A new surgical technique that reduces pain, shortens hospital stays and speeds the recovery of gallbladder patients will be performed at the University of Utah Medical Center beginning in February.
In the new laser procedure - laparoscopic cholecystectomy - surgeons use existing technology and surgical skills in a new way to remove gallbladders housing troublesome gallstones.Laparoscopes, metal tubes about the size of a magic marker, have been used in gynecological procedures for a number of years. In the past year they have proved useful in cholecystectomies or gallbladder removal - one of the most common surgeries performed in the United States. Some 500,000 Americans undergo the procedure each year.
To perform the procedure, the surgeon makes a one-inch incision near the navel, through which the laparoscope in inserted. The small metal tube allows the physician to see and work inside the abdominal area.
Three additional punctures are then made in the abdominal wall through which other instruments can be manipulated.
A laser is used to separate the gallbladder from the surrounding tissues, and bile is drained from the gallbladder, leaving the organ looking much like a deflated balloon with the gallstones still inside.
The shriveled organ is removed through the small incision.
Dr. John Hunter, assistant professor of surgery, says the new procedure has a number of advantages.
Although it may be slightly more costly than a regular gallbladder operations, the patient's total bill is decreased because of a shorter hospital stay. With the current surgical method, a patient is hospitalized for about three days. The new technique requires only a one-day hospital stay.
According to Hunter, the new procedure is less painful (no nerves are cut and the incision is only an inch), and patients return to work and full activity within days following laparoscopic surgery.
Who will benefit from the surgery?
Hunter lists patients with gallstone pain who do not require hospitalization and those who have too many stones for shockwave lithotripsy, a procedure that uses sound waves to crush gallstones inside the organ. This procedure, also performed at the U., can be used on only about 25 percent of patients with gallstones.
Gallbladder surgery is the only definitive treatment of gallbladder stones. All other new treatments leave the gallbladder in place, allowing the stones to recur in about 50 percent of patients, Hunter said.
Roughly the size of a small Italian sausage, the gallbladder, which stores excess bile, is "rarely missed following cholecystectomy."
The new technique is currently being performed by a number of surgical teams, including two leading teams in Nashville, Tenn., and Los Angeles. In February, the U. Medical Center will host a seminar to teach physicians the technical aspects involved in laparoscopic cholecystectomy.