NONINVAGINATION VS. INVAGINATION OF APPENDICULAR STUMP: A RETROSPECTIVE STUDY

2021 ◽  
pp. 64-65
Author(s):  
Nirmal Kumar Agarwal ◽  
Bibhu Priyo Das
Keyword(s):  
Operative Time ◽  
Standard Treatment ◽  
Laparoscopic Approach ◽  
Purse String Suture ◽  
Purse String ◽  
Group I ◽  
Operative Complications ◽  
Average Operative Time ◽  
Good Technique ◽  
Appendicular Stump

Appendicitis is the most common abdominal surgical emergency. The standard treatment of acute appendicitis is appendicectomy which can be performed by either open or laparoscopic approach. While during laparoscopic approach the stump is mostly not invaginated, in open method management of stump remains debatable- simple ligation or ligation and invagination of the stump. Aim of the study was to compare results of simple ligation alone or ligation and invagination of the appendicular stump during appendicectomy. Materials And Methods: Altogether 74 patients were included in this study and divided into two groups. Group I ligation and invagination of the stump with purse string suture and Group II simple ligation of the stump. The two methods were compared with respect to operative time, intraoperative and post-operative complications. Results: There was no signicant difference in either the rate of post-operative complication and post-operative hospital stay between the two groups. The average operative time was shorter in group without invagination. Conclusion: simple ligation of appendicular stump is a safe, simpler good technique associated with shorter operative time.

scholarly journals Laparoscopic management of appendicular lump

2020 ◽  
Vol 7 (9) ◽  
pp. 3065
Author(s):  
Manoj Kumar Chaudhary ◽  
Mrinal Shankar ◽  
Tridip Dutta Baruah ◽  
Rubik Ray ◽  
Shubham Samal
Keyword(s):  
Retrospective Study ◽  
Learning Curve ◽  
Treatment Cost ◽  
Operative Time ◽  
Site Infection ◽  
Early Recovery ◽  
Operative Complications ◽  
Average Operative Time ◽  
Laparoscopic Intervention ◽  
Time Of Admission

The surgical management of an appendicular lump remains controversial. With the revolution and advancement of laparoscopic instrumentation and technical learning curve, it is possible to remove an inflamed appendix in presence of lump. This retrospective study was performed between August 2018 and August 2019 in AIIMS Raipur, 86 patients were treated for appendicitis laparoscopically, in these 14 patients had appendicular lump at the time of admission. 12 patients (total 14; 2 patients were excluded) underwent laparoscopic intervention for appendicular lump. Average operative time were 90 minutes. Average post-operative hospital stay were 5 days. Post-operative complications were seen in 2 patients (surgical site infection). In histopathology report, appendicular inflammation suggestive of appendicitis were present in all operated cases. We conclude, early laparoscopic appendectomy confirms the diagnosis. It is safe and feasible in patients with appendicular lump. It reduces the treatment cost, early recovery and satisfactory overall outcome.

scholarly journals Three port versus four port laparoscopic cholecystectomy: a prospective comparative clinical study

2019 ◽  
Vol 7 (8) ◽  
pp. 3054
Author(s):  
Shams Ul Bari ◽  
Faheem Ul Islam ◽  
Ajaz A. Rather ◽  
Ajaz A. Malik
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Operative Time ◽  
P Value ◽  
Analgesic Requirement ◽  
Medical College ◽  
Number Of Patients ◽  
Operative Complications ◽  
Comparative Clinical Study ◽  
Average Operative Time ◽  
Prospective Comparative Study

Background: Although, traditional laparoscopic cholecystectomy is performed using four-port technique, various modifications were made to further enhance the advantages of laparoscopic cholecystectomy. Aim of the study is to compare the results of three-port and four-port laparoscopic cholecystectomy at single center in terms of technical feasibility, safety of the procedure, operative time, intra-operative complications, postoperative pain and post-operative analgesia requirementMethods: It was a  prospective comparative study conducted  in the department of surgery Skims Medical college Srinagar, India from July 2015 to March 2017. The study was performed on all adult patients with ultrasound documented cholelithiasis and gall bladder Polyposis. The total number of patients studied was 100 which were divided into two groups of 50 each.Results: The average operative time in three port group was 29.2 minutes (range, 15-37) compared to 30.66 minutes (range, 15-42) in four port group, which was statistically insignificant. The final visual analog scores for pain in the postoperative period was 2.30 vs 2.86 in three port and four port group respectively, with a P value=0.008, which was statistically significant.Conclusions: The three-port technique is as safe as the standard four-port technique and can be a viable alternative to four port cholecystectomy with an advantage of less pain and less analgesic requirement and better cosmetic results.

Microdebrider-Assisted Supraglottoplasty for Laryngomalacia

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P66-P66
Author(s):  
Jan Casimir Groblewski ◽  
Rahul K Shah ◽  
George H Zalzal
Keyword(s):  
Surgical Treatment ◽  
Revision Surgery ◽  
Retrospective Review ◽  
Operative Time ◽  
Demographic Characteristics ◽  
Alternative Methods ◽  
Esophageal Reflux ◽  
Operative Outcome ◽  
Operative Complications ◽  
Average Operative Time

Objective To describe our series in the surgical treatment of laryngomalacia using a microdebrider. Methods A retrospective review of patients undergoing supraglottoplasty for laryngomalacia at a tertiary children's hospital between October 2004 and February 2008 was performed. Patients with complex co-morbidities and those undergoing alternative methods for supraglottoplasty were excluded. Patient charts and operative reports were reviewed to assess demographic characteristics, co-morbidities, procedural times, hospitalizations, intra-operative and post-operative complications, and post-operative outcome. Main outcome measures included complications, pain, resolution of stridor, presence of aspiration, and need for revision surgery. Results 27 patients underwent microdebrider-assisted supraglottoplasty. Mean age at diagnosis was 109 days; mean age at time of the procedure was 187 days. 18 Eighteen patients (67%) had gastro-esophageal reflux at the time the laryngomalacia was diagnosed. Average operative time was 35.7 minutes (std. dev. 12.9, range 11–65 minutes). No intra-operative complications or device problems were noted. Only 2 patients remained intubated at the conclusion of the procedure; no patient required tracheotomy or revision supraglottoplasty. One patient had post-operative aspiration, which later resolved. One patient was readmitted for stridor one month following her procedure. There was no pain from the procedure, as all patients immediately resumed a diet. All patients had eventual resolution of stridor. Conclusions This is the largest series of patients that underwent microdebrider-assisted supraglottoplasty for laryngomalacia. This procedure is safe, without pain, and effective in patients with laryngomalacia. Microdebrider- assisted supraglottoplasty is the method of choice for supraglottoplasty in our institution.

scholarly journals Randomised controlled study of laparoscopic versus open reversal of Hartmann’s procedure

2020 ◽  
Vol 7 (11) ◽  
pp. 3563
Author(s):  
Tarek M. Sehsah ◽  
Osama H. Abd-Raboh ◽  
Taha A. Ismail ◽  
Soliman M. Soliman
Keyword(s):  
Hospital Stay ◽  
Operative Time ◽  
Laparoscopic Approach ◽  
Mean Value ◽  
Hartmann’S Procedure ◽  
Controlled Study ◽  
Hartmann's Procedure ◽  
Operative Complications ◽  
The Difference ◽  
Post Operative Complications

Background: Laparoscopic reversal of Hartmann’s procedure has been increasingly practiced worldwide since the laparoscopic era. However, so far only a few studies have been published regarding the results of this procedure. Aim of this study was to compare laparoscopic reversal of Hartmann’s (LHR) versus open reversal of Hartmann’s (OHR) procedure regarding to operative time, postoperative pain, hospital stay, postoperative complications and cost.Methods: This study was conducted on 40 patients with Hartmann’s colostomy admitted to the general surgery department, Tanta university hospitals, during the period from February 2017 to August 2019.Results: Regarding operative time, it was with a mean value 274.75±80.65 min in the LHR group and 156.75±32.81 min in the OHR group. The difference in time to pass flatus was with a mean value 1.78±0.68 days in the LHR group and 2.49±0.78 days in the OHR group. The difference in the hospital stay was with mean value 6.1±2.47 days in the LHR group and 9.3±2.20 days in the OHR group. Regarding post-operative complications; 6 patients (30%) developed post-operative complications while in the OHR group 10 (50%).Conclusions: In this era of minimal-access surgery and with increasing attention to fast-track protocols, we believe the laparoscopic approach should be the standard technique for patients undergoing reversal of Hartmann’s procedure. However, laparoscopic reversal of Hartmann’s procedure needs a surgical learning curve.

Assessment of progress and competence in tonsillectomy surgery using cumulative sum analysis

2018 ◽  
Vol 132 (8) ◽  
pp. 734-738
Author(s):  
A K Abou-Foul ◽  
A Taghi ◽  
N S Tolley ◽  
Z Awad
Keyword(s):  
Standard Deviation ◽  
Operative Time ◽  
Outcome Measure ◽  
Poor Performance ◽  
Cumulative Sum ◽  
Cumulative Sum Analysis ◽  
Performance Curves ◽  
Operative Complications ◽  
Average Operative Time ◽  
Low Incidence

AbstractObjectiveTo assess the feasibility of using cumulative sum analysis to show trainees’ performance curves and highlight concerns in tonsillectomy surgery.MethodsIn this prospective study, the performance of eight otolaryngology trainees (in their first 6–12 months in the specialty) was compared to that of experts (over 150 tonsillectomies performed) in terms of operative time and post-operative complications. Cumulative sum analysis curves were generated to highlight trainees’ performance, and were updated after each performance.ResultsThe average operative time was 23 minutes (standard deviation = 11) for experts and 38 minutes (standard deviation = 16) for trainees (p < 0.0001). Cumulative sum analysis charts for trainees’ operative time initially rose and then started to plateau after a number of cases (range, 25–30), while that of experts remained low. Cumulative sum analysis charts for complications can be used to monitor performance. In this study, complications were combined (because of low incidence) to allow use of this outcome measure.ConclusionThe flexibility of the cumulative sum analysis makes it adaptable to any outcome. It is a strong adjunct in surgical training to monitor progress and competence. Its sensitivity also allows early detection of poor performance, to instigate intervention.

Clinical outcomes of tracheoesophageal diversion for intractable aspiration

2015 ◽  
Vol 129 (S2) ◽  
pp. S69-S73 ◽  
Author(s):  
K Adachi ◽  
T Umezaki ◽  
H Kiyohara ◽  
H Miyaji ◽  
S Komune
Keyword(s):  
High Risk ◽  
Clinical Outcomes ◽  
Operative Time ◽  
Oral Feeding ◽  
Speech Communication ◽  
Swallowing Function ◽  
Operative Complications ◽  
Average Operative Time ◽  
Intractable Aspiration ◽  
Risk Of Aspiration

AbstractObjectives:The purpose of the present study was to examine the clinical outcomes of using tracheoesophageal diversion for preventing intractable aspiration.Method:We retrospectively reviewed 25 patients who underwent tracheoesophageal diversion from 2003 to 2009 at our hospital (median age, 25 years; range, 0–78 years). End-to-side anastomosis was used in 16 cases and side-to-side anastomosis was used in 9.Results:The average operative time was 141 minutes for end-to-side anastomosis and 191 minutes for side-to-side anastomosis. Peri-operative complications were observed in only two (8 per cent) cases: one with infection and one with haematoma. No fistulas were observed. Aspiration was prevented in all cases, but the nutritional route depended on the swallowing function of the patient. Oral feeding was the main nutritional route after surgery in only four patients (16 per cent).Conclusion:This procedure is well suited to patients who lack speech communication and are at high risk of aspiration.

scholarly journals Two-layer duct-to-mucosa pancreaticojejunostomy with a half purse-string suture: A novel anastomosis technique for soft pancreas

2020 ◽  
Author(s):  
Yao Meng ◽  
Yabo Jiang ◽  
Wei Jing ◽  
Kailian Zheng ◽  
Peng Cheng ◽  
...  
Keyword(s):  
Operative Time ◽  
Traditional Approach ◽  
New Technology ◽  
Length Of Hospital Stay ◽  
Multivariate Regression Analysis ◽  
Purse String Suture ◽  
Purse String ◽  
New Approach ◽  
Soft Pancreas ◽  
Technology Group

Abstract Background: Pancreaticoduodenectomy (PD) is a routine method in pancreatic surgery. To date, postoperative pancreatic fistula (POPF) remains the most common complication and is also the major cause to death after pancreaticoduodenectomy. In order to reduce the incidence of POPF, we established a new anastomosis technique where we use a half purse-string suture on the basis of two-layer duct-to-mucosa pancreaticojejunostomy (PJ) technique and also assessed the effectiveness and safety of this approach in this study.Methods: To evaluate this new approach, 80 patients who received the new PJ technique were included in this study during 2017–2018. Meanwhile, 195 patients who underwent traditional duct-to-mucosa PJ were collected. We also introduced this new surgical approach in detail and analyzed various risk factors for postoperative complications to verify its safety and advantages.Results: First of all, there were no significant differences in patients' preoperative characteristics. Besides, patients in the new PJ group received a less operative time (175.2±45.8 vs. 161.3±41.0, p=0.022) while no differences were found in blood loss, length of hospital stay and cost. The incidence of POPF in the new PJ group was 19%, which was much lower than those in the traditional PJ group (36%) (p=0.007). More importantly, a much lower incidence of grades B POPF (14% vs. 4%, p=0.026) was found in the new technology group, which would clinically benefit patients a lot. Univariate and multivariate regression analysis also verified that this new PJ procedure was effective to improve postoperative POPF.Conclusions: Results demonstrate that this new technique is easy accomplished, safe and effective compared to traditional approach, which showed satisfactory outcomes especially at resulting in a lower POPF incidence.

scholarly journals Is laparoscopic totally extra peritoneal repair of hernia (TEP) superior than trans-abdominal preperitoneal (TAAP) mesh repair of inguinal hernia- our experience from a tertiary care hospital, Kolkata

2018 ◽  
Vol 9 (6) ◽  
pp. 20-24
Author(s):  
Ambar Gangopadhyay ◽  
Bikash Chandra Ghosh
Keyword(s):  
Inguinal Hernia ◽  
Hospital Stay ◽  
Peritoneal Cavity ◽  
Operative Time ◽  
Duration Of Hospital Stay ◽  
Tapp Repair ◽  
Group I ◽  
Operative Complications ◽  
Mean Time ◽  
Post Operative Complications

Background: The most common laparoscopic techniques for inguinal hernia repair are transabdominal preperitoneal (TAPP) repair and totally extraperitoneal (TEP) repair. In TAPP a mesh is placed through peritoneal incision over possible sites of hernia by going into peritoneal cavity, where as in TEP the peritoneal cavity is not entered and a mesh is used to seal the hernia from outside the peritoneum.Aims and Objectives: The aim of the current study was to compare the outcome of Total Extra- peritoneal (TEP) versus Trans-abdominal Pre-peritoneal (TAPP) repair of inguinal hernia, where both can be done.Materials and Methods: The current randomized control study was conducted among eighty patients of inguinal hernia. Of these, the sampling was done through random allocation of patients for TEP (Group-I) and TAPP (Group-II), comprising forty patients in each group. All patients irrespective of group were observed for pain (by VAS Score), mean operative time, duration of hospital stay, days taken to resume their normal activities, intra-operative and early post-operative complications and recurrence if any.Results: The pain in both groups was insignificant until one day but highly significant differences (p<0.0001) were observed by end of day 2 and 1 month, showing higher degree of pain in TAPP with respect to TEP procedure. The differences in mean operative time for surgery was highly significant (p<0.0001) with mean time of 86.72 min (TAPP) and 99.72 (TEP). The duration of hospital stay was higher in TAPP (5.2 days) compared to TEP (2.6 days). The mean time to return to normal activities was 10.8 days (TAPP) and 6.2 days (TEP) which was highly significant (p<0.0001). The recurrence though occurred only in one patient in TEP group which was negligible. The other post-operative complications was seroma (8 cases; TAPP) versus (1 case; TEP) and it was highly significant (p<0.0001). The port site infection was in 20 % patients (8/40) in TAPP compared to 2.5% (1/40) in TEP group.Conclusion: The TEP is comparatively superior than TAPP procedure in terms of post-operative complications, duration of hospital stay and return to normal activities.Asian Journal of Medical Sciences Vol.9(6) 2018 20-24

LAPAROSCOPIC TRANS-ABDOMINAL PRE-PERITONEAL (TAPP) REPAIR FOR TREATMENT INGUINAL HERNIA DISEASE

2018 ◽  
Vol 8 (4) ◽  
pp. 76-80
Author(s):  
Thao Nguyen Minh ◽  
Vu Pham Anh ◽  
Tri Nguyen Huu ◽  
Phu Nguyen Doan Van ◽  
Phuc Nguyen Thanh ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Operative Time ◽  
Bilateral Hernia ◽  
Repair Method ◽  
Tapp Repair ◽  
Post Operation ◽  
Average Operative Time ◽  
The Mean

Background: Inguinal hernia is one of the commonest surgical diseases and there are many different techniques applied. The laparoscopic trans-abdominal pre-peritoneal (TAPP) repair allows a better view of the inguinal anatomy, evaluation of opposite side and resolve combined peritoneal diseases as well. Patient and method: The study included 60 cases with inguinal hernia that have been treated by laparoscopic transabdominal pre-peritoneal (TAPP) repair. Method: Description, prospective follow-up. Result: The mean age was 58±18.2. 96.7% were males. The average operative time was 45.6±15.1 minutes for one side hernia, 73±25.2 minutes for bilateral hernia. 02 cases have been post-operation inguinal seroma complication (3.3%), 02 cases with hydrocele (3.3%), 01 case with abdominal seroma (1.7%). 04 cases (6.7%) opposite inguinal hernia were detected and 05 cases (8.3%) with combined diseases were resolved. Duration of post-operative stay was 3.9±1.1 days. Conclusion: TAPP is a safe and feasible procedure, allows evaluation of opposite side and resolve combined peritoneal diseases.

scholarly journals Distal purse-string suture technique for TaTME

2018 ◽  
Vol 23 (1) ◽  
pp. 67-68 ◽  
Author(s):  
R. Wu ◽  
R. Benedict ◽  
A. Caycedo-Marulanda
Keyword(s):  
Suture Technique ◽  
Purse String Suture ◽  
Purse String
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