Single-Incision Laparoscopic Surgery (Gallbladder Removal)

Washington University minimally invasive surgeons now offer a new laparoscopic gallbladder removal procedure that offers cosmetic advantages while maintaining the traditional benefits of laparoscopy.

The procedure is identical to traditional laparoscopic gallbladder removal, a procedure called a cholecystectomy, except that the surgeon makes just one tiny incision instead of four.

In traditional laparoscopic cholecystectomy, incisions are made in the abdomen — one on the rim of the navel (umbilicus), one beneath the navel and two beneath the navel and to the right side. A laparoscope (optical instrument) and surgical instruments are passed into the interior of the abdomen to aid the surgeon in removal of the gallbladder.

In single-incision surgery, the laparoscope and all of the instruments are inserted through one 1.5-2 cm incision within the navel. Thus, the patient recovers with a single, almost invisible scar in the umbilical area. As with all laparoscopic surgeries, patients also generally experience less pain and blood loss, and a shorter recovery time, than with open surgery.

Washington University MIS surgeons use cholangiography (radiographic technology to make the bile ducts visible) and the critical view technique to visualize the operative area as safety measures during single-incision cholecystectomy. They also use these techniques during traditional laparoscopic cholecystectomy.

When these MIS surgeons performed their first single-incision cholecystectomy in July 2008, the procedure had been performed at only a handful of academic medical centers in the country.

Other single-incision surgeries performed at the medical center include single-incision gynecologic surgery and kidney surgery. Washington University MIS surgeons also are working in the laboratory to develop techniques for single-incision hernia surgery and other foregut procedures. Typically, they work in the lab to standardize new minimally invasive techniques — making them safe and efficient — and later train community surgeons in the St. Louis area, the Midwest and other areas of the country through classes offered by the Washington University Institute of Minimally Invasive Surgery (WUIMIS).

Washington University MIS surgeons who perform single-incision laparoscopic cholecystectomy are:

L. Michael Brunt, MD

For a patient appointment, please call (314) 454-8877.