Persistent efforts are being made to reduce operative trauma and morbidity and to improve cosmesis following laparoscopic cholecystectomy. The trend is to reduce the number of incisions, and thus single-incision laparoscopic cholecystectomy (SILC) and natural orifice endoscopic surgery (NOTES) are becoming popular. There is a paucity of studies pertaining to cosmetic outcome after SILC and conventional laparoscopic cholecystectomy in rural Indian population. In the present study, the cosmetic outcome of SILC versus conventional laparoscopic cholecystectomy (CLC) in rural Indian population was evaluated. Sixty patients with gallstone disease were randomly assigned to two groups. In group A (n=30), CLC was performed, while group B (n=30) was subjected to SILC. The cosmetic outcome was evaluated using a body image questionnaire on the 7th and 30th postoperative days. On the 7th postoperative day, the body image score for SILC was 6.23±0.89 and for CLC, 8.26±1.08 (p<0.0001), while the cosmetic score for SILC was 19.56±1.07 and for CLC, 15±1.20 (p<0.0001). On the 30th postoperative day, the body image score for SILC was 5.50±0.68 and for CLC, 8±1.31 (p<0.0001), while the cosmetic score for SILC was 21.13±0.57 and for CLC, 15.63±1.06 (p<0.0001), which favored SILC over CLC. The patient perception and acceptance of SILC was better than that of CLC in terms of cosmetic outcome.

There was no distinct advantage to SILC with regard to immediate postoperative pain. Pain was significantly less (P < 0.01) in the SILC group on postoperative day 7.

Introduction: Abdominal surgeries have high rate of surgical site infection (SSI), which leads to significant morbidity and financial burden. There is paucity of studies on SSI in rural Indian setup, where there is scarcity of adequate resources. The aim of this study was to determine the incidence and determinants of SSI after abdominal surgeries in a rural setup. Aim: To determine the incidence of and associated risk factors for superficial SSIs in abdominal surgery cases at a central Indian rural teaching hospital. Methods: This cohort study included 100 patients undergoing abdominal surgery between April 2016 and May 2017 at a central Indian rural teaching hospital. The outcome of interest was superficial SSI and the factors associated with it. Association between risk factors and SSI was calculated using either Chi-square test or odds ratio with 95% CI. Results: The cumulative incidence rate of superficial SSI was 39% with 95% CI (29.4%–49.2%). The analysis defined 12 variables significantly associated with superficial SSI: middle or elderly age, male gender, diabetes mellitus, preoperative anemia, preoperative hypoalbuminemia, tobacco smoking, higher ASA score, perioperative blood transfusion, drain placement, surgery duration >2 h, contaminated/dirty wound class and emergency surgery. However, economic status and BMI grade of the study subjects were not associated with development of superficial SSI.

according to the ASPS Rating Scale. The 'seroma occurrence ratio,' defined as the percentage of seroma events in the interventional group divided by that in the respective control group, was calculated to compare seroma occurrence rates between techniques.

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