Only mild hypercoagulability was observed in patients who had undergone laparoscopic cholecystectomy. The cytokine surge was correlated with hypercoagulability. There was in fact a positive correlation between IL-6 level and hypercoagulability. The correlation between cytokine levels and coagulation activation may be related to the type of surgery performed. Further studies are required to investigate these issues.

Drains have been used in surgery for several years to remove body fluids thereby preventing the accumulation of serous fluid and improving wound healing. Drains may be classified as closed or open systems, and active or passive depending on their intended function. Closed vacuum drains apply negative suction in a sealed environment, producing apposition of tissues and thus promoting healing. Correct assessment of clinical indications might reduce unnecessary usage. This article will introduce the principles and practice of various types of drains and highlight the importance of understanding how surgical drains promote quality patient care.

The umbrella method has a distinct advantage over the roll-up technique, in which unrolling of the mesh is done in a plane parallel to the mesh. This may explain the time saved, as demonstrated in this pilot study.

The use of a simple sponge bridge allowed the simultaneous treatment of two adjacent wounds.

Giant diverticula of the colon are a rare complication of acquired diverticular disease, but 5 cases have been presented in Norwich within recent years. Patients may present with lower abdominal pain and be found to have a firm, round, resonant mass, usually on the left side of the abdomen. Plain abdominal x-ray shows an air-filled cavity with a smooth outline. Barium enema examination reveals diverticular disease and, in 60% of subjects, a communication between the colon and the diverticulum. We suggest that this complication of diverticular disease of the colon occurs rarely because of the requirement for the diverticulum to be surrounded by a fatty mantle, either an appendix epiploica or retroperitoneal fat. Inflammation of the diverticulum is thus contained, allowing for progressive distension by a gas-trapping mechanism. Once diagnosed, the lesion should be excised to prevent complications.