A “Navel” Idea: New Technique Can Remove Gallbladder With One Small Incision

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By Heather Maloney – Beth Israel Deaconess Medical Center staff

First, there was laparoscopic surgery, which allowed a surgeon to remove the gallbladder through small incisions in the abdomen. Though much less invasive than traditional open surgery, it still required making several cuts in the abdominal wall.

Now, some surgeons are trying a new method, called single-port access or reduced-port access surgery, that allows the entire procedure to be done through a one-inch incision in the patient’s belly button.

“This procedure is still investigational at this point,” says Dr. Benjamin Schneider, a surgeon at Beth Israel Deaconess Medical Center in Boston and an instructor at Harvard Medical School. “But it holds great potential.”

In an open cholecystectomy (the technical term for surgery to remove the gallbladder), the surgeon makes a single, large incision in the abdomen. Traditional laparoscopic surgery for gallbladder removal typically requires four small incisions. But with the reduced-port surgery, the instruments and camera are threaded through one small incision in the belly button.

As is the case with traditional laparoscopic surgery, the procedure is performed under general anesthesia with the aid of a laparoscope. This technique is also being tested for other types of surgeries, such as appendectomies and hernia repair.

One of the major benefits of the reduced-port surgery, Dr. Schneider says, is cosmetic. Since the entire surgery is performed through the navel, it does not leave any visible scars like the traditional multi-port approach.

“The advantages are theoretical, and the cosmetic benefit seems to be the biggest advantage at this point,” he says. “But with more research, we may find that patients experience less post-operative pain and a return to work or activity sooner than other methods.”

Currently, candidates for the reduced-port approach cannot be suffering from an infected gallbladder, and they cannot have a BMI over 30 or have lots of scar tissue in the abdominal area.

Dr. Schneider also points out that there is the chance that, once the surgeon begins surgery, conditions may require that the operation be converted to traditional surgery.

But so far, patients seem pleased with the results.

Jennifer Shumaker, 32, had just had her second baby when she underwent a reduced-port cholecystectomy in 2009. She had had gallbladder problems throughout her pregnancy, and was thrilled to be offered this minimally-invasive approach.

“I was very pleased with the results,” she says. “I had no pain, and I was up and around the next day.”

“I didn’t need any pain medication,” says the Framingham mom. “And since I was nursing, that was a huge factor for me.”

Above content provided by Beth Israel Deaconess Medical Center. For advice about your medical care, consult your doctor.

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