Speeding up treatment for gallstones and a UK first for Oxford University Hospitals

A revolutionary surgical technique to help patients with complex gallstone disease has been introduced at the John Radcliffe Hospital, with the support of funding from Oxford Hospitals Charity.

Oxford University Hospitals NHS Foundation Trust is only the second NHS Trust in the UK to offer this pioneering procedure, which uses laparoscopic lasers to break up gallstones and remove the gallbladder. 

Laser Assisted Bile duct Exploration utilising Laparoendoscopy or LABEL procedure is keyhole surgery that breaks down common bile duct (CBD) gallstones into tiny pieces and removes the need for patients to have a second invasive operation. The technique uses laparoscopic lasers to shatter the gallstones which can then be passed naturally in much the same way as kidney stones are routinely dealt with.

Previously, patients would first need an endoscopic procedure and then later, laparoscopic cholecystectomy - which is the removal of the gallbladder by inserting a tiny video camera and special surgical tools through four small incisions to remove the gallbladder.

Oxford will also be the only place in the UK to offer the treatment in a real-time emergency setting.

An £80,000 gift from a generous charity donor to Oxford Hospitals Charity has funded all the equipment for this innovation - covering the costs of laser glasses, surgical instrument kits, theatre reconfiguration and a significant amount of training to ensure the success of the project.

In December 2022 the team at the John Radcliffe Main Theatres were able to treat their first patient, with an operation to remove the gallbladder and then remove the complex CBD gallstones, all in one sitting.

Laura Cuthbertson, Laser Lead Senior Operating Department Practitioner at OUH, said: "The LABEL operation was entirely new to the theatre team in Oxford, so we are grateful to the Ambulatory Care and Diagnostic Centre at Middlesex Hospital for sharing their skills and expertise, which led to our first cases being a great success.

"Our first case would not have been a success without the skills of the theatre team: Marmie Valencia, Theatre team leader; Nikki Ordinario and Jeny James, Theatre Scrub nurses; Kavya Mohan, Anaesthetic nurse; Andrew Jones, Consultant Anaesthetist; Mr Mohamed Shams, Consultant Surgeon; Mr Alberto Martinez-Isla, Consultant and Mr Giles Bond-Smith, Consultant Surgeon."

Giles Bond-Smith, Consultant Surgeon at OUH, said: "This new procedure has allowed us to reduce the length of hospital stay to just one day – which is so much better for the patients and a significant financial saving for the Trust. It also puts the hospital on the UK map as the only centre in the UK to have this option available in an emergency setting.

"None of this would have been possible without the fantastic, and significant, donation by Oxford Hospitals Charity via a donor that had a specific interest in this area, whom we are most grateful to."

Anny Sykes, Interim Chief Medical Officer, Oxford University Hospitals, said: "We are proud of how well the initial procedure has gone. We have potential for a world class laser service here in Oxford and this technique could benefit over 700 patients each year."

Pictured: Left to right, Nikki Jane Ordinario, Staff Nurse; Mr Giles Bond-Smith, Consultant Surgeon; Dr Andy Johnson, Consultant in Cardiothoracic Anaesthesia; and Laura Cuthbertson, Laser Lead Senior Operating Department Practitioner