Utility of Tokyo guidelines and intraoperative safety steps in improving the outcome of laparoscopic cholecystectomy in complex acute calculus cholecystitis: a prospective study.

Background: Laparoscopic cholecystectomy (LC) in complicated acute calculus cholecystitis (ACC) poses multiple challenges. This prospective, observational study assessed the utility and safety of a set protocol and intraoperative steps in LC for complex ACC.

Methods: All cases of ACC from 2008 to 2018 were graded as per Tokyo guidelines; moderate and severe ACC were termed as 'complex ACC (CACC).

Laparoscopic splenectomy for spontaneous rupture of the spleen.

Laparoscopic splenectomy is a gold standard for management of planned benign splenic pathologies. Spontaneous rupture of the spleen (SRS) leading to acute abdomen occurs in only 1% of all splenic ruptures. Laparoscopic splenectomy in traumatic and atraumatic rupture due to intra-splenic pathology is reported.

Rudimentary Gallbladder Mimicking Choledochal Cyst.

Rudimentary gallbladder is a rare congenital anomaly. We present a case of an 18-year-old boy who was referred to us for surgical management of choledochal cyst. Clinical assessment and correlation of various investigations raised the possibility of rudimentary gallbladder rather than choledochal cyst.

Massive Liver Trauma-Multidisciplinary Approach and Minimal Invasive Surgery can Salvage Patients.

Management of massive liver trauma (grades IV-VI) is associated with high morbidity and mortality. It can pose serious challenges to treating physician and requires multimodality interventions. For a successful outcome, timing of intervention is crucial.

Use of ultrasonic shears in patients with breast cancer undergoing axillary dissection-a pilot study.

Patients with breast cancer and positive sentinel node biopsy usually require axillary dissection. Different instruments are used for axillary dissection like regular scalpel,monopolar cautery, bipolar cautery etc. All these instruments are having its advantages and disadvantages.