Tuesday, February 26, 2013

Is gallstone removal done by laser?


Is gallstone removal done by laser?
Everyone seems to be offering "Laser surgery" for Gall bladder. Is laser really used?
A young unmarried girl in her early twenties came to me with ultrasonography report of multiple stones in her Gall Bladder.  After listening to her complaints, I examined her. I went thro the reports and gave my opinion – she requires removal of her gall bladder (Cholecystectomy). The first question her father asked, "Will this be removed by laser or surgey?".  Her mother got up from chair indicating that she was not interested and said, "My daughter is unmarried and we want only laser to be done"
So this is a common misconception – Laser for Gall bladder stones.
It is a very funny misconception that many patients have that the gallbladder is removed by a laser. The gall bladder is removed only by two techniques open surgery or by laparoscopy. Practically no where in the world is laser is used for removal of gall bladder. I have spend many months in world renowned hospital in New York – Mount Sinai Hospital. I never evenheard of laser for Gall bladder.
When I replied to the parents that I do not use laser for gall bladder removal, they looked confused. Father replied, "We came here because we have heard lot of good reviews about you and this hospital. Our family physician had send us to ****** hospital. The surgeon there told me that he will perform laser removal of Gall bladder. We came to this hospital because we thought this is a bigger hospital and hence you will have better facilities."
This is Laser misconception has been created by the surgeons and used as a very effective marketing & money making tool. I saw the previous surgoen's case paper. He had scribbled an estimate that was nearly twice that of our hospital. Forget about the laser, that hospital does not even have standard laparoscopic instruments.
I made her parents come closer to my desk and showed them on internet about the standard gold standard procedure used for gall bladder removal – Laparoscopic cholecystectomy and made it very clear to them that there is no laser used in the surgery.
Subsequently I operated her and after a week she was back to her college.
Surgeon might be using the word "Laser" in their practice for following reasons:
  • To indicate that the surgery is hi-tech
  • To make patient feel that he is offering them something unique
  • To charge patients more
I have been performing Laparoscopies since 1994 and have attended many international hospitals and conferences. Its a perfect example where science has been used for reducing the trauma of open surgery. Patient just has a small cut in the belly button and 2 or 3 very small cuts instead of an incision of 10 – 20 cms length required in open surgery. In my early residency days I have seen the patients suffer after the open surgery and I can clearly see great benefit that Laparoscopic surgery offers. Although it requires a much more skill its really worth it. The hospital stay is less, pain is less, scar is negligible & the cost is nearly the same as open surgery.
Read more about benefits of Laparoscopic cholecystectomy versus open cholecystectomy.
- See more at: http://drbcshah.com/is-gallstone-removal-done-by-laser/#sthash.ArZRZlfV.dpuf

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