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A quick fix for an ailing gallbladder.

Gallbladder surgery normally requires four to six days of hospitalization and as much as a month's convalescence at home-not a pleasant prospect for anyone and particularly distressing to those employed outside the home. Nor is the long abdominal scar something that the female patient looks forward to. Now, however, some surgeons are using a new technique that requires only four half-inch incisions, allowing many patients to get out of the hospital the same day and back to work in two or three days.

One of the tiny slits, usually in the navel (where a scar would not be noticeable), is used to insert a tiny camera on an instrument called a laparoscope, connected to a video monitor that allows the surgeon to see what's going on. Other instruments, including a laser, are inserted in the other three slits to drain the gallbladder of bile, remove it from its connections to the liver, and then gently pull the now-shrunken organ through one of the slits.

One would expect enormous savings in costs with what is for most an outpatient procedure, but surgeons seem to have a habit of charging higher fees for newer procedures. The higher fees are, however, more than offset by the reduced hospital costs, and in cities where the new technique is being used, the overall costs have been reduced by $400 to $1,000. Given the fact that, in this country, half a million (!) gallbladders are removed each year, the potential savings are considerable.

In this era of skyrocketing health-care costs, it would behoove all general surgeons to learn the new procedure. Your editor is reminded of his last operation, repair of an inguinal hernia, nearly 25 years ago-postponed for many months because overseas travel commitments did not allow time for even a few days of hospital stay and weeks of somewhat limited activity. Then he heard of a new procedure being used by a surgeon he had once met in a distant city. Checking into the hospital a few hours before surgery, he underwent a 45-minute procedure under local anesthesia and was made to walk one mile through the hospital corridors immediately after getting off the operating table. Discharged the following morning, he was carrying heavy suitcases less than a week later to his next overseas project. Yet, 25 years later, many simple hernia operations are still being done under the more costly and potentially hazardous general anesthesia, with longer than necessary hospitalization and convalescence. How many more operations, besides this new one for gallbladder removal, could be performed without all the unnecessary time and cost (not to mention extra stress to the patient)?
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Title Annotation:using laparoscopy
Publication:Medical Update
Date:Feb 1, 1990
Words:438
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