Taiwan Today

Wen Yi-hui, director of surgery at Chimei Hospital, announced that at the end of June 2009, a 38-year-old breast cancer patient was diagnosed with gallstones and was scheduled to undergo surgery. The traditional laparoscopic surgery would have left three or four small scars, and the patient wanted to avoid any scars. Because of the high degree of difficulty of this operation, and as Taiwan holds no legally imported equipment suitable for the surgery, the medical team first refused, but privately believed that the procedure was worth a try. After considerable preparation, they improved currently available equipment and made many trial runs. Finally, in early July, the team successfully operated on the woman, removing her gallstones without leaving a single scar. The scarless gallstone removal depends on making a laparoscopic incision through the navel. This is an improvement over the traditional laparoscopic method, which uses three or four small incisions, and allows for the scar to be cleverly hidden, Dr. Wen says. With the success of the operation, Dr. Wen now calculates that it should be possible to apply this technique on operations of more complexity, such as removal of the common bile duct. This structure is located deeper than the gall bladder itself and usually requires a larger incision. The operation is challenging enough using three or four laparoscopic incisions; to reduce this to a single incision would further increase the level of difficulty. Dr. Wen originally hoped to perform such an operation with a single incision in the navel, but he was forced to make one more incision during the procedure, to insert a catheter. After the surgery, only one tiny scar from the catheter was visible. Since July, the team has performed 52 scarless gall bladder operations. Only one patient experienced a slight edema of the incision, while two others required one extra small incision each to complete their surgeries. There are 12 other cases of patients having the common bile duct removed with only two incisions, but with the appearance of only one. Dr. Wen says that the patients who have undergone this new surgical procedure have ranged in age from 24 to 81, and the procedure is quite safe.