As a milestone in the technological development of surgery in the 20th century, the high-tech laparoscopic surgical technique, known as keyhole surgery or minimally invasive surgery, is undoubtedly the first choice in the treatment of gallstone disease. Compared with traditional cesarean surgery, laparoscopic cholecystectomy has won praise from patients and high praise from the medical community for its advantages of less trauma, less pain, shorter operation time, faster recovery period and cosmetic appearance. The following are common gallstone disease frequently asked questions and answers, hope to help patients clear their doubts.
1.What is the gallbladder? Where does the bile come from? What is its function?
A: The gallbladder is a pear-shaped structure attached to the liver below the opening of the extrahepatic bile duct, and is called the gallbladder because it stores part of the bile from the liver. Bile is produced by liver cells and is discharged into the intestine through the intrahepatic and extrahepatic bile ducts to help digest food.
2.How are gallstones formed?
A: There are many things in bile that are normally in a dissolved state, just like sugar or table salt dissolved in water. If the concentration is too high, some of them will form crystals, which then grow further and become clumps, staying or blocking in the biliary system, affecting the flow of bile, and stones are formed. Due to the different composition of gallstones, the site of formation and the time of growth, their appearance and structure are also varied, large like eggs and small like sediment.
3.What are the dangers of bile duct stones?
A: Stones that grow in the bile ducts outside the gallbladder are called bile duct stones. Those inside the liver are called intrahepatic bile duct stones and those outside the liver are called extrahepatic bile duct stones. Bile duct stones can occur in the bile duct or drain from the gallbladder to the common bile duct, causing obstruction of the common bile duct and jaundice; some stones are located in the lower end of the common bile duct for a long time to stimulate the narrowing of the lower end, causing destruction of this special structure like a door and causing septic cholangitis. In addition, it can also cause pancreatitis and bile duct cancer.
4.How does biliary colic arise? Is it unnecessary to treat when the pain disappears?
A: When stones are blocked in the gallbladder duct or bile duct, the bile cannot pass through and the body will naturally produce a series of reactions to overcome it, such as gallbladder spasm or contraction of the lower sphincter of the common bile duct, which will produce severe pain if the stones cannot be discharged with great effort. If the pain disappears as a result of the complete expulsion of the stone, then no treatment is necessary, but this rarely happens. The majority of cases are due to the stone temporarily leaving the blockage site, and under certain conditions, such as eating fatty food, fatigue, drinking alcohol, etc., the attack can occur again. Therefore, as long as the stone exists, it should be removed firmly.
5.Why do gallstones cause yellow eyes, chills and fever?
Bile is produced by the liver and enters the intestine through the bile ducts. The bile ducts are like a tree, the intrahepatic bile ducts are like branches and the common bile ducts are like the trunk. If there is an obstruction in the trunk, the bile produced by the liver cannot be discharged and flows backwards into the bloodstream, where the bilirubin in the bile settles in the eyes and skin, manifesting itself as yellow sclera and skin staining, which is called jaundice. With stones in the bile duct causing poor bile flow, intestinal bacteria will easily enter and multiply, producing toxins, and the body will react with chills and fever.
6.Is it necessary to treat gallstones?
A: Strictly speaking, as long as there are stones, they should be treated because there should not be stones in the normal biliary system. Because gallstones will inevitably cause different degrees of harm to the human body, some harm in the early stage, no obvious performance, and some have developed to the point where treatment is necessary, medical practice has proved that the earlier any disease is treated, the better.
7.Is it necessary to treat gallbladder polyps?
A: There are three types of gallbladder polyps. Cholesterol polyps are multiple, generally less than 3MM in diameter, not cancerous, so no need to treat; inflammatory polyps are multifocal mucosal hyperplasia on the background of inflammation of the gallbladder, although rarely cancerous 44, but if the gallbladder inflammation for a long time, affecting the quality of life, it is better to remove; the third is the real polyps, generally single, ranging in size, more than 10MM is prone to cancer, should be particularly vigilant The third type is the real polyp, which is usually single, small or large, more than 10MM is prone to cancer, and should be especially alert. The following cases should be operated in time.
(1) Older patients;
(2) Single polyp or few polyps with diameter greater than 8MM;
(3) Recent ultrasound examination reveals significant polyp growth;
(4) Recent occult pain or pain in the gallbladder area. In fact, it is incomplete, or even wrong, to decide whether to operate based on the size of polyps. Polyps do not tell you when they will change, and once clinical symptoms or ultrasound suggest cancer, it is often too late, and lessons in this regard are not uncommon. Happily, with the improvement of people’s economic and cultural level and the enhancement of disease prevention awareness, especially the emergence of laparoscopic cholecystectomy, the occurrence of gallbladder polyp cancer has been significantly reduced.
8.What lesions can be produced by the gallbladder?
A: Gallbladder is a disease-prone structure, including cholecystitis, gallbladder stones, gallbladder polyps, gallbladder cancer and some rare lesions.
9.Who is prone to gallbladder stones?
A: A large number of epidemiological surveys have been conducted at home and abroad, and the following groups of people are found to be prone to gallbladder stones.
(1) Women;
(2) Age over 40 years
(3) Obese people
(4) People with gallbladder stones in their family
(5) people with a high-fat diet
(6) Those with liver lesions
(7) Breakfast fasters
(8) Oral contraceptive pill users
10.What are the dangers of gallbladder stones?
A: Patients with gallbladder stones have chronic inflammation of the gallbladder, which causes the gallbladder to lose its contraction function due to long-term stimulation, and a few of them can become cancerous. If the stone is blocked in the abdomen or the cystic duct, it can cause cut-like pain. If the stone cannot leave the obstruction site by changing the position or using medicine, the pressure in the gallbladder will be very high and the blood supply to the gallbladder wall will be reduced or stopped, so bacteria can easily enter and produce a lot of toxins, causing necrosis or even perforation of the gallbladder wall. The common bile duct, causing obstruction of the common bile duct (produce jaundice).
11.What if there are no stones in chronic inflammation of gallbladder?
A: There are two types of chronic inflammation of the gallbladder, one with stones and one without stones, called lithopathic cholecystitis, which may be related to allergic reactions or microbial infections, or may be part of hepatitis, with clinical manifestations mainly of epigastric distension and vague pain, aggravated by eating fatty food, some of which can be more severe and occur frequently, affecting daily life. Despite the absence of stones, the only solution to this problem is to remove the gallbladder, due to the ineffectiveness of drug therapy and the irreversible chronic inflammatory process of the gallbladder wall.
12.What are the methods of treatment for gallbladder stones?
A: There are two major types of treatment methods: one is the treatment method to preserve the gallbladder, such as herbal lithotripsy, Chinese and Western medicine lithotripsy, shock wave lithotripsy and lithotripsy; the other is the method to remove the gallbladder, such as cesarean cholecystectomy, small incision cholecystectomy and laparoscopic cholecystectomy. The purpose of the first method is to preserve the gallbladder, but the disadvantage is that the treatment effect is too poor, and it is easy to grow stones again, while the second method has a certain trauma, but the treatment effect is reliable, and there is no disadvantage of stone recurrence.
13.What is the best way to treat gallbladder stones?
A: An ideal treatment method should have the following conditions.
(1) No damage to the body;
(2) Preserve the function of gallbladder
(3) Reliable results;
(4) no recurrence of the stone, but so far there is no treatment method with the above conditions, at present, the more recognized is laparoscopic cholecystectomy, because preserving the gallbladder means inevitable recurrence.
14.I want to keep my gallbladder very much, under what circumstances can my request be satisfied
A: For every patient with gallbladder stones, we have the obligation to listen to his or her personal wishes and first see if there is a requirement to preserve the gallbladder. If so, then objective tests should be used to understand the functional status of the gallbladder and the nature of the stones, so that a judgment can be made about the value of gallbladder preservation and the possibility of recurrence. Explain to the patient the pros and cons of gallbladder preservation for stone extraction. If the conditions for gallbladder preservation can be met, then the patient’s needs should be met as much as possible and instructions should be given on how to prevent stone regrowth. However, surgical resection should be an option for patients whose gallbladder is no longer functional or is largely non-functional or for patients with a very high likelihood of stone recurrence (e.g., multiple stones or mucoid stones) or who have had pancreatitis or are suspected of having bile duct stones. The primary conditions: preferably a single stone; good gallbladder function and no previous violent attacks.
15.What is the effect of gallbladder removal on human body?
A: First of all, gallbladder is a useful auxiliary organ, but it is proved that it is not indispensable, only a few patients have a change in stool habit for a period of time after surgery, and the adjustment of diet and proper regulation of intestinal function will be recovered within 1-3 months; secondly, we remove the gallbladder which is diseased and may cause many serious complications, the result is to cure the disease, improve the patient’s nutrition, and improve the quality of life. The overall effect is that the benefits outweigh the disadvantages. Finally, more than 100 years of clinical evidence shows that gallbladder removal does not cause serious effects on the human body.
16.What do I need to pay attention to in my diet after gallbladder removal?
A: In the near future after surgery, you should eat low-fat and easy-to-digest food, and as the gastrointestinal function recovers, you can let go of the restrictions later. There is a wrong view that after gallbladder removal, you cannot eat fatty or high protein food, which is not based on science. However, if you have other problems and need to adjust the structure of your diet, the original plan does not need to be changed.
17.What causes diarrhea for a period of time after cholecystectomy?
A: Although some of the diseases have heavy clinical symptoms, the gallbladder function is not completely lost, and it has a certain regulatory effect on the bile flow.
18.Why do you still feel pain in the upper abdomen after gallbladder removal?
A: Most of the symptoms will disappear after gallbladder removal, but some patients still have symptoms, because the causes of upper abdominal pain or other symptoms, in addition to gallbladder stones, there are chronic gastritis, bile reflux, chronic pancreatitis, colonic hepatic flexure syndrome, etc. These pathological states can coexist with gallbladder stones, so the original symptoms can persist after gallbladder removal. If you encounter this situation, you need to make further examination and do not just think of gallbladder problems to avoid misdiagnosis.
19.A one-centimeter stone was found in my gallbladder, can I take Chinese medicine to expel it?
A: The idea is good, but in reality it is impossible because two major conditions must be met for the stone to be expelled from the gallbladder: firstly, the gallbladder has a good contraction function, and secondly, the outside diameter of the stone is smaller than the cystic duct and common bile duct. Under normal circumstances, the internal diameter of the cystic duct is only 2-3mm and the internal diameter of the common bile duct is 6mm, and the gallbladder of patients with gallbladder stones often does not function well, so it is very difficult to expel the stones. Your stone is 10mm, which is 3 times bigger than the cystic duct, so don’t do stone removal treatment, otherwise you will waste money.
20. What kind of stones can be dissolved with medicine?
A: Indeed, there are very few gallbladder stones that can be dissolved by taking medication, but the conditions are very high. Requirements.
(1) The gallbladder function is basically normal;
(2) The stones are purely cholesterol-based;
(3) The stones are not larger than 10 mm;
(4) Adherence to 1-2 years of medication. Even so, only 8-10% of the stones are completely dissolved. However, as soon as the medication is stopped, the stones will grow back, so the treatment is not the root cause.
21. There is a method to break up the stones and drain them out. Is this method reliable?
A: Logically speaking, breaking up stones is good for discharging them, which is the purpose of inventing shock wave lithotripter. However, the results of millions of cases treated by medical experts at home and abroad are very unsatisfactory, why? Firstly, gallbladder stones are not easy to be broken, and the efficacy of lithotripsy for stones larger than 15mm is very low; secondly, even if stones are broken, most of them cannot be small enough to be discharged; furthermore, the clinical standard for effective gallbladder stone treatment is to eliminate all stones, and as long as one stone is left, it is not considered a successful treatment. Finally, the lithotripsy process as well as the stone expulsion process can cause complications. This method was prevalent in the late 1980s and has now been eliminated.
22. Can a small hole be made in the abdominal wall to remove the stone?
A: Yes. This method is called percutaneous cholecystectomy, and there are two methods: one is to puncture the gallbladder under ultrasound guidance, then gradually cut the abdominal wall, put in a one-centimeter outside diameter tube, and then remove the stone through the tube; the other method is to cut 1-2 centimeters directly on the abdominal wall, then separate into the abdominal cavity, find the gallbladder, and then cut a small opening in the gallbladder U to remove the stone. The advantage of this method is that the results are more certain and there are no special requirements for the size, number and composition of the stones. The disadvantage of this method is the damage to the abdominal wall, the possibility of contamination of the abdominal cavity, the possibility of residual stones in some patients, and the high recurrence rate of stones. Since the availability of laparoscopic cholecystectomy, this method has been used less and less. However, it is still an option for those who are older and have a small number of stones.
23.What is laparoscopic cholecystectomy all about?
A: Cesarean cholecystectomy is an operation performed directly under the naked eye after the abdominal wall is cut open. The incision is usually 15-20 cm, and the doctor enters the abdominal cavity with instruments in hand to perform various operations. But laparoscopic cholecystectomy, as the name implies, the doctor does not observe the abdominal cavity with the naked eye, but transfers the image to a TV screen through a 1cm thick laparoscope to watch the TV surgery, so that the doctor only needs to make 3-4 small holes (usually in 0.5-1cm) in the abdominal wall, insert special instruments, cut down the gallbladder and then remove it from the small holes in the abdominal wall. Therefore, this operation is also called TV laparoscopic surgery, commonly known as “small-hole cholecystectomy”.
24.What are the advantages of laparoscopic surgery?
A: It has many advantages, summarized as follows.
(1) small incision, light injury, fast postoperative recovery, generally the same day can get out of bed, the next day can eat, 1-3 days can be discharged from the hospital, 7 days can resume daily activities
(2) The intraoperative field of vision is clear, and other organs can be observed at the same time;
(3) The operator’s hands do not enter the abdominal cavity, so there is little interference with other organs;
(4) No obvious postoperative scars, which do not affect the appearance. Last but not least, due to the removal of the gallbladder, such stones will not recur.
25.What if both gallbladder and bile duct stones are present?
A: In terms of risk, bile duct stones are more important than gallbladder stones and are the main focus of treatment, usually a caesarean bile duct exploration is considered and the gallbladder is removed. However, in some patients with better conditions, if the bile duct stones are single or few in number, it is estimated that the stones are not embedded and can be removed by choledochoscopy, then both problems can be solved laparoscopically.
26.Stones have been detected by ultrasound for many years, but only symptoms such as vague pain in the upper abdomen, abdominal distension and dyspepsia are related to stones?
A: There are three possibilities: first, it is caused by gastrointestinal lesions or pancreatitis lesions; second, it is caused by gallstones; third, both conditions exist at the same time. It is especially worth emphasizing that the presence or absence of biliary colic alone should not be used to determine whether stones cause symptoms. The clinical symptoms of gallbladder stones come from two sources: one is from stones obstructing the gallbladder duct, causing typical biliary colic; the other is from chronic inflammation of the gallbladder wall, manifesting as intestinal-like symptoms. In fact, most patients with gallbladder stones have these atypical manifestations.
27. Will gallstones definitely recur after surgery?
A: For gallbladder stones, as long as the gallbladder is removed, there will be no recurrence, but if only the stones are removed and the gallbladder is left, recurrence is inevitable. For common bile duct stones, especially from the gallbladder, if the damage to the common bile duct is not serious or not long, recurrence can be avoided after treatment. However, most of the patients are not treated in time and wait until the destruction of the common bile duct is obvious before surgery, and then they are prone to recurrence. For multiple stones in the liver, if the stones are removed together with part of the liver, the stones in this area will not recur, but if the stones are only removed, recurrence is inevitable. In short, as long as the growth site of stones is not removed, stones will recur.
28.Why do gallstones cause pancreatitis?
A: The pancreas is behind the stomach and its main role is to produce enzymes for digesting proteins, fats and starches, which are dissolved in the pancreatic juice and discharged through the pancreatic duct to the intestines to digest food. In the very majority of cases, the bile ducts and pancreatic ducts converge together before entering the intestine. If the opening is blocked, bile may flow back into the pancreas, activating digestive enzymes in the pancreas and causing the pancreas to “self-digest”, thus causing pancreatitis, which is called cholestatic pancreatitis.
29. What are the causes of pancreatitis? Can it be prevented?
A: The most common cause is the obstruction or stimulation of the common opening of the bile duct and pancreatic duct by gallstones, and other causes are alcoholism and overeating. Therefore, on the one hand, we should pay attention to the regularity of life, not to drink alcohol, not to overeat, and more importantly, to treat gallstones in time. It is worth pointing out that if you have multiple gallbladder stones, do not just carry out stone removal treatment.
30.Does gallstones affect the heart?
A: Although the gallbladder and the heart are located far apart, the human being is a whole body, so it can be said that “the whole body is involved”, because the gallbladder and the heart are innervated by the same nerve, sometimes the high pressure or severe pain in the gallbladder can cause the heart vasoconstriction through the nerve reflex, reducing the heart blood supply and causing changes in heart rhythm. If the patient has a pre-existing heart problem, such as coronary artery disease, then it may trigger or aggravate the heart disease, which is clinically called “biliary heart syndrome”. If this is the case, for the sake of safety, the gallbladder stones should be treated as early as possible when the patient is not too old and in good physical condition.
31.Can laparoscopic cholecystectomy be done for heart disease?
A: With the improvement of the level of anesthesia and the reduction of surgical trauma, in most cases, even with heart problems, gallbladder can still be removed. However, patients with significant cardiac failure or hemodynamically compromised rhythm disturbances should be treated after these problems have improved. The advent of laparoscopy has made gallbladder removal safer for patients with heart disease.
32. Is laparoscopic cholecystectomy safe for diabetic patients?
A: Laparoscopic cholecystectomy can be safely performed in almost all diabetic patients as long as the complications caused by diabetes are properly controlled. The biggest concern in the past was incisional infection, but since laparoscopic cholecystectomy uses only 3-4 small holes, this problem can be avoided.
33.Can laparoscopic cholecystectomy be done for hypertensive patients?
A: Hypertension can be mild or severe. If there are no serious heart, kidney or cerebrovascular complications, it is safe to do this surgery as long as the blood pressure is controlled at the upper normal level. In fact, the trauma of laparoscopic surgery itself is very small, and as long as other organs can withstand the effects of anesthesia, there is no problem at all.
34.Is there any contraindication to laparoscopic cholecystectomy?
A: Like other surgeries, laparoscopic cholecystectomy also has contraindications, such as severe cardiopulmonary disease, coagulation disorders, concomitant intra- and extra-hepatic bile duct stones, suspected cancer, recurrent acute attacks of chronic cholecystitis with hyperthermia, suspected extensive intra-abdominal adhesions, etc. But contraindications are relative. However, the contraindications are relative and with the improvement of technology, many of them have been broken, such as. Atrophic cholecystitis, acute attacks of gangrenous cholecystitis, intra-abdominal adhesions with a history of previous abdominal surgery, and even internal fistulas formed between the gallbladder and the colon may all be done laparoscopically.
35.Can I work as normal after gallbladder removal?
A: You must establish the belief that since a diseased gallbladder has been cut away, it must be healthier than it was. Many patients who have had surgery will have the psychological idea that they are not as good as others, which is very wrong. Remember this famous saying: As long as you think you are sick, you will be sick, and as long as you think you are healthy, you will be healthier. So as long as you get reasonable treatment, there is no need to worry about working. Of course, if you really feel discomfort somewhere, you can ask your physician to check again. Generally, there is always slight discomfort, and you will recover after some time, so there is no need to have a psychological burden.
36.What should be done before laparoscopic cholecystectomy?
A: Just do some routine preoperative examination. If the operation is performed in the morning of the next day, only fasting after dinner on the same day is required, no intestinal preparation is needed, and no gastric tube needs to be inserted before the operation. There is no blood preparation, which is very different from traditional caesarean operation.
37.What should I pay attention to after laparoscopic cholecystectomy?
A: 6-8 hours after surgery, you can get up to urinate and defecate by yourself or with the help of your family members, do not rely on the potty, you should get out of bed the next day and eat liquid or soft and easily digestible food, you do not have to wait until the anal vent to eat. There will be mild pain in the puncture hole after surgery, which is usually tolerable, or if you are sensitive, you can use painkillers. In conclusion, one should strive to resume daily activities sooner after surgery and should forget about traditional practices.
38.Choledocholithiasis was found shortly after cholecystectomy, is it a recurrence? What should be done?
A: No! Recurrence means that stones grow back in the area where they were originally found. There are two possibilities for finding stones in the common bile duct: one is that the common bile duct already has primary stones, and the other is that the stones drained from the gallbladder to the common bile duct before surgery. Because the lower end of the common bile duct is covered by the intestine, the ultrasound may not be able to see it clearly, so even if the diagnosis is missed, it is not the fault of the ultrasonographer or the technical level. The good news is that the incidence of this condition is less than 1%. Therefore, the key is early detection and treatment.
39.What if gallbladder stones and chronic gastritis are both present?
A: These two diseases can have the same clinical manifestations. If there is typical biliary colic, of course, gallbladder removal is done first, and then gastritis is treated. If the symptoms are not typical, it makes one indecisive. The normal thinking should still be to solve the gallbladder problem and then treat the gastritis. The cost of removing the stomach is much greater than removing the gallbladder, and it is difficult to establish the effect of long-term medication because the medicine for the stomach is not effective for the gallbladder.
40.Does the weather affect the effect of laparoscopic cholecystectomy?
A: Not at all. It is natural to think that incisional infections are prone to occur in hot weather, but this is not true for modern medicine. Modern aseptic conditions, the air-conditioned environment of the ward coupled with the small poke holes in the laparotomy itself, make it extremely rare for infection to occur.
41. Is this method of laparoscopic cholecystectomy safe?
Answer: The safety of a medical technique is determined by many factors, such as the age of the patient and the functional status of the vital organs, the pathological changes of the gallbladder, the experience and skill level of the surgeon, and the management and equipment level of the hospital. Cholecystectomy has been performed for 116 years and has proven to be the most effective method for the treatment of gallbladder stones, with a high overall safety profile. The advent of laparoscopic cholecystectomy has undoubtedly further improved safety in terms of developmental trends. However, there is a learning and maturation process for the application of any new technology. In the early stage of this technology, the incidence of intraoperative and postoperative bleeding, biliary tract injury and peripheral organ damage is high, but gradually decreases or even does not occur as the number of cases increases. Therefore. The key for patients is to understand and find a doctor they fully trust and follow the doctor’s advice to perform the surgery at the most suitable time.
42.What are the characteristics of Dongfang Hospital in gallstone treatment?
A: Oriental Hospital has very significant features in gallstone treatment:
(1) Combination of traditional treatment methods and modern treatment methods. We oppose both blind gallbladder removal without regard to gallbladder function and ignorant non-surgical treatment without regard to gallbladder pathological changes and complications.
(2) Individualized treatment plan. Our center has not only conventional laparoscopic cholecystectomy, but also created mini-laparoscopic cholecystectomy, foreign body-free laparoscopic cholecystectomy and invisible laparoscopic cholecystectomy, so that we can develop the best treatment plan according to the patient’s specific situation
(3) Humanized service. Preoperatively, we analyze the condition in detail and objectively, and formulate the best surgical plan. The advantages and disadvantages of the implemented treatment methods, possible intraoperative problems and possible countermeasures are also explained to patients and their families. Intraoperatively, on the basis of adequate assessment, careful refinement and precision and minimization of losses are achieved. Postoperatively, effective approaches are taken to enable the patient to recover as soon as possible. Patients can contact us at any time after discharge to enjoy timely and quality services.
43.Can laparoscopy be used for other procedures besides gallbladder?
A: It can be said with certainty that almost all abdominal surgeries can be accomplished by minimally invasive methods with the assistance of laparoscopy. In addition to the gallbladder, the center also performs.
(1) Scarless endoscopic thyroid surgery on the neck;
(2) fundoplication for gastroesophageal reflux;
(3) laparoscopic gastric volume control for obesity;
(4) Laparoscopic abdominal wall and inguinal hernia repair;
(5) laparoscopic colorectal cancer resection;
(6) Splenectomy;
(7) laparoscopic appendectomy;
(8) Endoscopic parametrial mastectomy;
(9) Endoscopic mastectomy for benign breast masses;
(10) laparoscopic small hepatocellular carcinoma resection;
(11) hepatic cyst opening, etc.
44.Scarless surgery of abdominal wall: a new hot spot of minimally invasive surgery
We started to try another scarless abdominal wall surgery: transumbilical approach laparoscopic surgery in May 2007. Based on animal experiments, we were the first in China to use this technique to perform open-window drainage of liver cysts, laparoscopic exploration and appendectomy. After more than two years of efforts, we have continuously improved the instruments and techniques and successfully carried out laparoscopic cholecystectomy with transumbilical approach. After the healing of the umbilical wound after the operation, no trace of the operation could be seen.
The transumbilical approach laparoscopic surgery is performed by using the navel, a natural fold of the body, to place a laparoscope and specially designed surgical instruments. The laparoscope is connected to a camera device and the surgeon looks at the image of the abdominal cavity on the monitor to perform the surgery. After the removed gallbladder is removed from the belly button incision, the incision in the belly button is sewn up as is so that it is not visible that surgery has been performed. This technique not only looks good, but because there are no other puncture holes in the abdomen, the patient is less traumatized, has less pain after surgery, and can return to normal work and life more quickly. This technique that we have established is much less technically difficult and has much less surgical risk compared to transnatural cavity surgery.
Research on transumbilical approach laparoscopic surgery technique is developing rapidly in the world. Many people not only use this technique to remove the gallbladder, but also try to remove the colon and spleen and do bariatric surgery. It is believed that in the near futur