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Background: Single-incision laparoscopic cholecystectomy (SILC) can be done as a day-case procedure and may have advantages over conventional laparoscopic cholecystectomy (LC). We present the results of our study looking at post-operative pain and post-operative recovery time. Methods: This was a single-institution randomised double-blind controlled trial. Seventy-three patients with symptomatic cholelithiasis were randomized to SILC ( n = 37) or LC ( n = 36). The primary endpoint was to compare post-operative pain. We also compared surgical time, procedural difficulty, adverse events, additional ports used and conversion rate, success of day surgery process, return to work, aesthetic satisfaction, quality of life and 4-year incisional hernia rate. Results: In the SILC group, post-operative analgesic requirements were lower on day 7, there was an earlier return to work and cosmetic satisfaction was significantly higher. The SILC procedure presented a higher technical difficulty. Operative time, surgical complications, post-operative pain, success of the day-case process, return to normal activity, quality of life scores and incisional hernia rates were similar for both the procedures. Conclusions: SILC has advantages over LC in terms of late post-operative analgesic requirements and aesthetic results; however, it is technically harder to perform. There was no benefit in terms of day surgery outcomes.

Aim We present a case of a recurrent parastomal hernia with enterocutaneous fistula and subcutaneous abscesses and their management. Material & Methods 79-year-old patient with history of pT4b low rectal cancer treated with an abdominoperineal resection with adjuvant chemo-radiotherapy in 2000. Parastomal hernia repair was performed in 2016 with PTFEe mesh according to the Sugarbaker technique and closing midline with double-sided inlay mesh. A plastic peritonitis was found at this moment In July 2021 presented episodes of fever with spontaneous parastomal purulent drainage, deciding initially conservative treatment. Due to persistence of soft tissue infection local surgical drainage was performed in September 2021, removing previous parastomal PTFEe mesh. The patient presented multiple infectious relapses from January to March 2022, debridement was carried out combined with negative pressure therapy. During follow-up intestinal fluid was seen through the negative therapy what put on show an enterocutaneous fistula. Finally, we decided radical surgery in May 2022 performing an in-block resection of end colostomy, 30 cm of ileum and abdominal wall area affected of chronic infection and previous meshes. A 20×20cm defect was left. Reconstruction with double-sided inlay mesh and new colostomy in the right iliac fossa was performed. Skin closure required cutaneous plastia. Conclusions The use of suitable prosthetic material for the repair of parastomal hernia doesn't exclude the developing of severe complications. An early and decisive surgical approach is recommended in cases of chronic prosthetic material infection to avoid redundant and non-cost-effective treatments.