Ο διακεκριμένος γενικός χειρουργός Δρ. Αναστάσιος Ξιάρχος μιλά για τη νέα, πρωτοποριακή μέθοδο θεραπείας της χολολιθίασης, τη διαδερμική λιπαροσκοπική …
We have with us the surgeon
Mr. Anastasios Xiarchos.
-Welcome.
-It's nice to be here.
Each time, you raise the standards,
as you always inform us
on the very latest in your field
as regards technological
and scientific developments.
Mr. Xiarchos, let me first remind
you are the Director of General Surgery
of Medical Group and in Peristeri too.
Dear viewers, as you can see
at the bottom of your screen
today we are going to talk about
percutaneous laparoscopic cholecystectomy.
It concerns the latest developments
for the treatment of cholecystitis.
As far as I understand it.
It is a truly innovative method
that our doctor here applies.
Mr. Xiarchos, we hear you
on what we need to know.
What will make us feel much better?
First, we should mention that
10% of the world population
suffer from what we call
cholelithiasis or cholecystitis.
So are we referring to the presence
of stones or sand in the gallbladder?
Right.
The gallbladder or, else, cholecyst
is a cyst in the shape of a pear,
which functions as a reservoir,
a tank where the bile is stored.
In this image here,
we can see that our liver,
among its other functions,
produces this fluid that we call bile.
This fluid, the bile, is secreted
through the tubes inside the liver,
and through the bile duct
it is transferred lower
to the duodenum, to the intestine.
There, in the small intestine, the bile
produced by the liver meets the food.
The food passes through
the esophagus to the stomach
and meets the bile
inside the duodenum, the small intestine.
This is necessary for digestion
that is the breakdown of lipids.
When we eat a meal,
in order for it to be digested,
to be absorbed and broken down,
especially the lipids,
the food must interact with the bile.
The bile produced by the liver
amounts to 1.5 liters per day.
-That much?
-That much.
The gallbladder, resembling a pear,
this storage space,
stores up a quantity of
about one very small cup.
-Out of the 1.5 liters going down.
-Is that so?
And when we have a very heavy meal,
rich in lipids,
this causes the gallbladder
to contract, like a pump.
That way the additional bile stored
falls on the intestine.
So, the role of the gallbladder
is to store the bile
and provide this additional solution
to make possible digestion.
So when it doesn't function right,
food is not digested right
-…and it causes a problem.
-Exactly.
-So, in cholelithiasis…
-What are those?
Those are stones removed
from a gallbladder.
-These are stones!
-Yes.
They are all small stones. Like marbles.
In this picture I'd say
they look like pebbles
or semi-precious stones.
What did you say?
What did you think they were?
My colleagues tell me
they look like amber.
-These were inside the gallbladder?
-Yes.
There are various gallstones.
Larger ones, smaller ones.
Black, white, others like these here.
A great variety.
We don't know exactly how
they are formed inside the gallbladder.
But one factor is stagnation,
which leads to settlement.
As bile stagnates inside
the gallbladder for many hours,
this stagnation causes an accumulation of
bile salts or acids and therefore stones
Other risk factors are family history,
female gender, obesity,
birth control pills,
and something else
that is of interest to many people:
a strict diet, low in fat.
This is very important.
This is why patients
in intensive care, who are not fed,
often present with cholelithiasis.
-Really?
-Or an inflammation of the gallbladder.
So a very strict diet,
which is extremely low in fat
without balance
can cause or affect
the condition of cholelithiasis.
Let's talk about the method.
Our editor-in-chief was fascinated
by the video and wants us to share it.
The treatment of gallstones
is gallbladder removal.
Until 1989, removal of the gallbladder
was done in open surgery.
We removed it through a large cut.
Then we had laparoscopic cholecystectomy.
We use several small incisions
to remove the gallbladder,
using a video camera
and several thin instruments.
That is the laparoscopic method.
-That is correct.
-I see.
It is this method that we still use.
Through the navel, we insert
a special small video camera
which helps us see
the organs in magnification.
We use another three small instruments,
through three small incisions,
which allow us
to remove the gallbladder
inside a bag, together with the stones.
As we see it here.
A percutaneous laparoscopic
cholecystectomy is a development
in laparoscopic gallbladder surgery,
initiated in the U.S.A. three years ago.
So, it is a very new method.
The latest development.
Recently, we had the pleasure
of performing it here in Athens,
in our medical center.
What has changed?
The instruments that we use.
Because little by little
we wanted to have
a method which is
as minimally invasive as possible.
-To have a wound which is…
-The smallest possible.
-So that the recovery is fast.
-Exactly.
This is what surgery
is aimed at nowadays.
A smaller wound, less tissue damage
and going back
to normal activities soon.
This development made possible
the replacement of large instruments,
which we inserted with relatively
larger holes through the abdomen,
with half a millimeter wide instruments.
So thanks to this development,
when we take out the instruments
and our job is done,
there are no scars, nor pain,
nor the wound that we used to have.
It is very impressive.
Let me ask you, does this
require general anesthesia?
Yes.
-So, general anesthesia.
-In laparoscopic cholecystectomy, yes.
The incision, the hole, is tiny.
For how long does the patient
need to stay in the hospital?
With this method?
The patient comes in in the morning,
not having eaten anything.
We do some pre-surgery tests,
such as blood tests,
a chest X-ray and a cardiogram test.
Then the operation takes place
for 40 minutes up to 1-1.5 hours.
By the afternoon, the patients
can get up, walk, have a light meal.
The next morning, they return home.
So, one night only.
Well, that's amazing.
And you keep on
impressing us every time.
Thank you very much
for joining us once more.
We learned about the most
up to date and innovative method.
As presented by the surgeon,
Mr. Xiarchos.
For the treatment of cholecystitis,
through percutaneous
laparoscopic cholecystectomy.
The most recently developed method.

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