Why do gallstones appear in the gallbladder?
The bile produced by the liver is stored in the gallbladder. This bile is expelled at the time of digestion and helps to make the absorption of bile. The bile can precipitate to the bottom, the different components, appearing the stones and it is these stones that will produce these complications such as cholecystitis, choledocholithiasis, cholangitis or even inflammation of the pancreas in the common area of the bile duct and the pancreas. That is why the treatment is the removal of the gallbladder because it is the only factor that we can modify for the stones to reappear.
What does mini-laparoscopic cholecystectomy consist of?
It is the removal of the gallbladder. Up to now, after open surgery, we have been doing it by laparoscopic surgery. We introduced forceps into the abdomen with instruments called trocars that had different calibers, 5, 10, 12 millimeters, and we needed 3, 4 access ports to manipulate the gallbladder. Nowadays these laparoscopic techniques have been evolving, we need smaller and smaller incisions because we have thinner material, nowadays it is 2 or 3 millimeters, and without the need of trocars we can perform exactly the same intervention we did before. The intervention itself consists in the manipulation of the gallbladder. We will look for the duct that joins the gallbladder to the biliary duct and we section it in order to separate the gallbladder from the liver. In this way we manage to solve one of the factors that caused the stones to appear, which is the storage time of bile prone to precipitation.
For which people and in which cases is it indicated?
We must evaluate it on a case by case basis with your surgeon, but in principle all cases of patients with cholelithiasis, which are stones in the gallbladder, that have an indication for surgical treatment, are cases that can be evaluated to be treated completely or partially with minilaparoscopy techniques.
What are the benefits of this technique?
The first thing is that it is a safe technique, in fact we are reproducing the same surgery that we used to perform with conventional laparoscopic techniques, therefore we are not adding complexity and this makes the procedure safe. We do it in this case with a thinner material that does not require the trocals that we used previously and therefore the wounds are smaller in size. This reduces pain during the immediate postoperative period and also achieves a clear aesthetic improvement. The wound is so small, it is like a pinprick in fact, that it does not even require sutures, so the aesthetic result is very good after a short time.