Background/Aim: Mini-incision open cholecystectomy remains relevant in resource-limited peripheral settings. This prospective study evaluated the safety, feasibility, and recovery profile of mini-incision open cholecystectomy under low-dose spinal anaesthesia and multimodal analgesia.

Methods: A prospective observational study was conducted at Sub-Divisional Hospital Patti, Punjab, India, between June 2025 and 15 June 2026. A total of 100 patients with symptomatic cholelithiasis undergoing elective mini-incision open cholecystectomy were included.Eras protocols were implemented in all cases. Primary outcomes included postoperative pain scores and complications. Secondary outcomes included operative duration, hospital stay, ambulation, oral intake, and return to routine activities. Data were analysed using descriptive statistics. Continuous variables were presented as mean ± standard deviation, whereas categorical variables were shown as frequencies and percentages.

Results: Mean age was 41.02±12.77 years; 95% were female. Mean operative duration was 40.2±10.6 minutes. Mean hospital stay was 2.8±0.7 days. No major post operative complication such as bile leak, or surgical-site infection or mortality occurred.

Conclusion: The procedure is safe, economical, and highly suitable for peripheral resource constrained hospitals.