Background: The third most common healthcare-associated infection is surgical site infection (SSI), accounting for 14%–16% of infections. These SSIs are associated with high morbidity, numerous deaths, and greater cost. Methods: A prospective study was conducted to assess the incidence of SSI in a single university hospital in Croatia. We used the Hospital in Europe Link for Infection Control through Surveillance (HELICS) protocol for surveillance. The SSIs were classified using the standard definition of the National Nosocomial Infections Surveillance (NNIS) system. Results: The overall incidence of SSI was 1.44%. The incidence of infection in the open cholecystectomy group was 6.06%, whereas in the laparoscopic group, it was only 0.60%. The incidence density of in-hospital SSIs per 1,000 post-operative days was 5.76. Patients who underwent a laparoscopic cholecystectomy were significantly younger (53.65±14.65 vs. 64.42±14.17 years; p<0.001), spent roughly one-third as many days in the hospital (2.40±1.72 vs. 8.13±4.78; p<0.001), and had significantly shorter operations by nearly 26 min (60.34±28.34 vs. 85.80±37.17 min; p<0.001). Procedures that started as laparoscopic cholecystectomies and were converted to open procedures (n=28) were reviewed separately. The incidence of SSI in this group was 17.9%. The majority of converted procedures (71.4%) were elective, and the operating time was significantly longer than in other two groups (109.64±85.36 min). Conclusion: The HELICS protocol has a good concept for the monitoring of SSI, but in the case of cholecystectomy, additional factors such as antibiotic appropriateness, gallbladder entry, empyema of the gallbladder, and obstructive jaundice must be considered.

Background: Laser hemorrhoidoplasty (LHP) has emerged as a novel, minimally invasive technique for managing symptomatic hemorrhoids, gaining popularity among clinicians. Despite its increasing adoption, significant variations exist in the application of LHP across different practices. Purpose: The aim of these recommendations was to spell out some basic principles and recommendations for performing a standard LHP procedure. Methods: The Recommendation Development Group (RDG) consisting of surgeons with experience in LHP were invited to formulate recommendations for the procedure. The recommendations were generated following systematic literature research and discussion amongst experts (expert opinion) where no substantial literature was available. The developed recommendations were voted upon by a panelist via the Delphi process. Consensus was a priori defined as agreement of 75% and above, with strong consensus defined as 85% and above. Results: The RDG developed 21 recommendations that were voted upon by 49 panelists. Consensus was reached for all 21 recommendations after the first Delphi round, including 16 recommendations with strong consensus. Conclusion: The RDP offers a comprehensive suite of guidelines to enhance the safety and efficacy of standard LHP procedures. Out of 21 detailed recommendations, 16 reached strong consensus, collectively addressing the full spectrum of LHP procedures—from laser settings and preoperative preparations to perioperative strategies and postoperative care. This coherent framework is anticipated not only to standardize but also to refine the LHP technique across the board, thereby elevating the management of symptomatic hemorrhoidal disease.

Background: Fistula tract laser closure (FiLaC) represents a minimally invasive, sphincter-sparing technique for managing fistula in ano with increasing popularity among proctologists. Despite its increasing adoption, significant variations exist in the application of FiLaC in daily practice. Purpose: The aim of these recommendations was to define some basic principles and recommendations for performing a standard FiLaC procedure. Methods: The recommendation development group (RDG) consisting of surgeons with experience in the FiLaC were invited to formulate recommendations for the procedure. The recommendations were generated following systematic literature research and discussion amongst experts (expert opinion) where no substantial literature was available. The developed recommendations were voted upon by a panelist via the Delphi process. Consensus was a priori defined as agreement of 75% and above. Results: The RDG developed 25 recommendations that were voted upon by 21 panelists from 13 nations. Consensus was reached for all 25 recommendations after the first Delphi round. Conclusion: The FiLaC RDG offers a comprehensive suite of recommendations to enhance the safety and efficacy of standard FiLaC procedures. These 25 detailed recommendations collectively address the full spectrum of FiLaC procedures—from laser settings, preoperative preparations, and perioperative strategies to postoperative care. This coherent framework is anticipated not only to standardize but also to refine the FiLaC technique to ensure best possible surgical outcomes while preserving patient safety.