scholarly journals Natural Orifice Non-Descent Hysterectomy - Revisiting Fading Surgical Art

2021 ◽  
Vol 10 (44) ◽  
pp. 3781-3784
Author(s):  
Shashi Prateek
Keyword(s):  
Blood Loss ◽  
Tertiary Care ◽  
Surgical Techniques ◽  
Natural Orifice ◽  
Indication For Surgery ◽  
Tertiary Care Centre ◽  
Surgical Time ◽  
Surgical Expertise ◽  
Abdominal Route ◽  
Operative Recovery

BACKGROUND We wanted to assess the feasibility of natural orifice non-descent hysterectomy (NONH) for various benign gynaecological indications. METHODS This retrospective study was conducted at a tertiary care centre including patients requiring hysterectomy for various gynaecological indications over 12 months. Outcomes including time of surgery, blood loss, intraoperative surgical technique, complications, and conversion to the abdominal route were noted. RESULTS A total of 68 cases of natural orifice non-descent hysterectomy were performed. The uterine fibroid was the most common (50 %) indication for surgery followed by adenomyosis. Uteri with previous multiple surgeries were also successfully operated vaginally. The average surgical time was 60 min, with minimal blood loss. Post-operative recovery was good and patients were discharged after 48 hours. CONCLUSIONS This article concludes that natural orifice is a safe route of non-descent hysterectomy even for larger and scarred uteri using various debulking and surgical techniques but requiring good anatomical knowledge, surgical expertise and teamwork. KEY WORDS Natural Orifice Non-Descent Hysterectomy (NONH); Surgical Variations; Debulking Technique; Post-Operative Recovery

Comparison of 5 Surgical Techniques for Partial Liver Lobectomy in the Dog for Intraoperative Blood Loss and Surgical Time

2010 ◽  
Vol 39 (7) ◽  
pp. 856-862 ◽  
Author(s):  
Marije Risselada ◽  
Gary W. Ellison ◽  
Nicholas J. Bacon ◽  
Maximilian M.R. Polyak ◽  
Jim Van Gilder ◽  
...  
Keyword(s):  
Blood Loss ◽  
Surgical Techniques ◽  
Intraoperative Blood Loss ◽  
Surgical Time

scholarly journals Comparison of laparoscopic-assisted vaginal hysterectomy, total abdominal hysterectomy and vaginal hysterectomy: A four years retrospective study in tertiary care centre

2018 ◽  
Vol 7 (9) ◽  
pp. 3596
Author(s):  
Namrata Vasant Padvi ◽  
Jitendra Pundalik Ghumare
Keyword(s):  
Blood Loss ◽  
Vaginal Hysterectomy ◽  
Tertiary Care ◽  
Operating Time ◽  
Abdominal Hysterectomy ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Average Hospital ◽  
Intraoperative Complication ◽  
Estimated Blood Loss

Background: Hysterectomy is one of the commonest gynaecological operations performed in India. Traditional surgical treatments performed are abdominal hysterectomy and vaginal hysterectomy. Vaginal and laparoscopic procedures are considered “minimally invasive” surgical approaches because they do not require a large abdominal incision and, thus, typically are associated with shortened hospitalization and postoperative recovery times compared with open abdominal hysterectomy. With the aid of laparoscopic procedure, a potential abdominal hysterectomy can be converted to a vaginal one and a difficult vaginal hysterectomy can be converted into a fairly simple vaginal hysterectomy. Aim of the present study is to compare above methods of hysterectomy in terms of operating time, estimated blood loss, and postoperative hospital stay and complication, so as to provide best course of treatment to patient.Methods: A retrospective observational study was conducted in tertiary care centre. Four-year data was collected from January 2012 to December 2016. Cases of LAVH with benign gynaecological condition and up to 12 weeks size uterus, without any associated medical condition were selected in study randomly, and compare with cases of NDVH, TAH in terms of duration of operative procedure, blood loss during surgery, and postoperative hospital stay.Results: In present study we found that average duration of procedure in LAVH was 84.35 minute, which was maximum compare to other method. Estimated blood loss in LAVH was least as compare to NDVH and TAH it was maximum. The average hospital stays in LAVH and NDVH was less as compared to TAH.Conclusions: LAVH should be considered a better approach in view of the relatively less blood loss and intraoperative complication. Due to lack of large randomized controlled trials, the role of Laparoscopic hysterectomy is difficult to define.

Coblation tonsillectomy: our experience as a day care procedure

2021 ◽  
Vol 7 (5) ◽  
pp. 764
Author(s):  
Kripamoy Nath ◽  
Ritu Gupta
Keyword(s):  
Blood Loss ◽  
Prospective Study ◽  
Day Care ◽  
Tertiary Care ◽  
Operating Time ◽  
Tertiary Care Centre ◽  
Post Operative Pain ◽  
Care Surgery ◽  
A Prospective Study ◽  
Care Procedure

<p class="abstract"><strong>Background: </strong>A prospective study to cite our experience in adult and pediatric patients undergoing coblation tonsillectomy. We emphasised on the intra operative and post operative morbidity in coblation tonsillectomy and its feasibility as a day care procedure.</p><p class="abstract"><strong>Methods: </strong>It is a prospective study done on both paediatric and adult cases presenting to our tertiary care centre between January 2018 to February 2020. Study was done to analyse operating time, intraoperative blood loss, post-operative pain, post-operative haemorrhage and post-operative return to home and normal diet.</p><p class="abstract"><strong>Results: </strong>114 cases were selected where bilateral tonsillectomy was performed using Coblation technique. 83 were adult patients and 31 paediatric. 56 were females and 58 males. 1 case presented with secondary haemorrhage, none with primary haemorrhage. No other complications were noted.</p><p class="abstract"><strong>Conclusions: </strong>Coblation tonsillectomy yielded good results in reference to patient morbidity and low complication rate. It turned out to be a success as a day care procedure. Short operating time, minimal blood loss, less post-operative pain specially in the early post-operative period, minimal chance of complication and short stay at hospital as a day care surgery, Coblation tonsillectomy stood out as a hands down winner in our study. In this fast paced life, where consumerism demands everything instant, coblation tonsillectomy as a day care procedure provides good alternative to the patient requiring tonsillectomy. yroidectomies.</p>

scholarly journals Comparative study of nondescent vaginal hysterectomy and abdominal hysterectomy at tertiary care centre, Maharashtra

2021 ◽  
Vol 10 (9) ◽  
pp. 3397
Author(s):  
Sharayu Prashant Mujumdar ◽  
Priyanka Kunal Purohit ◽  
Shwetambari S. Navale ◽  
Chintan M. Upadhyay
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Tertiary Care ◽  
Study Groups ◽  
Abdominal Hysterectomy ◽  
Economic Benefits ◽  
Tertiary Care Centre ◽  
Abdominal Incision ◽  
Operative Complication ◽  
Duration Of Surgery

Background: Vaginal route of hysterectomy has distinct health and economic benefits in terms of less morbidity, better postoperative quality of life outcomes, reduced hospital stay and better patient satisfaction. Objectives of current study were to evaluate the appropriate route of hysterectomy (abdominal or vaginal) in terms of intra and post-operative complication, morbidity and blood loss. Methods: This prospective study was done among 100 cases of hysterectomy of which 50 patients underwent NDVH and 50 underwent abdominal hysterectomy. This study included all emergency and booked patients having Size of uterus less than 12 weeks size, adequate uterine mobility, adequate access, adenomyosis, dysfunctional uterine bleeding, chronic PID & fibroid uterus.Results: Study found statistically significantly higher number of the participants with parity 3 & 4 in both the study groups. Bulky uterus followed by 12 and 10 weeks uterus in statistically significantly higher number of the participants of both the study groups. Duration of surgery statistically significantly less in NDVH group compare to TAH group. Fibroid was the main indication of hysterectomy in both the groups. Hemorrhage was the main intra-operative complication in both the groups. Fever & respiratory tract infection was the main post-operative complications in both the groups.Conclusions: Benefits of NDVH over TAH are Cosmetic advantage as less invasive, No discomfort of abdominal incision, shorter operative time, lesser blood loss, lesser intraoperative and postoperative complications, postoperative comfort is more, lesser requirement of postoperative analgesia, early ambulation and shorter hospital stay.

scholarly journals A study of various cesarean section techniques at a government tertiary care centre: Misgav Ladach cesarean section versus Pfannenstiel cesarean section

2017 ◽  
Vol 6 (8) ◽  
pp. 3449
Author(s):  
Medha Kanani
Keyword(s):  
Blood Loss ◽  
Cesarean Section ◽  
Tertiary Care ◽  
Breech Presentation ◽  
Care Hospital ◽  
Tertiary Care Centre ◽  
Pfannenstiel Incision ◽  
Emergency Cesarean ◽  
Post Operative Pain ◽  
Duration Of Surgery

Background: It is important to examine every step in any surgery to identify and evaluate its imortance, necessity and purpose with a view to find its better alternatives if they can be found at all. The most appropriate surgical procedure is the one which takes minimum time to be complete, simplest to perform, causing least damage and least complication for the patient. Present study was undertaken to assess the benefits of the Misgav Ladach cesarean section technique in comparison to the conventional Pfannenstiel technique in the tertiary care hospital and evaluate the operative parameters like efficacy, safety, duration of surgery, blood loss, need for suture material, post-operative pain and post-operative stay in hospital.Methods: All the women posted for emergency cesarean section in the Obstetrics OT at Sir T Hospital, Bhavnagar, Gujarat were included in this study. Some of the common indications at our hospital for cesarean section were fetal distress, cephalopelvic disproportion, failure of progress of labour, breech presentation, previous cesarean section and failed induction. Informed consent was taken. All the patients were randomly allocated to two groups with 50 women in each group. Group 1 Pfannenstiel incision and Group 2 Misgav Ladach.Results: The duration of surgery, blood loss and post-operative pain were significantly less in the Misgav Ladach group (P<0.001).Conclusions: Misgav Ladach technique of cesarean section has many advantages and should be used routinely.

scholarly journals Placental cord drainage during third stage of labour: a randomized control trial at a tertiary care centre

2020 ◽  
Vol 9 (3) ◽  
pp. 1143
Author(s):  
Megha Chaudhary ◽  
Maitri Shah ◽  
Nitin Makwana
Keyword(s):  
Blood Loss ◽  
Randomized Control Trial ◽  
Tertiary Care ◽  
Normal Vaginal Delivery ◽  
Control Group ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Third Stage ◽  
The Mean ◽  
Randomized Control

Background: Labour is a physiological process, but it is often associated with morbidity and mortality, with the most common cause being blood loss. Primary postpartum hemorrhage is commonly defined as a blood loss of 500 ml or more within 24 hours after normal vaginal birth. A prolonged third stage of labour (more than 20 min) is associated with postpartum hemorrhage. The present study was undertaken with the objective of assessing efficacy of placental cord drainage (PCD) during active management of third stage of labour.Methods: This is a randomized control trial in which full term primi gravida who were expected to have normal vaginal delivery, admitted in labour room of a tertiary care centre were evaluated for inclusion in the study. Total 126 participants were enrolled after having normal vaginal delivery. In study group (n = 63), placental cord drainage was used for management of third stage of labour while in control group (n = 63), third stage was managed without PCD.Results: The mean difference in duration of third stage of labour in study and control group was 1.79 minute and the mean difference in blood loss during third stage of labour in both groups was 57.86 ml which was statistically significant.Conclusions: The results of this study show small positive effects from cord drainage in reducing the length of the third stage of labour and in reducing the amount of blood loss when compared with those without cord drainage. The observed changes may be of clinical significance in reducing third stage related complications.

scholarly journals A Comparative Study on Functional Status of Recurrent Laryngeal Nerve with or without Exploration of the Nerve during Thyroid Surgery in a Tertiary Care Centre of Eastern India

2021 ◽  
Vol 8 (13) ◽  
pp. 768-772
Author(s):  
Nabanita Mandal ◽  
Atish Haldar ◽  
Ranjan Paul
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Functional Status ◽  
Thyroid Surgery ◽  
Nerve Palsy ◽  
Controlled Trial ◽  
Tertiary Care ◽  
Surgical Techniques ◽  
Laryngeal Nerve ◽  
Care Centre ◽  
Tertiary Care Centre

BACKGROUND From the last century to modern days, there has been a paradigm shift in the field of thyroid surgery. Initially what was a dreadful surgery with multi fold serious complications, now with the advent of modern surgical technique (bipolar to nerve monitoring & emerging use of microscope), and better knowledge of anatomy, it has become one of the most frequently performed surgeries worldwide with very few complications. In spite of all these, postoperative complications like recurrent laryngeal nerve (RLN) palsy is still mostly feared by surgeons and still is one of the most frequent complications. METHODS This was a prospective nonrandomised controlled trial conducted among 60 study participants in the Department of Otorhinolaryngology and Head & Neck Surgery, of a tertiary care centre in West Bengal from July 2016 to June 2018. In this study two different surgical techniques were applied in two patient groups. In one group subcapsular dissection of thyroid gland was done without exploration of recurrent laryngeal nerve course in neck; and in another group, the complete course of the aforesaid nerve in the neck was explored and preserved. The postoperative functional status of RLN was assessed by fibreoptic laryngoscopy immediately after recovery from anaesthesia and in postoperative follow ups. We wanted to compare the outcome (in terms of functional status of RLN) in these two groups. RESULTS 3 patients (10 % cases) of nerve palsy were seen among 30 patients of subcapsular dissection group, whereas only one case (3.3 %) of nerve palsy was seen amongst 30 cases of complete exploration of recurrent laryngeal nerve. CONCLUSIONS Thyroidectomy with meticulous exploration of the recurrent laryngeal nerve was found to be a superior method as compared to the subcapsular dissection. KEYWORDS Recurrent Laryngeal Nerve, Subcapsular Dissection, Complete Exploration, Thyroidectomy

scholarly journals Plastibell circumcision in neonates and infants at tertiary care centre

2018 ◽  
Vol 5 (4) ◽  
pp. 1488
Author(s):  
Nandkishor D. Shinde ◽  
Mohammad Moinuddin ◽  
A. N. M. Owais Danish
Keyword(s):  
Prospective Study ◽  
Surgical Procedure ◽  
Tertiary Care ◽  
Care Centre ◽  
Inclusion Criteria ◽  
Medical Sciences ◽  
Tertiary Care Centre ◽  
Surgical Time ◽  
The Mean ◽  
Neonates And Infants

Background: Circumcision is the most common surgical procedure in children worldwide. The aim of this study was to study the safety and complication of Plastibell circumcision in neonates and infants.Methods: This prospective study of 420 male children less than 1 years who underwent Plastibell circumcision for religious or cultural indication in the Department of Surgery at KBN Institute of Medical Sciences, Kalaburagi, during February 2016 to January 2018. Children were divided into two groups; neonates (0 to 4 weeks) and infants (5 weeks to1 year). Parents were given specific instructions on care of the device on discharge and followed up on day 3 and on day of separation of the Plastibell.Results: During the study period, 420 cases of Plastibell circumcision fulfilling the inclusion criteria were included and analyzed. Out of the total cases, 120 (28.57%) were neonates, whereas the remaining 300 (71.42%) were infants. Mean surgical time was 4±2 minutes. The mean number of days for Plastibell to separate was 6.2 days, Plastibell ring separation in neonates earlier (3 days to 7 days) as compared to infants (5 days to 12 days). Out of the total 420 cases 65 (15.47%) cases developed minor complications. In neonates, out of 120 cases only 05 (4.16%) developed complications. In infants, out of 300 cases, 60 (20%) developed complications.Conclusions: Neonates had shorter time for the Plastibell to separate and with fewer complications than infants. Though complications were present, they were few and could be managed easily. Plastibell circumcision is safe in neonates and infants.

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