Objective: To compare surgical site infection (SSI) rates in open or laparoscopic appendectomy, cholecystectomy, and colon surgery. To investigate the effect of laparoscopy on SSI in these interventions. Background: Lower rates of SSI have been reported among various advantages associated with laparoscopy when compared with open surgery, particularly in cholecystectomy. However, biases such as the lack of postdischarge follow-up and confounding factors might have contributed to the observed differences between the 2 techniques. Methods: This observational study was based on prospectively collected data from an SSI surveillance program in 8 Swiss hospitals between March 1998 and December 2004, including a standardized postdischarge follow-up. SSI rates were compared between laparoscopic and open interventions. Factors associated with SSI were identified by using logistic regression models to adjust for potential confounding factors. Results: SSI rates in laparoscopic and open interventions were respectively 59/1051 (5.6%) versus 117/1417 (8.3%) in appendectomy (P ϭ 0.01), 46/2606 (1.7%) versus 35/444 (7.9%) in cholecystectomy (P Ͻ 0.0001), and 35/311 (11.3%) versus 400/1781 (22.5%) in colon surgery (P Ͻ 0.0001). After adjustment, laparoscopic interventions were associated with a decreased risk for SSI: OR ϭ 0.61 (95% CI 0.43-0.87) in appendectomy, 0.27 (0.16 -0.43) in cholecystectomy, and 0.43 (0.29 -0.63) in colon surgery. The observed effect of laparoscopic techniques was due to a reduction in the rates of incisional infections, rather than in those of organ/space infections. Conclusion: When feasible, a laparoscopic approach should be preferred over open surgery to lower the risks of SSI. (Ann Surg 2008;247: 627-632)

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Laparoscopic RYGBP for morbid obesity results in good and maintained weight loss up to 7 years in the majority of patients, improves quality of life and markedly improves all the evaluated comorbidities, resulting in good to excellent overall 5-year results in 97% of the patients according to the BAROS score.

Roux-en-Y gastric bypass (RYGBP) is currently the most common bariatric procedure. One of its late complications is the development of internal hernia, which can lead to acute intestinal obstruction or recurrent colicky abdominal pain. The aim of this paper is to present a new, unusual, and so far not reported type of internal hernia. A common computerized database is maintained for all patients undergoing bariatric surgery in our departments.

TEP repair is a safe procedure when performed by supervised senior surgical trainees. Teaching of TEP should be routinely included in general surgery residency programs.