[Mini-lap cholecystectomy]. / Minilaparotomijska holecistektomija.

In a selected group of patients, cholecystectomy through small incision, the so called minilaparotomy, has certain advantages over an operation throug classical laparatomy. Over a period of seven years, at the Surgical Ward of the Health Centre, Vranje, 504 patients were operated for gallbladder stones, 455 of whom by classical laparatomy (90.28%) and 49 patients by minilaparatomy (9.72%). Of 49 patients minilaparatomy cholecystectomy was successfully carried out in 45 patients (91.83%). Mortality, morbidity of major significance, or operative injuries to the main bile duct did not occur in this group of patients, in contrast to the group with classical laparatomy, where mortality of 0.66% and injuries of the main bile duct in 0.66% of the cases, were recorded. The hospital stay was shorter and working abilities were re-established faster in the group of patients with minilaparatomy operation. We conclude that in selected group of patients minilaparatomy cholecystectomy is a reasonable alternative to the classical operation.

[Ishiadic hernia (sciatic hernia)]. / Isijadicna kila.

The sciatic hernia is a protrusion of the peritoneal sac and its contents through the great or small sciatic foramen. This kind of hernia is an extremely rare. The authors present patient with ischiadic hernia and its operative repair. The preoperative diagnosis was a tumour (cyst) localized intraglutealy, but during operation sciatic hernia was found. Hernia was operatively removed making an oblique incision over the palpable mass, splitting the gluteous maximus, and exposing and opening the hernial sac, avoiding nerve and vascular injury by careful dissection of the sac. Then the sac was ligated and excised. Closing of the musculature defect was made with interrupted sutures of 000-Dexon, aproximating the gluteus maximus and medius muscles to the musculus piriformis. The authors consider that transgluteal approach has priority to transabdominal approach.