New technique minimizes scar from gallbladder surgery

URBANA — If that pain and indigestion mean your gallbladder has got to go, you may be able to have the surgery and skip the scar.

Provena Covenant Medical Center and Christie Clinic have teamed up to offer what they call virtually scarless gallbladder removal with a single incision in the belly button, using Covenant's da Vinci robotic-controlled surgical system.

Dr. Douglas Jones, a Christie surgeon, did the first single-site gallbladder surgery in Champaign-Urbana on June 15. Two weeks later, he said, you could barely see it.

"It's done in a way that it's very well hidden," he said. "Once everything heals up, it's very hard to see the incision."

That's the major advantage of this procedure over the more common way to remove a gallbladder, through laparoscopic surgery, which involves four cuts, Jones said.

In laparoscopic surgery, a thin, lighted tube called a laparoscope is inserted into one of the incisions and surgical instruments are inserted through the others.

During robotic surgery, the surgeon works at a computer console with a 3-D high-definition view inside the patient. The doctor controls tiny surgical instruments in the patient from the console.

Jones said the da Vinci surgical system had been used with four-incision gallbladder surgeries until recent months, and the Single-Site surgery is an update. The system's maker, Intuitive Surgical Inc., received Food and Drug Administration clearance to market single-site instruments for gallbladder procedures this past December.

"This is a great new procedure available to people in East Central Illinois," he said.

Jones said gallbladder trouble is an all-too-common ailment that comes with upper or right rib-area pain, nausea or vomiting after eating or a bloated feeling. Some people have trouble eating certain fatty or spicy foods, he said.

There are other conditions, such as gastroesophageal reflux and irritable bowel syndrome, that can share these symptoms, he said, so he advises people suffering from any of these symptoms to be evaluated by their primary-care doctors or a specialist.

Whether a patient has a gallbladder removed through laparoscopic or robotic-assisted surgery, Jones said, there's usually about a one-day stay in the hospital, and most people have discomfort for a week or two afterward.

The basic difference in the surgeries is how they'll affect people who would be prone to have scars from multiple incisions, he said.

"The main thing with this (single-site surgery) is it allows you to have a great cosmetic result," he said.

Covenant has been making robotic-assisted surgery available for about a year, and also uses its da Vinci system for women's health and urology procedures.

Carle Foundation Hospital has had its da Vinci system since 2008 and currently upgraded to the latest model and bought a simulator for training surgeons, Carle spokesman Sean Williams said.

Carle doesn't have any doctors on staff doing the single-site gallbladder procedure, Williams said.

Carle uses its da Vinci system for a variety of urinary and gynecological procedures and for removal of the prostate gland, kidneys and adrenal glands. Carle also recently added two pediatric da Vinci procedures recently, Williams said. They include ureteral reimplantation, and pyeloplasty, a surgical reconstruction of the renal pelvis.

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