Background: In the era of minimal access surgery laparoscopic cholecystectomy is the gold standard of treatment for calculous cholecystitis. But laparoscopic surgery comes with its fresh set of complications. Port Site Infections (PSI) is one of the most bothersome complications that overshadow the benefits of a minimal invasive procedure and delays recovery. Atypical mycobacterial infection complicates the situation as it is difficult to diagnose and is resistant to treatment. In our institute (a tertiary level centre) the incidence of PSI was very high and we were in search of alternate methods of sterilisation for laparoscopic instruments as well as any prophylactic treatment that would prevent the development of PSI. Aims and Objectives: The aim was to study the role of low temperature gas plasma technology (STERRAD) as an appropriate method of sterilisation for laparoscopic instruments to reduce the incidence of PSI and to study the role of prophylactic port site Amikacin in preventing PSI. Methodology: This is a prospective non randomized study which was done over 15 months. During this study period patients admitted in general surgery wards of IPGME & R and SSKM Hospital with cholelithiasis were included in the study. After undergoing laparoscopic cholecystectomy they were followed up for 3 months. Results: Among the 220 cases of laparoscopic cholecystectomy done during this period a total of 30 cases of PSI were noted. There was a drastic reduction in the incidence of PSI when patients were operated using instruments sterilised by the low temperature gas plasma technology (STERRAD). In patients where surgery was done with instruments using the usual 2% glutaraldehyde sterilisation technique, prophylactic port site amikacin injection therapy reduced the incidence of PSI. Conclusion: The use of low temperature gas plasma technology (STERRAD) is an appropriate method of sterilisation of laparoscopic instruments to reduce the incidence of PSI. Prophylactic use of port site Amikacin might be another cost effective solution in preventing PSI.

Keywords: Port site infection; Sterrard; Low temperature gas plasma technology; Sterilisation of laparoscopic instruments; Port site amikacine.