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Surgical Options for Treating Gallbladder Problems

First in Massachusetts to perform single-incision robotic surgery

The gallbladder is a small, hollow organ, shaped like a crook-necked squash, located below the liver. Its role is to store bile until it's needed to digest fat from food. If the chemicals naturally found in bile get out of balance, crystals form and can harden into gallstones which can block the flow of bile, causing pain, inflammation or infection.

An estimated 10 to 15 percent of American adults have gallstone disease. About one million new cases are diagnosed every year, and approximately 800,000 operations are performed to treat gallstones – making gallstone disease the most common gastrointestinal disorder to require hospitalization.

"Surgery is needed when gallstones act up," explains Michael Jiser, MD, Lowell General Hospital's Chief of General Surgery. "Patients often will experience intermittent pain in the upper right abdomen, usually after eating, especially fatty foods."

Less than two decades ago, surgery to remove the gallbladder (a procedure called cholecystectomy) entailed a large abdominal incision and several weeks' recovery time. Today, however, minimally invasive surgical techniques have made open gallbladder removal nearly obsolete.

"The minimally invasive approach – laparoscopy – is the standard of care today," says Dr. Jiser, a pioneer in minimally invasive surgery. "In our practice we do minimally invasive cholecystectomies 100 percent of the time." For the patient, this means less pain and a faster recovery.

In the spring of 2012, Dr. Jiser became the first surgeon in Massachusetts to use the advanced da Vinci® Si Surgical System to perform gallbladder removal. The robotic system enhances the surgeon's skill with computer technology, enabling him to see vital anatomical structures more clearly and perform surgical procedures more precisely – through four small incisions.

And in May 2012, Dr. Jiser became the first surgeon in the state to use the da Vinci surgical system to perform gallbladder removal through a single incision.

"The biggest benefit of this approach is cosmetic," he notes, since there is just one small incision in the belly button. "In most cases, this approach is preferred by younger patients who care about scarring, but it can be offered to almost everyone."

To date, Dr. Jiser has performed more than 75 robotic cholecystectomies. Of these, about 40 have been single-incision procedures.

"Five years ago, traditional laparoscopy was the only minimally invasive surgical option for gallbladder removal," he says. "Today, patients here at Lowell General have a choice.

"Lowell General continues to be at the forefront of minimally invasive surgical techniques across all specialties," he adds. "Patients don't have to travel outside the area for the most advanced care."

Symptoms of Gallbladder Disease

Symptoms of gallbladder disease are often called an "attack" because the symptoms occur suddenly. Gallbladder attacks often follow a fatty meal and may occur at night. A typical attack can cause steady pain in the upper, right side of your abdomen, pain in your back between the shoulder blades and pain under your right shoulder.

Call your doctor if you think you're having a gallbladder attack. These attacks may end when gallstones shift or move. However, if a blockage persists, your gallbladder can become infected and rupture. It is important to seek care immediately.

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