Introduction: Diagnostic laparoscopy is now frequently used for small bowel obstruction with a varying degree of success. However, emergency laparoscopic resection of gangrenous small bowel has not yet been reported in the English literature. We report the world first case of successful laparoscopic assisted resection of gangrenous small bowel in a 64 year old female with an excellent postoperative outcome. Presentation of Case: A 64 years old woman with a virgin abdomen presented with a clinical and radiological features of small bowel obstruction. The patient was hemodynamically stable with mild central abdominal distension and tenderness but there was no guarding or rebound tenderness. On diagnostic laparoscopy a loop of gangrenous small bowel was noted secondary to an adhesion band. The patient had a successful laparoscopic assisted resection and extra-corporal anastomosis of the small bowel with an excellent postoperative outcome. Discussion: Diagnostic laparoscopy plays a vital role for the diagnosis and treatment of selected cases of small bowel obstruction in a virgin abdomen. However, appropriate patient selection as well as the availability of a skilled laparoscopic surgeon is off paramount importance for a successful outcome. Contrast enhanced CT scan is also a useful tool for appropriate patient selection. The morbidity of laparotomy can often be avoided in presence of a skilled laparoscopic surgeon. Conclusion: Laparoscopic approach can be attempted in selected patients with first episode of SBO and/or anticipated single band obstruction. Similarly, gangrenous small bowel can be resected laparoscopically in highly selected patients in the presence of an experienced laparoscopic surgeon.

Objective: Mesh infection post laparoscopic inguinal hernia repair is an uncommon complication. This increases patient morbidity and overall cost of a relatively low risk procedure. In this article, we sought to highlight the possible relationship between mesh infection and the biological nature of the mesh.Methods: Data of laparoscopic inguinal hernia repair was collected retrospectively from two separate private institutions, which were performed over a 5-year period. All information collected, including type of mesh used and arising complications, were documented on a computerized database.Results: Over the period of January 2011 and December 2015, a total of 81 elective laparoscopic inguinal hernia repairs were performed-59 from institution A and 22 from institution B. All repairs were performed by the same surgeon, using the Trans abdominal pre-peritoneal (TAPP) approach. Twelve repairs demonstrated evidence of mesh infection during this time frame, six (6) from each institution. Of these 12 cases, all underwent laparoscopic removal of the infected mesh, except one. All removed mesh was made of a polyester material. Conclusion:The associated advantages of using mesh to repair inguinal hernias are numerous and it is a great asset in modern day surgery. The choice of the "right" mesh to use should depend on surgeon experience, personal outcome and of course, evidence-based.

Background: The use of laparoscopy in the management of Acute Mesenteric Ischemia (AMI) has been a topic of debate. Its application is generally limited to highly selective cases in the early stages, primarily for diagnostic purposes and potentially as a therapeutic option. In recent times, laparoscopy has emerged as an alternative to 2 nd look laparotomy in an increasing number of cases. However, there remains a lack of reported cases detailing the successful laparoscopic management of AMI with gangrenous small bowel in the English literature. Case Report: We report the case of a 59-year-old male patient who presented with symptoms suggestive of AMI. A Computed Tomography (CT) scan confirmed the diagnosis, revealing gangrenous changes in the small bowel. The ischemic segment was meticulously resected using laparoscopic techniques, ensuring an adequate margin of healthy tissue. Postoperatively, the patient showed remarkable improvement. The recovery was uneventful, with no significant complications observed. Conclusion: Despite the limited recommendations for laparoscopy in AMI cases, our experience highlights the potential therapeutic utility of laparoscopy in carefully selected patients with AMI and gangrenous small bowel.