The gallbladder is an organ that sits just underneath the liver within the right upper abdomen. It is responsible for storing bile that is necessary in the digestion of fatty foods. Once this food enter the intestines the gallbladder is stimulated to contract and expel bile into the intestines. Gallbladder disease is largely the result of stone formation within the gallbladder. When stones appear within the gallbladder and it is then stimulated to contract the stones may block the outlet of the gallbladder. This results in pain in the upper abdomen that can be sharp and episodic. It is usually associated with food intake, particularly food containing a lot of fat. Should the stones get stuck within the outlet this can result in inflammatory changes to the gallbladder known as acute cholecystitis. Usually, patients that develop this will have constant upper abdominal pain along with signs of infection. This is considered a surgical emergency. Additionally, the stones within the gallbladder may travel out of the gallbladder and get stuck in the main duct that delivers bile to the intestines (common bile duct). Should this happen, patients may complain of pain. But also they may complain of yellowing of the skin and/or eyes. They may also notice stools that appear clay-colored. Patients may also develop pancreatitis, inflammation of the pancreas, should stones get stuck in the region of the pancreas duct.
The mainstay of treatment is surgical removal of the gallbladder. This is one of the most common surgeries performed in the United States. It is done laparoscopically. The surgery involves identification and clipping of the duct that connects the gallbladder to the main duct. This duct is called the cystic duct. Additionally, the cystic artery (the artery that supplies blood to the gallbladder) is also clipped. Once this is done the gallbladder is taken off the liver bed and removed through the biggest port site usually by the belly button. This surgery is done as an outpatient procedure. This means patients are welcome to go home on the day of surgery after a period of observation. In the situation that stones are present in the main duct system (common bile duct) a procedure, known as an ERCP, may need to be performed prior to removal of the gallbladder. This procedure involves removal of stones from the main duct.
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Hernias develop in naturally occurring weak areas within the abdominal wall and groin regions. Belly button hernias are known as umbilical hernias and groin hernias are known as inguinal hernias. Hernias may also occur from incisions from previous surgeries. These are known as incisional hernias. Fatty tissue or organs within the abdomen can sometimes squeeze through these weakened areas and cause symptoms of pain and discomfort. The symptoms may first be noticed with increased activity or heavy lifting. These activities may sometimes make the symptoms worse. Should the contents of the hernia get trapped and not be able to go back into the abdomen this is known as a strangulated hernia and is considered a surgical emergency. Once a hernia develops and causes symptoms it will not heal on its own and surgery is required to fix them. Today, hernia surgeries are one of the most common procedures performed in the country. We offer both open and minimally invasive (laparoscopic and robotic-assisted) techniques to fix hernias. Most of our hernia repairs involves the use of mesh. Mesh is a surgical device constructed of synthetic material. We have found that this decreases the chance of the hernia coming back in the future. A number of our hernia procedures are outpatient, meaning patients are welcome to go home on the day of surgery following a period of observation.
More information further describing hernias and the mesh used to fix them may be found at the following website: