Gallbladder Disease – Myth vs Truth
The success of laparoscopic removal of gallbladder in late 1980s ignited the surgical revolution of minimally invasive surgery. This operation still continues to rank among the most commonly performed laparoscopic procedures in North America.
Gallbladder disease is a common problem in the United States and approximately 10-15 percent of the adult population have gallstones. Gallstones are more common in women, older patients, and certain ethnic groups, and are associated with multiple pregnancies, obesity, and rapid weight loss.
Most patients with gallstones remain symptom-free for many years and may, in fact, never develop symptoms. Asymptomatic patients usually develop symptoms before they develop complications related to gallbladder disease. Once symptoms appear, they recur in the majority of patients. Furthermore, patients with symptoms secondary to gallstones are more likely to develop complications. Therefore, most symptomatic patients should be treated by surgical intervention. Patients usually present with episodic upper abdominal pain, mostly after a meal which last around 1-2 hours. They also might have nausea, vomiting, bloating, indigestion and reflux.
Laparoscopic Gallbladder Surgery
Since the introduction of laparoscopic gallbladder surgery in 1985, this procedure has become the gold-standard for gallbladder removal. Most patients with symptomatic gallstones are candidates for laparoscopic surgery, if they are able to tolerate general anesthesia and have no serious cardiopulmonary diseases or other coexisting conditions that preclude operation.
Laparoscopic gallbladder surgery is performed by making four incisions in the abdominal wall. Using the laparoscope and other special instruments, the gallbladder is removed through one of the small incisions. The operation requires general anesthesia but in most cases it is done as an outpatient basis. Most people can return to their normal activities, regular work and exercise within two weeks. No special diets or other precautions are needed after surgery.
More recently, removal of gallbladder can be performed through a single incision using robotic system. The da Vinci System is a robotic surgical platform designed to enable complex procedures of all types to be performed. The Da Vinci robotic system has designed a special single incision port that enter the abdominal cavity through a small intra-umbilical incision and allows the special curved robotic devices to enter the abdomen for removal of the gallbladder. There have been some potential benefits experienced by surgeons using the da Vinci Surgical System over traditional laparoscopic approaches. These benefits are less pain, virtually scarless, faster recovery and high patient satisfaction.