amazing what a surgeon can do and it's such an easier recovery.

    01:55 Now, I want you to know that you explain to your patient.

    01:58 Hey, the average time of surgery is gonna vary.

    02:00 So, while your family is waiting for you in the waiting room, there's gonna be a period of time that seems like a fairly wide range, because it just depends on how severe the disease is and how difficult it is to remove the gallbladder.

    02:13 Now, sometimes during the laparoscopic cholecystectomy, it just can't be accomplished this way so the patient will have to be opened up.

    02:20 The surgeon will have to make the incision to remove the gallbladder.

    02:23 Patients are educated about this before they receive the procedure and they know it's an option, but the surgeon will try to keep it to a laparoscopic procedure.

    About the Lecture

    The lecture Laparoscopic Cholecystectomy (Nursing) by Rhonda Lawes, PhD, RN is from the course Gallstones and Cholecystitis: Treatment (Nursing).

    Included Quiz Questions

    1. Laparoscopic camera is inserted into the abdomen
    2. Small incisions are made
    3. Clips are placed on the cystic artery and duct
    4. The surgery takes less than an hour
    5. Laparoscopic camera is inserted through the mouth

    Author of lecture Laparoscopic Cholecystectomy (Nursing)

     Rhonda Lawes, PhD, RN

    Rhonda Lawes, PhD, RN

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