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Without a Trace

Innovative gallbladder surgery leaves no visible scars. Another big plus: a fast recovery.

As an athletic pro golfer, Melanie Willhite of Farmers Branch never relished the thought of inactivity. So when told she needed gallbladder surgery after years of recurring discomfort, she knew exactly what she wanted: a brief recovery period so she could return to competitive play quickly. 

“I really wanted to get back on the tour as soon as possible,” says the 29-year-old Melanie, who has since retired from pro golf and now works as a civil engineer.

In years past, fast convalescence from gallbladder surgery was as likely as shooting a hole-in-one on a difficult par five. But thanks to a recent innovation – and the skill of a UT Southwestern Medical Center surgeon –recovery from the surgery is now much quicker, and the procedure leaves no scar. 

“It was phenomenal,” says Melanie of her recovery from the operation early last year. “I was back putting within two weeks, and within a month, I was back on the tour.”

As for any scars that might now be noticeable? “If somebody were to look at me with my bathing suit on, they would never know I had gallbladder surgery.”

Less Invasive, More Convenient

Melanie was one of the first patients in the area to benefit from single-incision laparoscopic cholecystectomy. The new patient-friendly gallbladder procedure takes less than one hour and requires just a single incision in the belly button, through which doctors insert surgical instruments and a video camera.

Almost one million Americans have their gallbladders removed every year; the vast majority are women, who tend to get gallstones more than men because of hormone differences. Doctors perform most of the surgeries on an outpatient basis using a four-incision technique, rather than a single incision.

Melanie’s innovative surgery was done by Homero Rivas, M.D., assistant professor of  GI/endocrine surgery and  J. Esteban Varela, M.D., assistant professor of GI/endocrine surgery at UT Southwestern. With extensive training and experience at medical facilities on four continents, including fellowships in laparoscopic surgery in the U.S. and Europe, Dr. Rivas also teaches the fier points of minimal  access surgery around the world. His presence at UT Southwestern places the university among the handful of medical facilities in the country – and the only one in North Texas – using the single-incision technique to remove gallbladders.

“This completely new technology makes gallbladder surgery less invasive than before,” says Dr. Rivas. “It can be performed safely on an outpatient basis; potentially there’s less chance of infection since there’s only one incision versus four; and recovery is faster. For the patient, it’s much more convenient.”

Besides, he asks, “Why have four incisions on your body when we can do the same thing with just one  incision that doesn’t show?”

Gallbladder Disease – What it is
The gallbladder is a small organ that stores bile secreted by the liver to help digest food. Occasionally, substances in the bile crystallize, leading to gallbladder disease in the form of gallstones that can in ame the gallbladder and block bile ow. That can produce symptoms similar to indigestion and even intense pain if the stones become lodged in the bile duct.

Feeling Good Again

Melanie’s surgery ended more than a decade of gallbladder attacks, which sometimes left her with pain so intense she couldn’t stand. “I had been having pain for so long. I had just come to think it was something stress-related from golf,” she says. Finally, after she lost about 12 pounds in two months, her doctor diagnosed gallbladder disease and referred her to Dr. Rivas, who told her about the single-incision operation.

“I was all for it,” says Melanie. “I’m not going to say I wasn’t nervous about it, but when you have full confidece in your doctor and in your faith that you’re going to be fie, that really helps.

“It’s nice to feel good and healthy,” she adds. “It’s been wonderful for me.”

About a year ago, Diana Castro also opted for the new procedure, hoping for a faster recovery – and she wasn’t disappointed either. “I was able to travel on a sixhour plane trip to my home country just 10 days after the operation. There were no complications,” says the 42-year-old mother of three from Dallas, whose doctor recommended she see Dr. Rivas when ongoing gallbladder problems intensified.

“I was back on my feet the next day after the procedure, and two weeks later I was completely recovered,” says Diana. “The short recovery time and the aesthetics were the surgery’s best benefits. I feel perfect.”

Best Candidates

Though the procedure offers appealing advantages, it’s not for everyone.

“Generally speaking, most patients with gallbladder disease would be able to have the single-incision procedure if they could normally have outpatient surgery – but not everyone,” says Dr. Rivas. It comes down to complexity: The simpler or less advanced the gallbladder disease, the more likely single-incision surgery would be an appropriate option. “Because this is a new technique, it’s currently best suited for not very complex problems,” he says.

The best candidates for the procedure? Dr. Rivas says people between the ages of 20 and 40, because their cases tend to be more straightforward and less complex, though he has performed the surgery on patients in their 60s.

It’s not suited for people who have had several open operations in the upper abdomen or those who are morbidly obese, two conditions that present technical challenges to surgeons. 

“In those cases, patients are better served by using the existing fourincision procedure,” says Dr. Rivas.

Doctors now perform numerous types of advanced laparoscopic surgeries at UT Southwestern, making its Center for Minimally Invasive Surgery the North Texas region’s foremost source for innovation and patient care in these types of procedures. For an appointment, call 214-645-8300.