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Background: The main challenge facing the laparoscopic surgery is the primary abdominal access, as it is usually a blind procedure and associated with many complications including life threading vascular and visceral injuries. Techniques for the creation of pneumoperitoneum in laparoscopy include the standard technique of insufflation after insertion of the Veress needle (closed method), open laparoscopy (Hasson technique) and many others.Methods: This is observational study conducted in the department of General surgery, PDUMC, Rajkot from September 2018 to September 2020 comprising of 100 cases, 50 cases from each methods. The patients admitted in our department for Laparoscopic surgery was taken up for the study. The Purpose of our study is to assess the practicality of both methods in creation of pneumoperitoneum and to compare both methods with regards to ease of performance and incidence of complications.Results: Average size of incision (p=-5.426) is more in open method, hence more incidence of minor complications like multiple attempts, gas leak at port site and port site bleeding in open method while less duration for creating pneumoperitoneum (p=0) as compared to closed method. While there is no major complications in either groups.Conclusions: Open technique is as good as closed technique, and is good alternative to closed technique.

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Background: Intestinal obstruction is a common clinical occurrence and can be either dynamic or adynamic. The old saying “Never let the sun set or rise on an obstructed bowel” taught to minimize missing strangulation. Helical CT with its multiplanar reformatted imaging can accurately characterize the level, degree, cause and associated complications of obstruction. Aim of the study was to depict the spectrum of MDCT findings in cases of small and large bowel obstruction and correlation of CT scan with intraoperative findings and the cause of intestinal obstruction.Methods: Contrast enhanced MDCT examination of 50 patients were prospectively included in the study who had evidence of clinical as well as MDCT evidence of bowel obstruction and in whom surgical/clinical follow-up for final diagnosis was available. CT scan was done in all the patients with MDCT (Brightspeed GE 16 slice system). The axial sections were reconstructed in coronal and saggital planes to determine site and cause of bowel obstruction.Results: The commonest cause of intestinal obstruction in adults in this study series was adhesions/bands in 38% cases. Out of 47 operated patients for intestinal obstruction, CT findings matched with intraoperative findings in 43 patients (91%) whereas cause of intestinal obstruction matched with CT findings in 37 patients (74%).Conclusions: Management decisions in intestinal obstruction remain notoriously difficult, relying on a combination of clinical, laboratory, and imaging factors to help stratify patients into conservative or surgical treatment. CT in these patients can help surgeon to go for surgery early and prevent complications.