Fifteen cases of trocar-size metastasis from unsuspected gallbladder carcinoma following laparoscopic cholecystectomy have been reported in the literature. We present the case of a 66-year-old woman who developed this complication 21/2 months postoperatively. We feel that carcinoma of the gallbladder is a contraindication to laparoscopic cholecystectomy. When unsuspected lesions are discovered, intraoperative frozen-section lesions will facilitate the surgical management.

The laparoscopic approach to appendectomy for acute appendicitis is becoming increasingly favored among surgeons. Endoscopic stapling remains a common approach for division of the appendix and mesoappendix, but staple line bleeding along the mesentery is commonly observed, occasionally demanding surgical control for complete hemostasis. Bioabsorbable seamguard was used as an adjunct to endoscopic stapling of the mesoappendix in 33 consecutive adult patients during laparoscopic appendectomy for acute appendicitis, with complete immediate staple line hemostasis observed by the operative surgeon in all cases. There were no intraoperative complications and no late infectious intra-abdominal complications. There were no postoperative bleeding complications. Bioabsorbable seamguard is a safe and effective adjunct to endoscopic mesoappendiceal stapling which prevents intraoperative and postoperative staple line bleeding.