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New Approach to Gallbladder Surgery, Smallest Reported Incision

Santiago Horgan, MD, chief of minimally invasive surgery at UC San Diego Health.


  • Jackie Carr

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  • Jackie Carr

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A surgical team at UC San Diego Health has completed the first series of operations with a novel surgical system that can remove a diseased gallbladder through a single incision hidden in the belly button.

Santiago Horgan, MD, chief of minimally invasive surgery, was able to successfully remove the gallbladder through a 15-millimeter incision – roughly half an inch. This is believed to be the smallest reported successful incision for this procedure.

“What we are seeing is the rapid evolution of traditional laparoscopy toward less and smaller incisions — just one tiny incision, in fact,” said Horgan, professor of surgery and director of the Center for the Future of Surgery, UC San Diego School of Medicine. “Normally, a gallbladder removal would be performed with four incisions across the abdomen. We achieved the surgery with one small cut hidden in the umbilicus. So not only are there fewer incisions, the one that remains is incredibly small.”

Horgan said the new approach is dramatically better for patients in terms of healing and appearance. He cited fewer incision site complications, less post-operative pain, reduced chance of hernia, faster recovery and exceptional cosmetic outcomes as potential benefits. The 30-minute procedure was performed under general anesthesia. Patients returned home the same day with no complications. Approximately 600,000 people per year have their gallbladder surgically removed in the United States.

Horgan is a global leader in minimally invasive surgery and is on the forefront of developing surgeries that can be performed through natural body openings. He was the first U.S. surgeon to perform an appendectomy through the mouth in 2008. As head of the Center for the Future of Surgery, Horgan is a vocal proponent of developing new surgeries and tools that are safer for patients, and training surgeons on how to perform the techniques.

Horgan performed the gallbladder removal, also known as laparoscopic cholecystectomy, with the Fortimedix FMX314 surgical system. The system was approved by the FDA in August 2016.

To learn more about minimally invasive surgery at UC San Diego Health, visit

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