New surgery to remove gallbladder nearly scarless, less painful

In a first for the St. Louis region, School of Medicine surgeons are removing patients’ gallbladders using a single small incision in the belly button that leaves only a barely visible scar.

“The more than a dozen patients who have had the procedure have fared extremely well,” said L. Michael Brunt, M.D., professor of surgery and co-director of the Institute for Minimally Invasive Surgery at the School of Medicine. “They typically go home the same day as the surgery or the morning afterward. But the most striking difference is that when patients come back several weeks later for a checkup, you essentially can’t see a scar.”

L. Michael Brunt, M.D. (left), professor of surgery, and Ankit Bharat, M.D., a resident in the Department of Surgery, perform surgery at Barnes-Jewish Hospital to remove a patient’s gallbladder through the belly button.

Surgery to remove the gallbladder is one of the most common operations performed in the United States. More than 750,000 patients undergo the procedure each year, often due to the formation of gallstones that cause intense pain. The surgery typically is performed using a laparoscopic technique in which surgical instruments and a miniature video camera are inserted into four small incisions in the abdomen. The camera is linked to a video monitor, where surgeons view the patient’s internal organs.

With the new procedure, the long, slender surgical instruments and camera are all inserted through a one-inch incision in the belly button.

“This not only minimizes scarring but reduces pain because there are fewer incisions,” said Brunt, who performs the surgery at Barnes-Jewish Hospital.

The single-incision surgery is more technically challenging than a traditional laparoscopic procedure, said Brent Matthews, M.D., associate professor of surgery and chief of the Section of Minimally Invasive Surgery, who also performs the operation at Barnes-Jewish Hospital. But he predicts that the majority of gallbladder surgeries at Barnes-Jewish soon will be performed using this technique.

“One of the biggest advances in surgery over the past 20 years was the development of laparoscopic techniques to perform many operations that were traditionally done through a large, open incision,” Matthews said. “Now, we’re looking for ways to make those operations even less invasive, and the single-incision belly button surgery is one alternative.

“In the future, I think we’ll see a number of different operations besides gallbladder surgery that can be done using this technique,” Matthews said.