Gallstones are still common in Thai people
The high-risk group commonly found is women aged 40 and over who are overweight while men can also develop this disease, although less frequently. Contributing factors to gallstones include high-fat dietary habits, obesity, and genetics
Gallstones, a disease not to be overlooked
Gallstones (Gallstones) are caused by the precipitation of bile into hard stones. If the stones block the bile duct, patients will experience pain in the right upper abdomen, nausea, vomiting, and it can be severe enough to cause cholecystitis or bloodstream infection, which can be life-threatening
Currently, the standard treatment is gallbladder removal surgery which has evolved from open surgery to small incision laparoscopic surgery, and most recently developed into scarless laparoscopic surgery through the vagina, or SILS-V
What is SILS-V?
Single Incision Laparoscopic Surgery through the Vagina (SILS-V) is a gallstone surgery technique that uses a natural orifice, the “vagina” to insert surgical instruments into the abdominal cavity. There is only a small hole about 0.5 centimeters at the navel for inserting the camera and carbon dioxide gas to expand the space for the surgeon to work comfortably
The highlight of this method is almost no visible external scars less postoperative pain, and faster recovery
Steps of scarless laparoscopic gallstone surgery (SILS-V)
- Make a small hole at the navel (0.5 cm) The surgeon makes a small hole at the navel to insert a small endoscopic camera and release carbon dioxide gas into the abdominal cavity to expand the space and help visualize the internal organs clearly
- Insert instruments through the vagina Use small surgical instruments through the vagina to dissect and remove the gallbladder without affecting the uterus or reproductive organs
- Safely remove the gallbladder Once the gallbladder is separated, it is placed in a protective bag (Endo bag) to contain it and removed through the vagina to prevent bile leakage into the abdominal cavity
- The surgery takes about 40 minutes which is comparable to standard laparoscopic surgery and does not require the patient to stay in the operating room longer than necessary
- Postoperative recovery Patients experience very little pain, can walk, eat soft food, and return to daily life quickly. Importantly, there is almost no external scarring
Advantages of scarless laparoscopic gallstone surgery (SILS-V)
- No external scars boosts confidence in appearance
- Less pain than traditional methods reduces the need for postoperative pain medication
- Short recovery time patients can return to daily life quickly
- Reduces risk of complications such as hernia at the navel incision site
Limitations of this method Although SILS-V has many advantages, it is not suitable for all patients, such as
- Patients with severe acute cholecystitis
- Patients with extensive abdominal adhesions from previous surgeries
- Male patients (standard laparoscopic surgery through the abdomen is still used)
Who is suitable for vaginal gallstone surgery (SILS-V)
- Working-age or middle-aged women especially those aged 30–60 years and older, who are commonly found to have gallstones. Their physiology allows the vagina to be used as a passage for instruments
- Those diagnosed with gallstones but without acute inflammation such as stones causing intermittent abdominal pain, nausea, bloating after eating fatty foods. In non-emergency cases, SILS-V is safe and effective
- Those who want to reduce surgical scars suitable for those concerned about aesthetics, such as not wanting scars on the abdomen or navel. This method is considered “scarless externally” which meets cosmetic needs well
- Those who want a quick recovery people with busy schedules who want to return to daily activities quickly. SILS-V surgery usually causes less pain and has a shorter recovery time than traditional methods
- Those assessed by doctors as having no contraindications no severe inflammation, no extensive adhesions from previous abdominal surgeries, no underlying diseases that increase risk of complications
Self-care to reduce risk
Although treatment technology has advanced, the most important thing is prevention
- Avoid very fatty foods
- Maintain weight within a healthy range
- Exercise regularly
- Monitor for abnormal symptoms such as pain in the right upper abdomen, nausea after eating fatty foods
Phyathai 2 Hospital was the first to introduce vaginal gallstone surgery, led by a team of experienced specialized surgeons in small incision laparoscopic surgery since 2016 and has continuously developed techniques and tools to be safer and easier, helping patients return to daily life almost immediately after surgery
If you have pain in the right upper abdomen or suspect gallstones, consulting a specialist will help you receive appropriate advice and choose the safest treatment option for each individual. The medical team at Phyathai 2 Hospital is ready to provide care with a focus on medical standards and patient safety
Dr. Angkoon Anuwong
Specialist Surgeon in Laparoscopic Surgery
Phyathai 2 Hospital
