By Dr Thomas Hanna MBChB, FRCS, MSc, PGCE, PhD and Dr Peter Swan MBChB, FRACS
Compass Surgical | MacMurray Centre, Auckland
If you and your surgeon have decided that gallbladder removal is the right option, the next question is often:
“What actually happens during the operation?”
The good news is that gallbladder surgery is one of the most commonly performed operations worldwide and, for most patients, is a safe and straightforward procedure with a predictable recovery.
Today, the vast majority of gallbladder operations are performed using a minimally invasive technique known as laparoscopic surgery, often called keyhole surgery.
At Compass Surgical, laparoscopic gallbladder surgery is one of the most common procedures we perform. Understanding what happens before, during and after the operation can help patients feel informed and confident about their decision.
If you’ve been following this series, we’ve already discussed gallstones, biliary dyskinesia, gallbladder polyps, and when surgery may be appropriate. This article focuses on the operation itself.
The medical term for gallbladder removal is cholecystectomy.
A laparoscopic cholecystectomy involves removing the gallbladder through several small incisions in the abdomen rather than a large traditional cut.
The operation is performed under a general anaesthetic, meaning you are asleep throughout the procedure.
A small camera and specialised instruments are inserted through the incisions, allowing the surgeon to perform the operation while viewing a magnified image on a monitor.
The gallbladder, together with any stones it contains, is then removed.
Importantly, the stones are not removed separately. The gallbladder is removed because leaving it behind would allow stones to continue forming.
Before laparoscopic surgery became widely available, gallbladder removal required a much larger incision beneath the rib cage.
While open surgery is still occasionally required in complex situations, laparoscopic surgery has become the standard approach because it offers several advantages:
For most patients, these benefits make laparoscopic surgery the preferred option. If you would like to learn more about laparoscopic gallbladder surgery or discuss whether surgery may be appropriate for you, visit the Compass Surgical Gallbladder Surgery page or arrange a consultation with one of our surgeons.
Before surgery, you will meet with your surgeon to discuss:
This consultation is an opportunity to ask questions and ensure you feel comfortable with the proposed treatment plan.
Depending on your medical history, additional tests may occasionally be required before surgery.
Patients often find it helpful to understand the operation step by step.
Step 1: General Anaesthetic
You are given a general anaesthetic and will be asleep throughout the procedure.
Step 2: Small Incisions
Several small incisions are made in the abdomen.
Carbon dioxide gas is used to gently inflate the abdominal cavity, creating space to work safely.
Step 3: Identifying the Gallbladder Safely
A camera and specialised instruments are inserted through the small incisions.
One of the most important safety principles in modern gallbladder surgery is obtaining the Critical View of Safety. This recognised surgical technique helps ensure the correct structures are identified before they are divided.
Step 4: Removing the Gallbladder
The gallbladder is carefully separated from the liver and removed through one of the small incisions.
Step 5: Closing the Wounds
The small wounds are closed and covered with dressings.
The procedure usually takes between 30 and 90 minutes, depending on the complexity of the surgery and the degree of inflammation present.
Most patients spend far longer recovering from the anaesthetic than they do in the operating theatre.
Patients sometimes worry about what happens if severe inflammation, scarring or unexpected findings are encountered.
Fortunately, this is uncommon.
Occasionally the safest option may be to alter the planned procedure. This could include:
Conversion to open surgery is not considered a complication or failure. Rather, it is a decision made when it is believed to be the safest option for the patient.
Many patients return home on the same day as surgery.
Others stay overnight, particularly if surgery is performed later in the day or if additional observation is appropriate.
Most patients are pleasantly surprised by how routine the day feels. Many are walking, eating, drinking and preparing to go home within hours of surgery.
Yes.
The liver continues producing bile after gallbladder removal.
Instead of being stored in the gallbladder, bile flows directly into the intestine.
Most people notice little or no long-term difference in digestion and go on to live completely normal lives.
Gallbladder surgery is common, but every patient is different.
Previous surgery, inflammation, anatomy and underlying health conditions can all influence the complexity of an operation.
At Compass Surgical, we believe good outcomes depend on careful patient selection, thoughtful decision-making and meticulous surgical technique.
Our goal is not simply to perform an operation.
Our goal is to perform the right operation, for the right patient,
Compass Surgical was founded on a commitment to:
We work closely with the multidisciplinary team at the MacMurray Centre, including gastroenterologists, upper gastrointestinal surgeons, colorectal surgeons, dietitians, psychologists and physiotherapists to ensure patients receive comprehensive care tailored to
Understanding what happens during surgery is only part of the picture.
Every operation carries potential risks and benefits. An important part of the decision-making process is understanding those risks and how surgeons work to minimise them.
In the next article, “What Are the Risks of Gallbladder Surgery?”, we’ll discuss the recognised complications of gallbladder removal, explain how uncommon serious complications are, and outline the safeguards used to maximise patient safety.
How many cuts are made during gallbladder surgery?
Most laparoscopic gallbladder operations involve four small incisions, although the exact number can vary.
How long does gallbladder surgery take?
Most operations take between 30 and 90 minutes, depending on complexity.
Will my gallstones be removed?
Yes. The gallstones are removed together with the gallbladder.
Is gallbladder surgery major surgery?
It is a significant operation performed under general anaesthetic, but it is also one of the most commonly performed abdominal operations and is usually associated with a relatively quick recovery.
Can gallstones come back after gallbladder removal?
Gallstones within the gallbladder cannot recur because the gallbladder has been removed. Rarely, stones can form within the bile ducts later in life, but this is uncommon.
Article 1 of 8 – What Are Gallstones and What Symptoms Do They Cause?
Article 2 of 8 – Do Gallstones Go Away Without Surgery?
Article 3 of 8 – What Is Biliary Dyskinesia?
Article 4 of 8 – What About Gallbladder Polyps?
Article 5 of 8 – What Is Laparoscopic Gallbladder Surgery?
Article 6 of 8 – What Are the Risks of Gallbladder Surgery?
Article 7 of 8 – Recovery After Gallbladder Surgery
Article 8 of 8 – Why Your Follow-Up Appointment Matters After Gallbladder Surgery?
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Dr Thomas Hanna MBChB, FRCS, MSc, PGCE, PhD
Dr Thomas Hanna is a general and transplant surgeon practising in Auckland. He trained in the United Kingdom before moving to New Zealand in 2019. He has specialist interests in gallbladder surgery, hernia repair, minimally invasive surgery and complex abdominal surgery. Tom is a founding partner of Compass Surgical and is committed to patient-centred surgical care, clear communication and surgery performed with integrity.
Dr Peter Swan MBChB, FRACS
Dr Peter Swan is a general surgeon practising in Auckland with expertise in gallbladder surgery, hernia repair and general surgical conditions including lumps and bumps. He is a founding partner of Compass Surgical. Peter’s practice focuses on practical, evidence-based advice, careful patient selection and personalised treatment.
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