Ventral hernia is a common condition treated by general surgeons. Open ventral mesh hernia repair has been in practice; the high failure rates have led to the rise of minimally invasive techniques. The da Vinci robot-assisted repair is a minimally invasive technique that provides an advantage of three-dimensional imaging, precise suturing, and dissection at difficult angles. In this study, we share our experience of robot assisted retro rectus ventral hernia repair (RRVH) in four patients. Retro rectus mesh placement has the advantage of fewer chances of exposure of the mesh and a low operative cost, as polypropylene mesh can be used. Of the four patients, 3 were females, and one was male with a mean age of 46.5±6.5 SD. The mean operative time was 175±28.7 minutes for skin-to-skin completion and 151.25 ± 26.07 minutes for console duration. There were no intra-operative complications. Post-operatively, the average pain score on the day of surgery was 1.75±0.43 SD (on a scale from 0 to 10) and on the first postoperative day was 0.5 ± 0.5 SD. The average length of hospital stay was 2.25±0.43 SD days. None of the patients had seroma, surgical site infection, adhesive bowel obstruction, or recurrence of hernia on one month and six months follow up. RRVH has an advantage regarding the decreased postoperative pain and early return to daily activities. This technique promotes the usage of polypropylene mesh, which reduces the cost of surgery.

All patiets who underwent radical cholecystectomy during the study period of 1 year were enrolled. Result: Out of total patients operated for radical cholecystectomy with uneventful postoperative period, average preop albumin was found to be 4.22. In complicated postoperative patients' average albumin was 3.39. Average albumin levels in patients with SSI-3.38, Pneumonia-2.69, DVT-3.2, Wound dehiscence-2.58, Postop biliary fistula-3.6 and UTI-3.45. There was no postoperative myocardial infarction and mortality in any of the patients enrolled in this study. The incidence of SSI-35.2% , DVT-14.2% , Pneumonia-14.2% , UTI-7.1% & Postop biliary fistula-7.1% Conclusion: After detailed analysis it was found that low serum albumin was found to be associated with increased risk of postoperative complications including surgical site infection, pneumonia, urinary tract infection and DVT. Hence preoperative optimization of serum albumin levels by providing adequate nutrition supplementation will be beneficial to all patients of carcinoma of gall bladder undergoing radical cholecystectomy. This study is able to highlight preop albumin as a predictor for the postop outcomes in patients of GB Carcinoma.

Peritoneal inclusion cysts have been described in females of reproductive age. It is a rare cause of intestinal obstruction. Causes include pelvic inflammatory disease and prior abdominal surgery. We here present a case of young female of peritoneal inclusion cyst who presented with intestinal obstruction.

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