What is the cause of post-laparoscopic shoulder pain after laparoscopic cholecystectomy surgery?

Post-laparoscopic shoulder pain after a laparoscopic cholecystectomy is primarily caused by referred pain due to the impact of carbon dioxide (CO2) used during the procedure. When CO2 is insufflated into the abdominal cavity, it can irritate the diaphragm. The diaphragm shares an embryological origin and nerve supply with the shoulder region, specifically the C3, C4, and C5 nerve roots. As a result, irritation of the diaphragm from the gas can lead to referred pain that is felt in the shoulder.

This phenomenon occurs because the brain interprets signals from the diaphragm as originating from the shoulder due to the shared nerve pathways, which is referred pain, a common occurrence in many surgical cases that involve the diaphragm. It highlights the importance of understanding how visceral pain can manifest as shoulder pain after certain abdominal surgeries.

Other potential causes of shoulder pain, such as direct nerve injury or inflammation of the gallbladder, are less relevant in this context since the pain specifically results from diaphragmatic irritation rather than from direct trauma or inflammation. Muscle strain due to positioning may occur post-operatively but is not the primary cause of the referred shoulder pain following laparoscopic procedures.