Gallbladder removed through the vagina

So, it’s Friday.  You’re tired and don’t want to plough through a post on some complicated issue.  Perfect time to revive my neglected Weird medical stories series then.

gallbladder

And here’s today’s bizarre case study: surgeons at Northwestern Memorial Hospital in Chicago have successfully removed a woman’s gallbladder through her vagina.

Heather Lamb, a junior high math teacher, was diagnosed with gallstones and had been experiencing severe abdominal pain for weeks. Surgeons at Northwestern decided to remove the offending gallbladder, but by using natural orifice translumenal endoscopic surgery (NOTES) rather than more-invasive laparoscopic or open surgery.

“I went home the day of surgery and felt nothing more than a little discomfort the following day,” said Ms Lamb, “I returned to work a few days later and I’m feeling great.”

The gallbladder concentrates bile produced by the liver, which is then released into the small intestine during the digestive process and helps to break down fatty  food.  In some people in balance of bile components gets out of whack, causing gallstones to form in the gallbladder.  Gallstones can make the organ inflamed and painful and can cause bile to become trapped in the gallbladder, leading to infection.  In such individuals this non-essential organ then needs to be removed.

NOTES can be used remove organs such as the gallbladder, kidney and appendix through the body’s natural orifices, such as the vagina or mouth, instead of via openings created in the skin by a surgeon’s scalpel.

Eric Hungness, a minimally invasive gastrointestinal surgeon at Northwestern Memorial Hospital who led the team that performed the surgery, says, “NOTES reduces the number of and may eliminate the need for abdominal incisions compared with traditional laparoscopic surgery, and may reduce pain and shorten recovery time for patients. This technique may also eliminate the risk of post-operative wound infections or hernias.”

In another recent example of NOTES, surgeons at Johns Hopkins University in Baltimore managed to successfully remove a healthy kidney through a donor’s vagina.  Even more remarkable, the kidney was then transplanted into the donor’s niece. Transvaginal kidney removals has been performed before in order to remove cancerous or nonfunctioning kidneys that endanger a patient’s health; however, this case is the first time that a healthy organ has been removed and then transplanted.

Speaking to the BBC, Dr Robert Montgomery, chief of the transplant division at Johns Hopkins University School of Medicine, Maryland, who led the team that performed the operation, said: “Surgeons have been troubled by the need to make a relatively large incision in the patient’s abdomen after completing the nephrectomy to extract the donor kidney.

“That incision is thought to significantly add to the patient’s pain, hospitalisation and convalescence. Removing the kidney through a natural opening should hasten the patient’s recovery and provide a better cosmetic result.”

It’s quite astounding that a relatively large organ like the kidney can be teased past connective tissue and other organs to be removed through a natural orifice such as the vagina.  Gross, but astounding.

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