Early experience with elective single-port laparoscopic appendectomy and cholecystectomy in day-case surgery.

BACKGROUND: Single incision laparoscopy aims to reduce access trauma and facilitate specimen extraction. We report our early experience and describe the learning curve for single-port laparoscopic appendectomy and cholecystectomy as a primer for more advanced single-port laparoscopic procedures. METHODS: From June 2009 to February 2010, all consecutive patients undergoing elective single-port appendectomy and cholecystectomy at the day surgical centre were included. A prospective database with perioperative data was created. RESULTS: Ten appendectomies and 4 cholecystectomies were done in 13 patients, predominantly males (77%), with a mean age of 45 years and a mean BMI of 23 kg/m2. The mean operative time was 31 minutes and 75 minutes for appendectomy and cholecystectomy, respectively. One extra trocar was placed in the first two cholecystectomies, to improve exposure and allow cholangiography. All patients did well at a median follow-up of 5.8 months and no wound infections, nor incisional hernias were detected. CONCLUSION: Single-port laparoscopic appendectomy and cholecystectomy is safe and feasible with a short learning curve and has good outcome.

Virological diagnosis of respiratory virus infection in patients attending an emergency department during the influenza season.

To investigate the burden of influenza-like illness (ILI), patients attending an emergency department during the influenza season were tested for several common respiratory viruses, using PCR-based methods. Influenza A viruses were detected in 25 of 103 recruited patients (24%), rhinoviruses in 15%, and respiratory syncytial virus in only one. The data suggest that triage criteria based on ILI case definitions would not contain the spread of the influenza virus during pandemic alerts and could lead to unnecessary isolation of patients with other infections. Application of broader triage criteria followed by timely molecular diagnosis could be effective in preventing new respiratory agent transmission.