https://www.journals.krishviphysiocare.in/index.php/ijmags <p align="justify">Rubatosis Publication has launched its scientific journal named International Journal of Minimal Access and General Surgery (IJMAGS)IJMAGS will be published quarterly per year in January, April, July, and October. The journal publishes original research work that contributes significantly to further the scientific knowledge inAdvanced Research in Surgical Sciences.</p> Rubatosis Publications en-US International Journal of Minimal Access and General Surgery https://www.journals.krishviphysiocare.in/index.php/ijmags/article/view/14 <p style="text-align: justify;">This is a case report of a 46-year-old male who presented with a large inguino-scrotal swelling with symptoms of discomfort and pain in the scrotum. CECT revealed most of the colon, ileum with stretched and thinned out omentum contained in hernia sac without significant lesions of large bowel and atrophied left testis. He underwent omentectomy, right hemicolectomy, left orchidectomy and hernioplasty with vypro mesh. He recovered uneventfully.</p> Dr. Desagani Venumadhav Dr. D. Anvesh Kumar Reddy Dr. Murali Mohan Reddy Copyright (c) 2018 International Journal of Minimal Access and General Surgery https://creativecommons.org/licenses/by-nd/4.0 2018-10-09 2018-10-09 1 1 1 4 https://www.journals.krishviphysiocare.in/index.php/ijmags/article/view/72 <p align="justify"><strong>Background: </strong>Laparoscopic assisted transgastric endoscopic retrograde cholangiopancreatography (LAERCP)&nbsp; is used for treatment in patients after&nbsp; gastric bypass , where transoral access to the biliary tree is not possible. We describe our technique and experience with this procedure for&nbsp; 12&nbsp; of our patients of which 7 of them had undergone Roux en y gastric bypass (RYGB) and 5 of them had undergone mini gastric bypass (MGB).</p> <p align="justify"><strong>Methods:</strong> For all 12 patients intraoperative cholangiography revealed common bile duct (CBD) stones. A combined laparoscopic-endoscopic approach was attempted. A small gastrotomy with a purse-string suture was performed on the anterior wall on remanant stomach. A side viewing scope was introduced through a 15 mm trocar on the upper left quadrant and through the gastrotomy. The duodenum was occluded to prevent air passage and small bowel distension. Endoscopic sphincterotomy and stone extraction were carried out according to standard techniques. Occlusion cholangiogram confirmed CBD clearance. There was one procedure-related complication, and the patients were discharged on the third postoperative day. The patients are doing well at 1 year follow up<strong>. </strong></p> <p align="justify"><strong>Results:</strong> Average time since bypass was 3 years, and length of stay was 3 days. Seven patients underwent simultaneous cholecystectomy. Two patients, had cholecystectomy more than 2 years previously. Our technique involves access to the bypassed stomach via a laparoscopically placed 15 mm port. We observed one major complication. No minor complications except , port site infection for one patient was observed in our series.</p> <p align="justify"><strong>Conclusion:</strong> Biliary obstruction can occur many years after gastric bypass with or without cholecystectomy. Our findings suggest that gastric bypass patients may be at a higher risk of symptomatic cholelithiasis with CBD stones . LAERCP is a reliable option for common bile duct clearance; our technique of LAERCP is technically simple and associated with low complication rate, making it appealing to surgeons&nbsp; trained in&nbsp; laparoscopy.</p> Rajiv maharaj Lakshmi kumari kona Rakesh kumar adi Aditya tv chowdary Bharat kumar nara Copyright (c) 2019 Rubatosis Publications http://creativecommons.org/licenses/by-nd/4.0 2019-05-05 2019-05-05 1 1 5 9 10.33974/ijmags.v1i1.72