Gall Stones

Gall stones are hardened deposits of digestive fluid that can form in your gall bladder. Your gall bladder is a small, pear-shaped organ on the right side of your abdomen, just beneath your liver. The gall bladder holds a digestive fluid called bile that’s released into your small intestine.

Gall stones range in size from as small as a grain of sand to as large as a golf ball. Some people develop just one gall stone, while others develop many gall stones at the same time.Gall stones are common in the United States. People who experience symptoms from their gall stones usually require gall bladder removal surgallery. G stones that don’t cause any signs and symptoms typically don’t need treatment.

 

What Causes Gall bladder Problems?

  • Gall bladder problems are usually caused by the presence of gall stones which are usually small and hard, consisting primarily of cholesterol and bile salts that form in the gall bladder or in the bile duct.
  • It is uncertain why some people form gallstones but risk factors include being female, prior pregnancy, age over 40 years and being overweight. Gall stones are also more common as you get older and some people may have a family history of gall stones.
  • There is no known means to prevent gall stones.
  • These stones may block the flow of bile out of the gall bladder, causing it to swell and resulting in sharp abdominal pain, vomiting, indigestion and, occasionally, fever.
  • If the gall stone blocks the common bile duct, jaundice (a yellowing of the skin) can occur.

How are These Problems Found and Treated?

  • Ultrasound is most commonly used to find gall stones.
  • In a few more complex cases, other X-ray test such as a CT scan or a gall bladder nuclear medicine scan may be used to evaluate gall bladder disease.
  • Gall stones do not go away on their own.  Some can be temporarily managed by making dietary adjustments, such as reducing fat intake. This treatment has a low, short-term success rate. Symptoms will eventually continue unless the gall bladder is removed. Treatments to break up or dissolve gall stones are largely unsuccessful.
  • Surgical removal of the gall bladder is the time honored and safest treatment of gall bladder disease.

Advantages of Performing Laparoscopic Gall bladder Removal

  • Rather than a five to seven inch incision, the operation requires only four small openings in the abdomen.
  • Patients usually have minimal post-operative pain.
  • Patients usually experience faster recovery than open gall bladder surgery patients.
  • Most patients go home the same day of the surgery and enjoy a quicker return to normal activities.

Who needs Laparoscopic Gall bladder Removal

Although there are many advantages to laparoscopic gall bladder removal, the procedure may not be appropriate for some patients who have severe complicated gall bladder disease or previous upper abdominal surgery. A thorough medical evaluation by your personal physician, in consultation with a surgeon trained in laparoscopy, can determine if laparoscopic gall bladder removal is an appropriate procedure for you.

Preparatio for Laparoscopic Gall bladder Removal?

  • The following includes typical events that may occur prior to laparoscopic surgery; however, since each patient and surgeon is unique, what will actually occur may be different:
  • Preoperative preparation includes blood work, medical evaluation, and an EKG depending on your age and medical condition.
  • After your surgeon reviews with you the potential risks and benefits of the operation, you will need to provide written consent for surgery.
  • It is recommended that you shower the night before or morning of the operation. Your surgeon may also want you to use an antibiotic soap.
  • After midnight the night before the operation, you should not eat or drink anything. You may take medications that your surgeon has told you are permissible to take with a sip of water the
    morning of surgery.
  • Drugs such as blood thinners, anti-inflammatory medications (arthritis medications) and Vitamin E may need to be stopped temporarily for several days to a week prior to surgery.
  • Diet medication or St. John’s Wort should not be used for the two weeks prior to surgery.
  • Quit smoking and arrange for any help you may need at home.
  • Do not shave your abdomen before surgery.

Kidney stones

Kidney stones have many causes and can affect any part of your urinary tract — from your kidneys to your bladder. Often, stones form when the urine becomes concentrated, allowing minerals to crystallize and stick together.

Passing kidney stones can be quite painful, but the stones usually cause no permanent damage. Depending on your situation, you may need nothing more than to take pain medication and drink lots of water to pass a kidney stone. In other instances — for example, if stones become lodged in the urinary tract or cause complications — surgery may be needed.

Two types of minimally invasive surgery that urologists are well known for are:

• Laparoscopic kidney operations
• Endoscopic procedures used to diagnose and treat upper urinary tract disorders.

Laparoscopic Kidney Procedures

Most people with kidney disease are candidates for laparoscopy. In the past, obesity, previous abdominal surgery and pulmonary disease were considered barriers to laparoscopic operations. But in the experience of Sunrays Clinic urologists, patients in these situations enjoy the same success and recovery rates as other patients.

Description

In a laparscopic procedures, surgical tools and a tiny video camera are inserted into the patient’s abdomen through several small incisions (less than one-half inch in length). The camera transmits video images that allow the surgeon to see the kidney in great detail. The surgeon then inserts surgcial instrument through two or three other small incisions and perfoms the operation.

Laparoscopic kidney procedures are performed under general anesthesia and last 2 to 4 hours. Following the procedure, the incisions are closed with a stitch or two or with surgical tape; within a few months, they are barely visible. Complications are minimal and success rates are comparable to those of conventional kidney surgery.

Endoscopic kidney procedures

Urologists at Sunrays Clinic have been using endoscopy for more than a quarter of a century for diagnosis and treatment of upper urinary tract disorders. Over the past decade, the Sunrays Clinic urologists have seen a significant rise in the success of these procedures, thanks to the development of ever smaller and more flexible endoscopic equipment.

There are no age restrictions for endoscopic procedures. However, people who have had previous bladder operations or who have marked enlargement of the prostate require a different type of treatment.

Description

An endoscope is a small, flexible tube with an attached optical system that is inserted into the body through an opening (like a urethra) or through a small incision. The optical system allows doctors to see the insides of organs and body cavities, and to perform surgery by inserting and manipulating equipment through the tube. Because they require little or no incision, endoscopic surgeries cause minimal scarring and allow rapid recovery times.

Sunrays Clinic urologists use endoscopic procedures to:
• diagnose and treat a wide variety of upper urinary tract disorders
• find sources of bleeding or infection
• determine the nature of lumps found in the upper urinary tract
• biopsy tumors in carefully selected cases
• treat stones in the ureters and kidney
• treat strictures in the upper urinary tract
• treat certain types of benign tumors and lesions in the upper urinary tract