The current study was carried out at a MMIMSR, Mullana, Ambala (in remote village) from period of December 2014 to November 2015 in India. We accessed the safety, efficacy, effectiveness and how to avoid the formation of port site hernia. Most routinely performed laparoscopic surgery is laparoscopic cholecystectomy, appendicectomy, and hernia repair. For laparoscopic surgery, two, three or four ports were made a 10-mm trocar was first placed in the umbilicus under direct vision and without vision. A second 10- mm trocar was then placed inferior to the sternum at the midline, while the third 5-mm trocar was placed 4-5 cm inferior to the costa on the right midlaviculer line. In our modification of ports, we never used the umbilical area inspite of that we used the epigastric port as camera port. Rest two or three 5 mm ports were made away from the umblicus. This modification was named as Rikkis technique. The specimen was removed from the epigastric port only. After completion of the dissection, telescope removed and cystoscope entered through the 5 mm port and specimen removed from the epigastric region. There were no visceral or organ injuries seen and neither any PSH seen. It is safe and cosmetically effective, not required prolonged hospital stay. For laparoscopic cholecystectomy, we successfully performed the procedure and by avoiding umbilical port we directly preventing the chances of formation hernia and without fascial closure.
