The key feature of 3D laparoscopic surgery is that it allows doctors to see a clear and detailed picture of the organs, almost as if they were inside the patient’s body. This surgical technique provides several advantages, including smaller incisions, less pain, faster recovery, improved accuracy, and a high level of safety. This technology has been certified by international medical standards and is widely used in many countries across the world. Bangkok Hospital Khon Kaen was the first hospital to bring this technology to Northeast Thailand. The introduction of this technology serves as an important foundation for achieving Thailand’s national policy goals to offer medical services to patients from across Southeast Asia and make Khon Kaen the center of health services in the region.

Gallstones are a common disease, in which the digestive fluid produced by the gallbladder forms into hardened deposits. They are found in 10-20% of people and can be diagnosed using ultrasound. So, you probably want to know how dangerous they are. The first thing to consider are the risk factors. There is a mnemonic taught in medical school, which is “forty, fertile, fat, and female.” That is, the incidence of gallstones may be more common in “females” over “forty” as they are reaching perimenopause. Women who are “fertile” (i.e., had one or more children) and those that are “fat” (i.e., overweight or obese) may also be at increased risk of gallstones. In many cases, however, the detected gallstones do not result in any symptoms in the patients. Only a small proportion of gallstones result in symptoms, meaning that there is about a 1-2% overall risk for developing symptomatic gallstones each year. Nevertheless, the number of people suffering from gallstones continues to increase.

Many people are curious: what do gallstones look like? Well, it depends on the type. There are two types of gallstones that can form: cholesterol gallstones and pigment gallstones. In Asia, pigment gallstones are most common. They look like dark round or angled lumps with a dark brown color, which are caused when the gallbladder produces too much bilirubin (a chemical produced when your body breaks down red blood cells). Gallstones can cause several complications. First, if a gallstone becomes lodged in the neck of the gallbladder, it can cause inflammation of the gallbladder (cholecystitis). Second, if the gallstone obstructs the bile ducts that run from the liver and gallbladder to your small intestine, it can cause infection or jaundice. Finally, in cases of chronic inflammation, the gallstones can cause gallbladder cancer.

Symptoms are usually mild at first, such as pain in the upper right portion of the abdomen. This pain may also be accompanied by a feeling of bloating under the right rib and feeling full easily, especially after eating oily food or a large meal. However, if the gallbladder becomes inflamed, the abdominal pain will become intense and possibly result in fever, nausea, and vomiting. Diagnosing the disease is not difficult and can be done using an ultrasound. In cases where an ultrasound identifies gallstones without any symptoms, surgery may not be necessary. However, once symptoms or complications develop, surgery may be considered following a doctor’s consultation. Currently, gallbladder removal (cholecystectomy) remains the standard treatment. This can be done laparoscopically by making 3-4 incisions in the abdomen, resulting in less pain and a recovery time of only 1-2 days before returning home. However, major surgery may be needed in cases of acute inflammation in the gallbladder. Furthermore, proactive removal of the gallbladder may be recommended before severe symptoms develop.

Patients often question whether gallbladder removal is effective and whether removal will impact their lives. The important thing to know is that bile is made by the liver and then stored in the gallbladder. Bile is excreted by the liver to help digest fatty foods, such as fried pork belly with rice. So, after the gallbladder is removed, the bile isn’t stored and instead travels directly through the bile duct to the small intestines. Therefore, the biggest change for a patient is to eat fewer fatty foods and focus instead on vegetables and fish. Since most patients are 40-50 years old, these diet changes are already recommended. If a patient that has undergone gallbladder removal continues eating a high fat diet, though, it may result in bloating or in stool that contains undigested fat deposits. For the most part, patients are able to make these adjustments.