Background An important aspect of a new surgical technique is whether it can be performed by other surgeons in other institutions. The authors report the first 297 cases in a multi-institutional and multinational review of laparoscopic cholecystectomy performed via a single portal of entry. Methods Data were collected retrospectively for the initial patients undergoing single-port cholecystectomy by 13 surgeons who performed these procedures in their institutions after training by the authors. The review included operative time, blood loss, incision length, length of hospital stay (LOS), necessary additional trocars, and other parameters important to cholecystectomy. A database of all the single-port-access (SPA) surgeries performed by the surgeons included demographic and procedural details, LOS, complications, and initial follow-up data. Results To date, 297 single-port cholecystectomies have been performed for a variety of diagnoses, primarily cholelithiasis. The average operative time was 71 min, and the average LOS was 1-2 days. The average blood loss was minimal. The use of additional port sites outside the umbilicus occurred in 34 of the cases. Of the 35 intraoperative cholangiograms performed, 34 were successful. No significant complications occurred except for seromas and minor postoperative wound infections. These results are comparable with those for standard multiport cholecystectomy. In addition, no access site hernias (ASH) occurred. SPATM is a Trademark

Non-operative management of uncomplicated appendicitis with antibiotics was associated with significantly fewer complications, better pain control, and shorter sick leave, but overall had inferior efficacy because of the high rate of recurrence in comparison with appendectomy.

Use of biologic mesh for ventral hernia repair results in less infectious wound complications but similar recurrence rates compared to nonbiologic mesh. This supports the application of biologic mesh for ventral hernia repair in high-risk patients or patients with a previous history of wound infection only when the significant additional cost of these materials can be justified and synthetic mesh is considered inappropriate.

Increasing rates of community-acquired methicillin-resistant Staphylococcus aureus (MRSA) infections have also affected the microbial profile of breast abscesses.Objective: To update the decade-old bacteriologic description of breast abscesses to improve the choice of initial antibacterial drug therapy.Design: Retrospective case series.Setting: County hospital emergency department.Patients: Forty-four women (mean age, 41 years; age range, 20-63 years) with breast abscesses.Methods: All cultures from the breast abscesses of patients were reviewed. Main Outcome Measures:The microbiologic features and sensitivities of breast abscesses.Results: Of 46 specimens only 28 showed bacterial yield (61%). Of these, 11 (39%) were polymicrobial, for an average of 1.4 isolates per specimen. The most common or-