Gallstones

Treatment and Options

Gallstones are hardened deposits of digestive fluid that can form in your gallbladder. This small organ sits just beneath your liver and aids in digestion by storing bile. Gallstones can vary in size and number, often leading to significant discomfort and health issues.

Laparoscopic Cholecystectomy:
A laparoscopic cholecystectomy is the surgical removal of the gallbladder through several small incisions in the abdomen. This minimally invasive approach, commonly known as keyhole surgery, is the standard treatment for symptomatic gallstones due to its high safety profile and effectiveness. The procedure prevents the recurrence of gallstones by completely removing the gallbladder.
During the surgery, typically three to four small incisions are made. A laparoscope, which is a thin tube with a camera, is inserted through one incision, giving the surgeon a magnified view of the gallbladder on a screen. Other surgical instruments are introduced through additional incisions. The abdomen is inflated with carbon dioxide gas to create space for the operation.
The surgeon carefully detaches the gallbladder using specialized tools. Clips are then applied to seal off the cystic duct and artery, which remain safely in the body post-surgery. Once the gallbladder is removed, the instruments are taken out, the gas is released, and the incisions are closed with sutures that naturally dissolve over time.

Symptoms of Gallstones:
Upper right abdominal pain
Shoulder pain on the right side
Nausea and vomiting
Dark urine and pale stools
Jaundice

Diagnosis:
A physical exam may reveal jaundice, while blood tests assess bilirubin levels and exclude infections. Imaging tests like ultrasounds and CT scans provide detailed abdominal visuals.

Treatment Options:
Open surgery
Laparoscopic surgery

Benefits of Laparoscopic Treatment:
Minimal incisions and reduced discomfort
Shortened hospitalisation
Accelerated recovery

Delaying treatment for gallstones can lead to severe complications such as infections, inflammation, impaired gallbladder function, cholecystitis, and sepsis.The laparoscopic procedure is typically:
Under 60 minutes
Minimally painful
Allows for same-day discharge
Involves a 1 cm incision
Ensures swift recovery

Kidney Stone Treatments

Percutaneous nephrolithotomy/ nephrolithotripsy, abbreviated as PCNL, is a surgical technique designed to extract notably large kidney stones or those in the upper ureter through a minimally invasive approach. The procedure entails a small incision in the side of the body, enabling surgeons to either remove the stones or fragment them into smaller pieces, typically with negligible risk of complications. PCNL is particularly advantageous for stones that are too substantial for other treatments to address. It is known for its high rate of completely clearing stones, especially those over 2cm in diameter, often making it a preferable alternative to open surgery.

Retrograde Intrarenal Surgery, or RIRS, is a method of removing kidney stones that utilizes a ureteroscopic approach. This minimally invasive surgery employs the urethra as a channel to access the kidneys without the need for incisions. An optical endoscope is used to navigate to the kidneys, detect the stones, and then a laser is employed to pulverize the stones into dust. RIRS is typically reserved for large or intricate stones that are not suitable for lithotripsy treatment. The procedure boasts a high success rate with an exceedingly low risk of complications.