Single incision gallbladder surgery available locally

Sometimes the pain from a diseased gallbladder presents itself in different areas, and it can take a while to diagnose the problem.
For Amy Greene, a hair salon owner and stylist at Mirror Mirror in Lenoir, it took about five years.
"I was having pain, but I didn't know what caused it," she said. "I would have pain in my back so I thought I had a back problem. I had pain in my upper stomach so I thought I had ulcers."
Greene learned to deal with the pain, but the attacks got worse and her doctor pinpointed the problem after running an upper gastrointestinal endoscopy exam and gallbladder ultrasound.
In a good news/bad news situation, Greene was glad to finally know what caused her pain, but she wasn't looking forward to having cholecystectomy — surgery to remove her gallbladder.
She worried about her recovery time. "I'm a workaholic," she said. "I enjoy working."
And she was worried about scars.
Alan Jacks, MD, a surgeon at Valdese Hospital, put both her worries to rest. "He told me about the single incision surgery," Greene said. "The only scar I have is hidden in my navel."
Dr. Jacks has become skilled at laparoscopic surgery using one incision to gain access through a patient's "belly button" or umbilicus.
"The latest thought in all areas of surgery is to be less invasive with fewer incisions for less trauma to the body," Dr. Jacks said. "With the improvements in cameras and instruments we now can approach some surgeries with single incision at the umbilicus. It's the same internal operation and the same care is taken for safety and visualization."
Before laparoscopic surgery, patients undergoing a gallbladder operation faced a large inches-long incision and a lengthy stay in the hospital. The advent of using cameras to guide surgery allowed for smaller incisions, which cut recovery time tremendously. Now with a single incision that is only millimeters in width, recovery is even better.
The procedure takes a specialized camera and a bit more dexterity, but the effort is worth it, Dr. Jacks says. "It seems to create less pain and certainly there is better cosmetic results," he said. "Patients may possibly return to work earlier. It's just practical that one incision is better than four. There should be less pain and the ability to do more activity more quickly."
That was important to Greene who stays on the go with her business and with her son and husband. "I'm a soccer mom and I enjoy that," she said. "I'm very involved in Micah's life and everything he does. I'm a volunteer coordinator at his school."
Greene says she was back to work less than a week after the surgery. "Within two weeks I felt like I hadn't even had surgery," she said. "I had a few lifting restrictions, but I felt better than I did before the surgery."
She now could also eat anything she wanted. "One of the main things I couldn't eat before the surgery was salad," she said. "Lettuce bothered me. I missed my salads. Now I can have them."
The single incision laparoscopic surgery, also known as single port access, is quickly becoming popular. People facing an appendectomy, hernia repairs, removal of ovaries or abdominal pain due to previous surgical scar tissue may be able to have the surgery.
In choosing single incision candidates, the number one rule is to be safe, Dr. Jacks said. "If you can't see and perform the operation as safely and adequately as you would in standard laparoscopic surgery then you create more ports [small incisions]," he said. "That's not a failure. It's just sound surgical judgment."
Not every patient will be a good candidate. "If the area around the gallbladder is significantly inflamed, then we probably can't do it," Dr. Jacks said. "People who are morbidly obese may not be candidates either."
Currently, Dr. Jacks also doesn't recommend the surgery for patients who have been diagnosed with cancer. "Especially with colon cancer, you really have to do a meticulous dissection to make sure you are giving them the best chance to be cured," he said. "Single incision surgery has not been fully evaluated, as of yet, in the treatment of malignancies. This approach, however, is constantly being refined with new instruments, cameras and techniques. I wouldn't be surprised if in the next year or two, single incision surgery proves to be an acceptable surgical approach to common malignancies."