I am having my gallbladder removed. which kind of surgery is best? i was told to either do the 1 cut through the bellybutton or the 1 cut plus 3 additional small cuts on my right side. which one will be less painful and have less issues?

Actually, : Actually, your surgeon will need to determine which one is most appropriate for you. Of course when it can safely be done through a scope, you would anticipate a quicker recovery. However some gallbladders need to be removed via an open cholycytectomy. I would add ask the surgeon.

The : The other 2 answers are good but would fall under the "politically correct" heading. The "traditional" laparoscopic procedure with 4 small holes is the best operation. There is not a single good reason to have a single incision laparoscopic cholecystectomy. The beg proponents of the single incision (sils) keep coming up with good sounding theories as to why this should be better. The two reasons that they keep hanging their hat on are that there will be better cosmesis with only one incision and that since there are fewer incisions there will be less pain. So far, neither of these have actually been proven true. In the most recent study that was done comparing post operative pain between these two techniques the patients who had the single incision procedure actually reported more pain than those with the standard four incisions. As for the cosmetic advantage, the incision that has to be made at the umbilicus (belly button) to accommodate the instruments for the surgery is larger than any single incision that would be made during the standard technique. This means that there is a greater chance of developing a hernia at this incision later on, which will require another surgery, and with that more scarring. This effectively eliminates the cosmetic advantage of the single incision. The sils procedure has only been around for a couple of years, but there are reports coming out already demonstrating a hernia rate at that incision that is 5x greater than what it would be using the more traditional approach. I've personally done over a thousand laparoscopic cholecystectomies and have not had a single patient ever complain about the size or appearance of their incisions. Most people can't even see them after a few months.

Dr Fowler agreed

Laparoscopic : Laparoscopic cholecystectomy is the standard of care. In selected patients, a single incision cholcystectomy is very safe and effective. Newer curved instruments and special ports allow surgeons to perform a single incision cholecystectomy that is virtually identical to that of a 4 port cholecystectomy. In an experienced surgeon's hand, a single incision cholecystectomy is very safe and effective. The cosmetic results are better with sils and is most appreciated by younger women. I have performed sils choecystectomies for over 4 years on selected patients. Every procedure has been under 60 minutes with no complications. Ask yourself this: if you can have a cholecystectomy via a 2 cm umbilical incision that is just as safe as a 4 port cholcystectomy, why have 3 extra incisions. The technology will continue to improve. It is very important to pick a surgeon who has experience with these new techniques.

I : I agree with dr. Villeneuve. Every operation should be approached with the perspective of benefits vs. Risks. Having performed over 1, 000 laparoscopic cholecystectomies, i can comfortably state that the cosmetic effects of 5mm incisions are trivial. In my personal experience with sils cholecystectomies, the risks of less optimal exposure did not justify the theoretical advantage of less incisions. I believe that, until there is definitive data of any significant benefit, the tried-and-true method of 4-incision laparoscopic cholecystectomy is the gold-standard.