Although we have not conducted any sellckchem cost-analysis comparisons in this study, given that the routine laparoscopic instruments were used with better operative timings without any major complications (Table 2), we feel that the SSMPPLE may become a valuable option of the per-umbilical laparoscopy especially for the patients of the developing nations. However, this technique is a modification of minimally invasive cholecystectomy. We further stress that it is not a modification of single incision laparoscopic cholecystectomy in any way because it includes three separate skin incisions/punctures. 5. Conclusion The presented SSMPPLE cholecystectomy technique does not need any specialized ports or other equipment; it seems safe, efficient, and potentially economically viable alternative to the single-incision laparoscopic cholecystectomy using commercially available specialized port/instruments.

Conflict of Interests The authors declare that there is no conflict of interests regarding the publication of this paper.
Totally extraperitoneal (TEP) inguinal hernia repair has gained popularity in the recent two decades since the first introduction in 1992 by Dulucq [1]. It offers a hernia repair of minimal incisions with more favorable postoperative course including less pain and quicker return to work especially more pronounced in bilateral inguinal hernia [2]. However, this technique requires specialized anatomical knowledge, two-hand manipulation for reduction of hernia sac, and mesh placement within a limited working space.

Therefore, acceptance and implementation of this technique have Dacomitinib been slow compared to the adoption of other minimal invasive procedures such as cholecystectomy [3, 4]. In addition to the technical dexterity, there are some drawbacks for the common adoption of this technique including increased operative times, complications during the early learning curve, and almost absolute necessity for general anesthesia [5, 6]. Consequently, the learning curve of TEP inguinal hernia repair for the inexperienced surgeons carries paramount importance. However, the exact nature of learning curve and the number required to master the technique are still focus of a debate. There are a limited number of studies evaluating the learning curve for TEP inguinal hernia repair [2, 3, 7, 8]. Although there were some numerical suggestions beginning from 20 cases, the required number of operation to fulfill the learning curve has been reported even 250 repairs to fully master all aspects of the TEP approach [2, 3, 6, 9].