Where will my incisions be and do I need to do anything special to take care of them?

Once it has been determined that a patient’s symptoms are related to gallbladder disease, laparoscopic cholecystectomy is often recommended.

Surgery to remove the gallbladder is completed laparoscopically (laparoscopic cholecystectomy) 99% of the time. This means it is completed with small incisions (usually 4 incisions – each about 1/4″-1/2″ in size) over the upper abdomen. The largest of the incisions is usually at the top middle of your abdomen. This incision is bigger to allow the gallbladder to be removed from your abdomen and can sometimes be more uncomfortable than the other incisions. Three smaller incisions are made – one in the right upper abdomen, one on the right side of the mid-abdomen, and one at the belly button. Sometimes the incision that is hidden at the belly button can be uncomfortable because of it’s location in a sensitive area. 

The surgery proceeds by inflating the abdomen with a gas and clipping the gallbladder duct and artery. This allows the gallbladder to be detached from it connections to surrounding structures. The gallbladder is removed via a small bag that is placed into the belly.

The incisions are closed with stitches placed underneath the skin that dissolve over time and are then covered with surgical glue.  This glue will flake off in about 1-2 weeks.  No Band-Aid or gauze is needed and you don’t need to do anything special to take care of these wounds. Some patients prefer to have a Band-Aid over their incisions and this is safe to do if you prefer it. Showering is safe right away after surgery. 

The best treatment of pain after gallbladder surgery is a combination approach where medications work in different ways to strengthen the overall effect. In most circumstances we recommend Ibuprofen 600mg and Tylenol 650mg – both taken every six hours. This helps limit the amount of stronger opioid pain medication needed, if any at all. Opioid pain medications can be used for any significant pain after use of the other medications. We aim to limit the amount of opioids a patient requires as these medications can be constipating, create changes mental state (“loopiness”, sleepiness, inability to focus), are not safe to use when driving or during certain other activities, and can lead to addiction when improperly used. 

Ice is an appropriate adjunct to medication for pain after gallbladder surgery. Ice on your incisions may reduce pain in this area. Make sure to ice for only 20 minutes at a time to avoid frostbite on your skin.

Check out this discussion of what to expect after laparoscopic gallbladder surgery for more information.