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<h2><span style="color: #00826a;">A Step Forward: “Gallstone Surgery” from Small Incisions to Scarless with a Newly Developed Technique Using Laparoscopy Through the “Vagina”</span></h2>
<div>Abdominal pain may no longer be just ordinary pain if the cause is <span style="color: #00826a;"><strong>“gallstones”</strong></span> left untreated until the large stones block the junction between the gallbladder and bile duct, causing inflammation and pain under the right rib cage. If it progresses to bacterial infection in the bloodstream, it can be life-threatening.</div>
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<div>Currently, gallstones remain a common disease among Thai people. The high-risk group is women over 40 years old who are overweight. Men can also develop this condition but with less chance. With continuous medical innovation, good news has been created for women at high risk of this disease with a technique for gallstone surgery using laparoscopy through the vagina, a natural route that causes no scars for patients.</div>
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<div>Previously, treatment involved open surgery, where patients had a 5-10 centimeter long incision, experienced significant pain, and required several days of recovery. Some cases with weak abdominal walls or poor wound closure could later develop hernias. Then, laparoscopic gallstone surgery technology was introduced, which is popular and considered the global medical standard. This method greatly reduces pain and shortens recovery time but leaves a 1-2 centimeter scar at the navel and 2-3 small 0.5 centimeter scars on the abdomen. Additionally, medical reports indicate that long-term follow-up of these cases over 10-20 years found about 10% of patients developed hernias as a side effect of inadequate navel wound closure.</div>
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<div>Subsequently, a German surgeon invented gallstone surgery through natural orifices. The human body has several natural orifices, but the most suitable for gallstone surgery is the <strong><span style="color: #00826a;">“vagina”</span></strong>. This method does not affect the uterus because the instruments are inserted into the space between the uterus and the abdomen. Initially, Asian doctors were less inclined to use this method due to its technical complexity. However, in early 2016, Dr. Angkoon Anuwong, a laparoscopic surgery specialist at the Advanced Minimally Invasive Surgery Center, Phyathai 2 Hospital, became the first surgeon in Thailand to apply vaginal gallstone surgery and improved the technique to make it easier. This is another interesting advancement in the medical field.</div>
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<div><span style="color: #00826a;"><em>“The first step is that the doctor makes a 0.5-centimeter incision at the navel to insert carbon dioxide gas. Then, a camera is inserted through the navel along with small instruments into the vagina to remove the gallbladder. The surgery takes about 40 minutes, similar to conventional laparoscopic surgery. After surgery, patients experience almost no pain and can immediately return to normal life without any bothersome scars. There are only some limitations where patients cannot undergo this method, such as those with acute gallbladder inflammation or severe inflammation. Another case is male patients, who will be treated with conventional laparoscopic surgery through the abdomen instead.”</em></span></div>
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<div><span style="color: #00826a;"><strong>More important than the technology for treating illness</strong></span> is taking care of the body to stay healthy, exercising regularly, reducing fatty food intake, maintaining weight within standard limits, and monitoring oneself for any abnormalities. If there are signs of illness, treatment can be provided promptly.</div>
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<div style="text-align: right;"><span style="color: #00826a;"><strong>Dr. Angkoon Anuwong</strong></span><br />
Laparoscopic Surgery Specialist<br />
<span style="color: #000000;">Surgical Center, Phyathai 2 Hospital</span></div>


With the technology of gallstone surgery through transvaginal endoscopy, patients recover quickly without surgical scars, making gallstone treatment less frightening than expected.

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A Step Forward: "Gallbladder Stone Surgery" From Tiny Incisions to Scarless

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