“ผ่าตัดนิ่วในถุงน้ำดี” จากแผลจิ๋ว สู่ไร้แผล เทคนิคใหม่ส่องกล้องผ่าน “ช่องคลอด”

Abdominal pain may no longer be just ordinary pain if the cause is “gallstones” and left untreated until a large stone blocks the junction between the gallbladder and bile duct, causing inflammation and pain in the right upper abdomen. If it progresses to bacterial infection in the bloodstream, it can be life-threatening.
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 disease but with less chance. With continuous medical innovation, there is good news for women at high risk of this disease with the development of gallstone surgery using a transvaginal endoscopic technique, a natural route that does not cause any wounds to the patient.
Previously, treatment was done by open surgery, where patients had a 5-10 centimeter long wound, experienced significant pain, and required several days of recovery. Some cases with weak abdominal walls or poor wound stitching could lead to hernias later on. Later, laparoscopic gallstone surgery technology was developed, 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 stitching.
Subsequently, a German surgeon invented gallstone surgery through a natural orifice. The human body has several natural orifices, but the most suitable for gallstone surgery is the “vagina.” 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 not very keen on this method due to its technical complexity. However, in early 2016… Dr. Angkoon Anuwong, a specialist in laparoscopic surgery at the Advanced Minimally Invasive Surgery Center, 1st Floor, Building A, Tel. 02-617-2444 ext. 4161, 4126 Call Center 1772, Phyathai 2 Hospital became the first surgeon in Thailand to use the transvaginal gallstone surgery method to treat patients and improved the surgical technique to make it easier. This is another interesting advancement in the medical field.
“The first step is for the doctor to make a 0.5 centimeter hole 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 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 abdominal surgery instead.”
More important than treatment technology is taking care of the body to stay healthy, exercising regularly, reducing fatty food intake, controlling weight within standard limits, and monitoring oneself for any abnormalities. If there are signs of illness, treatment can be promptly administered.
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Dr. Angkoon Anuwong 
Specialist in Laparoscopic Surgery 
Surgical Center, Phyathai 2 Hospital

One common disease found in Thai people is "gallstones," which requires surgical treatment. With current medical technology, laparoscopic surgery through the vaginal canal is performed, helping patients recover quickly.

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“Gallstone surgery” from a small incision to scarless, a new technique using endoscopy through the “vagina”

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