GARTH H. BALLANTYNE, M.D. M.B.A.
Gallbladder removal -known to physicians as cholecystectomy (Ko le sis TEK to me) – is a relatively straightforward and commonly performed surgical procedure. Until recently, however, the surgery required a six- to nine-inch incision and a weeklong stay in the hospital, followed by four to six weeks of recovery at home. Healing of the surgical incision could entail considerable pain.
Today, gallbladder surgery can be performed by laparoscopy, a minimally invasive technique not requiring a large incision. Patients usually return home on the morning following surgery, and they can resume their normal routine within a week. With laparoscopy, patients lose less blood during surgery, and they experience far less pain.
At the Center for Advanced Laparoscopic Surgery at St. Luke’s-Roosevelt Hospital Center, cholecystectomy patients benefit from the latest laparoscopic technology, including three dimensional imaging equipment and the most advanced ultrasound instruments in use anywhere.
TREATING GALLBLADDER PROBLEMS
Gallbladder problems are usually caused by gallstones, which are small hard masses that form in the gallbladder or in the bile duct. These stones may block the flow of bile, a digestive agent produced by the liver. As a result, the gallbladder may swell, causing sharp abdominal pain, vomiting, and indigestion.
Some gallstones can be treated with drugs or managed by changing one’s diet, particularly by eliminating fat. When these options fail, however, removing the gallbladder becomes necessary. After removal, bile will continue to flow from the liver to the small intestine, but it will no longer be stored in the gallbladder.
Virtually all patients needing cholecystectomy are candidates for laparoscopic surgery. Before recommending minimally invasive surgery, however, Dr. Ballantyne will carefully review your condition. If laparoscopy is appropriate, Dr. Ballantyne will discuss the benefits, risks, and complications of the procedure
Once the operation is scheduled, a physician at St. Luke’s-Roosevelt Hospital Center-or your personal physician-will evaluate your health and perform routine blood tests. You will also meet with an anesthesiologist or nurse anesthetist before the operation.
You will be admitted to the hospital on the morning of your procedure. Because laparoscopic gallbladder removal is performed under general anesthesia, you cannot eat or drink anything after midnight the day before your surgery.
THE LAPAROSCOPIC SURGERY PROCEDURE:
The first step in laparoscopic gallbladder removal is the insertion into the abdomen of four trocars, narrow tube-like instruments that require only very small surgical incisions. Into one trocar, Dr. Ballantyne inserts a laparoscope, which is a telescopic videocamera that provides magnified and dramatically enhanced views of internal organs. Other surgical instruments are inserted through the other trocars.
During surgery, the common bile duct and artery at the base of the gallbladder are severed from the liver using electronic instruments, then sealed. The surgeon empties the gallbladder of its contents and draws it out through one of the incisions. The incisions are then closed with surgical tape or stitches.
Immediately after surgery, you will be taken to a recovery room. In the hours following the operation, you will experience some pain from the small incisions made to permit insertion of the trocars. Under normal circumstances, you will be able to return home the next day.
At home, you will be able to take care of yourself and enjoy your regular diet. In as few as three or four days, you can return to your normal routine, including work. If you exercise, you can also resume a fitness program and sports competition.
After a few months, the surgical incisions will be barely visible.
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Copyright 1996, Garth Hadden Ballantyne, M.D. P.C. All rights reserved.
50 East 69th Street, New York, New York 10021 (212)-249-2626 or (800)-LAP-SURG
In the era of disposable cellphones, the Valentine One s 22-year-old design can t hide its age. Don t write it off, though, because the simple shape packs clever, enduring engineering. You can install, adjust, and remove the mount with one hand, and the front-facing controls are smartly canted toward the driver.
Inside the magnesium case, Valentine has updated the V1 s internals throughout the years to preserve its reputation as the most sensitive radar detector on the market, a title we re not about to rescind. (Admittedly, we haven t put it up against Escort s hyper-paranoid RedLine detector.) In each of our range trials, the V1 provided generous warning, and its second, rear-facing antenna an exclusive in this test gives it a leg up in rearward detection. The V1 also reported POP radar and laser alerts more consistently than the Passport Max.
One annoyance is incessant false alarms the Valentine s filtering isn t very effective. On our 22-mile loop, the V1 called out 53 threats in its most selective mode, which reduces but doesn t eliminate X-band alerts. Turning off X-band is an involved process that you wouldn t bother with on an interstate exit ramp. Determining what s a cop and what s not is left to the driver, who faces a steep learning curve to decipher the V1 s bogey count, band indicators, signal-strength meter, and the signature arrows at a quick glance.
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