HighlightsEndoscopic thyroidectomies aim to provide patients with minimal or no scars.Transoral endoscopic thyroidectomy is based on the principles of natural orifice translumenal endoscopic surgery (NOTES).Involves minimal dissection and is truly scar-free.Transoral endoscopic thyroidectomy has proven to be a feasible procedure.It provides easy access to the thyroid gland with aesthetically pleasing results.

Tigecycline monotherapy is a safe and effective therapy for cSSSIs in geographically distinct populations in Asia.

Background: Laparoscopic cholecystectomy is one of the most common surgeries performed nowadays. It remains an enigma regarding efficacy, safety and postoperative complications for using suture ligation for ligating cystic duct in laparoscopic cholecystectomy. The aim of the present study was to study the efficacy of ligating the cystic duct with sutures in laparoscopic cholecystectomy.Methods: This prospective study was performed between June 2018 and April 2019 in Saveetha Medical College and Hospital, in a rural center, Kanchipuram, India. All the patients included consented for the study. Patients who underwent subtotal cholecystectomy were excluded from the study.Results: The study included 70 patients who underwent laparoscopic cholecystectomy in a single unit. All cases were operated by a single surgeon. Of the 70 patients, the Cystic duct (CD) was simply ligated in 55 patients with CD <5 mm in diameter. The CD in 15 of those patients had to be divided and sutured in continuity for wide CD (>5 mm). The mean time for ligation of cystic duct was 5 min. Similarly, the mean time for ligation of cystic artery was 1.50 min. The mean operative time was 50 mins. There were no postoperative complications, such as bile leakage.Conclusions: SL of the CD is a very safe and secure alternative to the application of metal clips. It can be used in dilated CD, readily available and very cost effective and the complications of clips are avoided. The only disadvantage is that it needs expertise to perform and subsequently increasing the operating time. This technique is recommended in all laparoscopic cholecystectomies, especially in difficult cases.

Irreducible inguinal hernias are commonly encountered in an emergency setting. The content is usually small bowel or omentum and diagnosis is made by physical examination. We present a case of an irreducible inguinal hernia, which on opening of the sac revealed a perforated sigmoid colonic growth as the content.

Background: Even with a low post-operative infection complication rate in elective laparoscopic cholecystectomy (LC), most surgeons use prophylactic antibiotics out of habit. This prospective study was done to analyze the need for such prophylaxis in cases of elective LC.Methods: 135 successive patients undergoing elective LC were included in the study. Patients were randomized into 3 groups. Group A (n=45) cases received 3 doses of injection ceftriaxone in the post op period, group B (n=48) cases received a single dose of injection ceftriaxone at the time of induction of anesthesia, and group C (n=42) cases did not receive any antibiotic pre or post operatively. Post-operative infectious complications between three groups were compared.Results: There was no significant difference in surgical site infection rates between the groups for variables such as age, sex, body mass index, duration of symptoms, duration of surgery and hospital stay. Intraoperative spillage of bile [6.7% (A): 4.6% (B): 5.2% (C)] did not increase infectious complications.Conclusions: Routine use of prophylactic antibiotic in a clean, uncomplicated cases of laparoscopic cholecystectomy is not required. One dose of ceftriaxone at the time of induction or 3 doses of injection ceftriaxone post operatively following elective LC even in the urban Indian setting should be abandoned as it neither reduces the rate of surgical site infection but also contributes to adverse reactions, drug resistance, and unnecessary financial burden.