Backgrounds/AimsWe report our experience with day-surgery laparoscopic cholecystectomy and assess its feasibility and safety.MethodsData was collected on all the patients who underwent day-surgery laparoscopic cholecystectomy between February 2009 and February 2014 at Prince Sultan Military Medical City, Riyadh, Kingdom of Saudi Arabia. All patients had symptomatic cholelithiasis that was proven on imaging studies with clearance of the common bile duct. The patient biographical data (age, gender, American Society of Anaesthesiology status, medical comorbidities) and surgical outcomes were then obtained. There was an evaluation of the success rate of day-surgery laparoscopic cholecystectomy, reasons for unexpected admission, and the re-admission rate.ResultsA total of 1,140 patients were included in this study. The success rate for day-surgery laparoscopic cholecystectomy was 96%. The reasons for unexpected hospital admission for 46 patients (4%) included persistent abdominal pain and postoperative emesis. The postoperative re-admission rate was 0.4% (5 patients). There were no major complications, and the conversion rate was 0.5% (6 patients).ConclusionsWe suggest that day-surgery laparoscopic cholecystectomy is both safe and feasible in a local setting. Careful patient selection is essential in ensuring a high success rate.

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Anti-obesity surgery is the most effective therapy available for significant weight loss in patients with morbid obesity. Obesity in consider a major independent risk factor for Hiatal hernia (HH) and it is present in about 37%-50% of morbidly obese patients undergoing bariatric surgery.1,2,3 It might be overlooked or under looked especially if the patient was asymptomatic and no pre-operative endoscopy or radiological workup. Denovo closure of the hiatal defect in case of an intraoperative finding of HH strongly recommended preventing such acute postoperative complications. Herein we report a rare and acute post laparoscopic sleeve gastrectomy with gastric herniation were uneventfully diagnosed and interfered early to prevent a catastrophic outcome.

Introduction: Early post-operative small bowel obstruction is challenging. After laparoscopic surgery, port site herniation and herniation through a peritoneal defect into the preperitoneal space should be considered as causes of early post-operative small bowel obstruction. Case Report: A 36-year-old female developed early post-operative small bowel obstruction due to port-site Richter hernia after laparoscopic gastric bypass managed by diagnostic laparoscopy. Conclusion: Early post-operative small bowel obstruction should always be suspected and diagnosed early in certain high risk procedures.