scholarly journals Comparative study of harmonic scalpel haemorrhoidectomy versus conventional (milligan and morgan) haemorrhoidectomy

2017 ◽  
Vol 6 (1) ◽  
pp. 328
Author(s):  
Tariq Ahmed Mala ◽  
Shahid Amin Malla ◽  
Ajaz Ahmad Shah ◽  
Maria Kapoor ◽  
Ved Bushan Gupta
Keyword(s):  
Postoperative Pain ◽  
Blood Loss ◽  
Harmonic Scalpel ◽  
Symptomatic Relief ◽  
Treatment Modalities ◽  
Control Group ◽  
Case Group ◽  
Early Return ◽  
Routine Work

Background: Haemorrhoids are dilated veins occurring in relation to the anus. There are various treatment modalities for haemorrhoids and among them surgical treatment is considered to be most effective one. Harmonic scalpel hemorrhoidectomy was compared with conventional in terms of symptomatic relief and complications.Methods: The aim of our study was to compare harmonic scalpel haemorrhoidectomy with conventional in terms of various intraoperative and postoperative factors for the treatment of grade III and IV haemorrhoids.Results: In our case study of 25 patients average time taken was 17.68 ± 2.84 minutes, while it was 28.44 ±3.69 minutes in control group. The mean blood loss was 8.96 ± 2.15 ml, 31.72 ± 3.28 ml in the case and control group respectively. Postoperative pain with VAS in case group on the first postoperative day was 5.92 ± 0.72, while it was 8.52 ± 0 in the control group. The dose of analgesia was less in case group. The postoperative wound site soakage was less in case study, early ambulation and return to normal work was faster in case study group.Conclusions: Harmonic scalpel haemorrhoidectomy is a simple, bloodless, safe and effective procedure in terms of blood loss, postoperative pain early return to routine work because of less lateral thermal injury.

scholarly journals Safety and effectiveness evaluation of a two-handed technique combining harmonic scalpel and laparoscopic Peng’s multifunction operative dissector in laparoscopic hemihepatectomy

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Jingwei Cai ◽  
Guixing Jiang ◽  
Yuelong Liang ◽  
Yangyang Xie ◽  
Junhao Zheng ◽  
...  
Keyword(s):  
Blood Loss ◽  
Operative Time ◽  
Harmonic Scalpel ◽  
Peak Level ◽  
Bile Leakage ◽  
Liver Parenchyma ◽  
Control Group ◽  
Case Group ◽  
Intraoperative Blood Loss ◽  
And Control

Abstract Objectives This study was designed to evaluate the safety and effectiveness of a two-hand technique combining harmonic scalpel (HS) and laparoscopic Peng’s multifunction operative dissector (LPMOD) in patients who underwent laparoscopic hemihepatectomy (LHH). Methods We designed and conducted a case-control study nested in a prospectively collected laparoscopic liver surgery database. Patients who underwent LHH for liver parenchyma transection using HS + LPMOD were defined as cases (n = 98) and LPMOD only as controls (n = 47) from January 2016 to May 2018. Propensity score matching (1:1) between the case and control groups was used in the analyses. Results The case group had significantly less intraoperative blood loss in milliliters (169.4 ± 133.5 vs. 221.5 ± 176.3, P = 0.03) and shorter operative time in minutes (210.5 ± 56.1 vs. 265.7 ± 67.1, P = 0.02) comparing to the control group. The conversion to laparotomy, postoperative hospital stay, resection margin, the mean peak level of postoperative liver function parameters, bile leakage rate, and others were comparable between the two groups. There was no perioperative mortality. Conclusions We demonstrated that the two-handed technique combing HS and LPMOD in LHH is safe and effective which is associated with shorter operative time and less intraoperative blood loss compared with LPMOD alone. The technique facilitates laparoscopic liver resection and is recommended for use.

scholarly journals Safety and Effectiveness Evaluation of A Two-Handed Technique Combining Harmonic Scalpel and Laparoscopic Peng’s Multifunction Operative Dissector in Laparoscopic Hemihepatectomy

2021 ◽  
Author(s):  
Jingwei Cai ◽  
Guixing Jiang ◽  
Yuelong Liang ◽  
Yangyang Xie ◽  
Junhao Zheng ◽  
...  
Keyword(s):  
Blood Loss ◽  
Operative Time ◽  
Harmonic Scalpel ◽  
Peak Level ◽  
Bile Leakage ◽  
Liver Parenchyma ◽  
Control Group ◽  
Case Group ◽  
Intraoperative Blood Loss ◽  
And Control

Abstract ObjectivesThis study was designed to evaluate the safety and effectiveness of a two-hand technique combining harmonic scalpel (HS) and laparoscopic Peng’s multifunction operative dissector (LPMOD) in patients who underwent laparoscopic hemihepatectomy (LHH).MethodsWe designed and conducted a case-control study nested in a prospectively collected laparoscopic liver surgery database. Patients who underwent LHH for liver parenchyma transection using HS + LPMOD were defined as cases (n = 98) and LPMOD only as controls (n = 47) from January, 2016 to May, 2018. Propensity score matching (1:1) between the case and control groups was used in the analyses. ResultsThe case group had significantly less intraoperative blood loss in mL (169.4 ± 133.5 vs. 221.5 ± 176.3, P = 0.03) and shorter operative time in minutes (210.5 ± 56.1 vs. 265.7 ± 67.1, P = 0.02) comparing to the control group. The conversion to laparotomy, postoperative hospital stay, resection margin, the mean peak level of postoperative liver function parameters, bile leakage rate and others were comparable between the two groups. There was no perioperative mortality. ConclusionsWe demonstrated that the two-handed technique combing HS and LPMOD in LHH is safe and effective which is associated with shorter operative time and less intraoperative blood loss compared with LPMOD alone. The technique facilitates laparoscopic liver resection and is recommended for use.

scholarly journals Minimally invasive dynamic hip screw for intertrochanteric fractures: comparison with conventional method and surgical tips

2017 ◽  
Vol 3 (4) ◽  
pp. 712
Author(s):  
Kandarp Vidyarthi ◽  
Siddhartha Venkata Paluvadi ◽  
Abhinav Sinha
Keyword(s):  
Postoperative Pain ◽  
Blood Loss ◽  
Minimally Invasive ◽  
The Elderly ◽  
Perioperative Outcomes ◽  
Control Group ◽  
Case Group ◽  
Postoperative Rehabilitation ◽  
Pain Scores ◽  
Duration Of Surgery

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Intertrochantric fractures of the proximal femur are one of the most common injuries of the elderly. Prolonged duration and peroperative blood loss in this elderly frail population is one of the major problems in using the DHS. We performed minimally invasive DHS (MIDHS) implantation for such patients and compared results with conventional technique, hypothesising better perioperative outcomes.</span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">We operated upon 30 cases as the case group from June 2013 to August 2016 with this technique. Patients older than 60 years of age with BMI less than 25 with stable AO type fractures which were easily reducible without sag of the distal fragment were included. In a control group 30 patients who had their hip fracture fixed with a DHS placed through the conventional approach were included. These groups were matched for sex, age, ASA grade and fracture type according to the AO classification. All surgeries were performed within 3 weeks of injury. We studied the patients in terms of time taken for surgery, peroperative blood loss, postoperative pain scores, need for analgesics and improvement in postoperative mobilization and rehabilitation by HHS</span>.<strong></strong></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">Blood loss, duration of surgery and average pain score were significantly lower (p &lt;0.0001) for MIDHS group due to a smaller incision and less muscle dissection. The HHS was also significantly better at 10 days in the MIDHS group. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Minimally invasive DHS is a simple and effective technique for fixation of intertrochantric fractures, especially in elderly, with reduced operative time, blood loss and postoperative pain scores leading to a more effective postoperative rehabilitation.</span></p><p align="left"> </p>

Ayurvedic Management of Interstitial Lung Disease : A Case Report

The Healer ◽  
2021 ◽  
Vol 2 (1) ◽  
pp. 126-131
Author(s):  
Dr.Minal Shashikumar Vaidya ◽  
Vd.Ashwin Prakash Shinde ◽  
Vd. Mugdha Aveenash Vaidya
Keyword(s):  
Symptomatic Relief ◽  
Cost Effective ◽  
Blood Stream ◽  
Forced Expiratory Volume ◽  
Interstitial Lung Diseases ◽  
Treatment Modalities ◽  
Permanent Cure ◽  
Substantial Morbidity

Interstitial Lung Diseases(ILD) are a group of diffuse parenchymal lung disorders, most of which cause progressive scarring of lung tissue associated with substantial morbidity and mortality as the scarring in ILD eventually affects the ability to breathe and get enough oxygen into the blood- stream. Prolonged ILD may result in pulmonary fibrosis. As there is no definite treatment for the disease, it has remained a great problem for the patients. Several conventional treatment modalities are in existence but not much comprehensive. Though the permanent cure for the disease is not available but Ayurveda can provide cost-effective and conveniently the better treatment which relieves the symptoms to a good extent and improves the quality of life of the diseased. In this article, a case study presented on a case of ILD. A 63 years old female, diagnosed case of ILD, attended Kayachikita OPD , with chief complaint of breathlessness since 2018 but severe from 1 month. Patient got admitted in IPD and treated on the Ayurvedic principles. At the time of discharge, symptomatic relief was found in breathlessness, effectiveness in FEV1( Forced Expiratory Volume in 1 sec)and also maitained saturation , but no significant changes in X-Ray Chest was observed after treatment.

scholarly journals Impact of Comprehensive Nursing on Proximal Humeral Fracture Treated with Locking Plate through Subacromial Small Incision

2017 ◽  
Vol 1 (3) ◽  
Author(s):  
Yan Li
Keyword(s):  
Postoperative Pain ◽  
Blood Loss ◽  
Proximal Humeral Fracture ◽  
Locking Plate ◽  
Statistical Significance ◽  
Humeral Fracture ◽  
Nursing Intervention ◽  
Control Group ◽  
Small Incision ◽  
The Impact

Objective:Probe into the impact of comprehensive nursingintervention on clinical efficacy of 45 cases of patients withproximal humeral fracture treated with locking plate throughsubacromial small incision. Method: equally divide 90 cases ofpatients with proximal humeral fracture into an observation groupand a control group in a random manner. Both of the two groupswere treated with locking plate through subacromial small incision.Give routine orthopedic nursing to the control group, whileimplementing comprehensive nursing intervention on the basis ofroutine orthopedic nursing to observation group, including mentalintervention, comfortable nursing, recovery nursing, etc. Comparethe nursing efficacy of the two groups. Result: operations werecompleted in small incision to cases of both groups. By adoptingConstant scoring method and ASES and through statisticaltreatment, the differences in blood loss, operation time andduration of postoperative pain of patients with those applyingtraditional internal plate fixation, replacement of the humeral headand treatment with locking plate through deltoid & pectoralismajor have statistical significance (P ＜ 0.05). The duration ofpostoperative pain of patients is shortened and the blood loss isless. Conclusion: implementing the comprehensive nursingintervention to patients with proximal humeral fracture treatedwith locking plate through subacromial small incision can improvethe treatment effect, alleviate the postoperative pain, lower theoccurrence rate of complications, and improve prognosis as well aslife quality. The clinical effect is satisfying.

scholarly journals Stitch less, clip less, three ports laparoscopic cholecystectomy: experience of 300 cases

2019 ◽  
Vol 7 (8) ◽  
pp. 2899
Author(s):  
Ritvik Resutra ◽  
Neha Mahajan ◽  
Rajive Gupta
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Postoperative Pain ◽  
Hospital Stay ◽  
Operative Time ◽  
Normal Activity ◽  
Duration Of Hospital Stay ◽  
Bile Duct Injuries ◽  
Early Return ◽  
Routine Work ◽  
Better Than

Background: 300 cases of cholelithiasis were operated by stitch less, clip less, three ports laparoscopic cholecystectomy at Maxx lyfe Hospital, near Bathindi morh, Sunjwan road, Jammu with effect from August 2017 to May 2019. The outcome measures in the form of safety of the technique, postoperative pain, need of postoperative analgesia, number of OT assistants needed, duration of hospital stay, recovery and return to routine work, cosmetic satisfaction of the patient were taken into consideration and were found to be better than in conventional four ports technique of laparoscopic cholecystectomy.Methods: In three port laparoscopic cholecystectomy, first 10 mm umbilical, second 5 mm subxyphoid and third 5 mm subcostal ports are used and telescope is passed into the peritoneal cavity through the umbilical port. Retraction of the gallbladder is done by the long grasping forceps through the 5 mm subcostal port, whereas dissection is accomplished through the subxyphoid port. The gallbladder is retrieved through the subxyphoid port.Results: Mean operative time was 40 minutes and mean duration of postoperative stay in the hospital was 18 hours. Days to return to normal activity was 4 days at an average.Conclusions: The 3-port laparoscopic cholecystectomy  technique is safe and has better outcomes in the form of less postoperative pain, less duration of hospital stay, early return to routine work and more cosmetic satisfaction as compared to the conventional 4-port technique, with no obvious increase in bile duct injuries and it can be a viable alternative in the field of minimally invasive surgery.

Comparison of LigaSure Vessel Sealing System, Harmonic Scalpel, and Cold Knife Tonsillectomy

2007 ◽  
Vol 137 (3) ◽  
pp. 385-389 ◽  
Author(s):  
Vassilios A. Lachanas ◽  
John K. Hajiioannou ◽  
George T. Karatzias ◽  
Dimitrios Filios ◽  
Stylianos Koutsias ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Blood Loss ◽  
Operative Time ◽  
Harmonic Scalpel ◽  
Complication Rates ◽  
Intraoperative Bleeding ◽  
Vessel Sealing System ◽  
Vessel Sealing ◽  
Ligasure Vessel Sealing System ◽  
Cold Knife

OBJECTIVE: We sought to compare LigaSure Vessel Sealing System tonsillectomy (LT), Harmonic Scalpel tonsillectomy (HST), and cold knife tonsillectomy (CKT). STUDY DESIGN: We conducted a prospective study on 161 adult patients undergoing tonsillectomy. Subjects were randomized to LT, HST, or CKT groups, and intraoperative bleeding, operative time, postoperative pain, and complication rates were assessed. RESULTS: The LT, HST, and CKT groups consisted of 50, 43, and 37 individuals, respectively. Intraoperative bleeding was significantly lower in the LT group, whereas bleeding in the HST group was significantly lower than that in the CKT group. Operative time and postoperative pain were significantly lower in the LT and HST groups. One primary hemorrhage occurred in the HST group, and one occurred in he CKT group. Secondary hemorrhage occurred in one, two, and one patients in the LT, HST, and CKT groups, respectively. CONCLUSION: LT and HST have shown comparable results regarding intraoperative blood loss, postoperative hemorrhage, and pain. Compared with CKT, both were associated with less intra-operative blood loss and pain.

scholarly journals Cervical traction: a simple step ahead in the prevention of postpartum hemorrhage

2019 ◽  
Vol 8 (8) ◽  
pp. 3174
Author(s):  
Harshita Naidu ◽  
Sujatha B. S. ◽  
Muralidhar V. Pai
Keyword(s):  
Blood Loss ◽  
Postpartum Hemorrhage ◽  
Active Management ◽  
Control Group ◽  
Case Group ◽  
Postpartum Blood Loss ◽  
The Third ◽  
Third Stage Of Labor ◽  
Third Stage ◽  
Cervical Traction

Background: Postpartum hemorrhage is the most common preventable cause of maternal mortality in developing countries. The present study aimed to examine the impact of cervical traction technique in reducing the amount of postpartum blood loss and rate of PPH.Methods: This was a case-control, pilot study conducted in a tertiary hospital between June 2017 to June 2018. A total of 200 singletons, low-risk pregnant females, undergoing normal vaginal delivery, were enrolled in this study. Subjects showing a high risk for PPH were excluded. Patients were randomized as case group (n=100) and control group (n=100). The case group received sustained traction for 90 seconds to anterior and posterior lip of the cervix with active management of the third stage of labor, whereas the control group received routine active management of the third stage of labor. All subjects were followed up for 6 hours post-delivery. The amount of blood loss, hematocrit and hemoglobin post-delivery were compared between both groups.Results: The mean blood loss (ml), decrease in hemoglobin (g/L) and decrease in hematocrit post-delivery in cases were significantly low compared to controls (207±37.6 versus 340±49, P<0.01), (0.78±0.2 versus 1.4±0.3, P=0.03) and (1.7±0.2 versus 3.5±0.2, P<0.01). PPH occurred in 7 of 200 (3.5%) patients. The difference in the number of PPH was not significant (5/100; 5% versus 2/100; 2% P=0.2). There were no complications reported due to cervical traction.Conclusions: Cervical traction is a simple and safe maneuver to reduce the amount of postpartum blood loss. Larger RCT is recommended to investigate the reduction in PPH rate.

scholarly journals The Effects of Magnesium Sulfate with Lidocaine for Infraclavicular Brachial Plexus Block for Upper Extremity Surgeries

2020 ◽  
Vol 15 (01) ◽  
pp. e33-e39 ◽  
Author(s):  
Siavash Beiranvand ◽  
Arash Karimi ◽  
Majid Haghighat Shoar ◽  
Maryam Baghizadeh Baghdashti
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Postoperative Pain ◽  
Magnesium Sulfate ◽  
Normal Saline ◽  
Motor Block ◽  
Control Group ◽  
Case Group ◽  
Hemodynamic Parameters ◽  
Infraclavicular Block

Abstract Background An addition of analgesic to anesthetic agents is likely to increase the effects of anesthesia and reduce associated adverse outcomes. Several adjuvants are studied in this regard. The aim of this study is to investigate the effects of adding a magnesium adjunct to lidocaine for the induction of infraclavicular block. Methods Patients referred to Shohada Ashayer Hospital, Khorramabad, for wrist and hand surgery were enrolled in this study. The intervention/case group included patients who received 18 mL lidocaine (2%) + 2 mL magnesium sulfate (50%), 10 mL normal saline; control group: 18 mL lidocaine (2%) + 12 mL of normal saline. After the induction of ultrasound-guided infraclavicular block, parameters such as duration of reach with respect to complete sensory and motor block, hemodynamic parameters (hypotension and bradycardia), and postoperative pain, using visual analogue scale criteria, were measured. The obtained data were analyzed using a Bayesian path analysis model. Results A total of 30 patients were included in each group. In the case group, sensory and motor block was achieved for 12.136 ± 4.96 and 13 ± 3.589 minutes more than those in the control group. The duration of sedation and immobilization was 2.57 ± 0.764 minute and 4.66 ± 0.909 minutes lengthier in the case group. Regarding the hemodynamic parameters, blood pressure was 0.217 ± 5.031 and 1.59 ± 5.14 units lower in the case group, immediately following the block and the surgery. Similarly, heart rate was 0.776 ± 4.548 and 0.39 ± 3.987 units higher in the case group, after 30 minutes and 2 hours of the procedure. A decrease in the pain was seen at 8, 10, and 12 hours after the surgery, as compared with the control group. An addition of magnesium to lidocaine for infraclavicular block resulted in a significantly longer sedation and immobilization period and decreased postoperative pain at 12 hours. Conclusion Heart rate and blood pressure did not decrease significantly in the case group. It can be concluded that addition of magnesium sulfate to lidocaine can produce better anesthetic and analgesic outcomes with low-to-no adverse effects.

scholarly journals OUTCOMES OF MULTIMODAL COCKTAIL VS TRANEXAMIC ACID ON POST OPERATIVE PAIN AND BLOOD LOSS IN TOTAL KNEE REPLACEMENT PATIENTS: A PROSPECTIVE RANDOMIZED STUDY

2020 ◽  
Vol 4 (8) ◽  
Author(s):  
Suhail Malhotra ◽  
Parminder Kaur
Keyword(s):  
Postoperative Pain ◽  
Blood Loss ◽  
Total Knee Replacement ◽  
Tranexamic Acid ◽  
Pain Score ◽  
Knee Replacement ◽  
Control Group ◽  
Total Knee ◽  
The Mean ◽  
The Difference

Background: Osteoarthritis is the most common form of arthritis and a leading cause of disability. Total knee replacement (TKR) is one of the most effective surgical procedures, providing improvement in function and relief of pain for the majority of patients. Intra-articular tranexamic acid [TXA] and multimodal cocktail (mixture of ketorolac, tramadol and bupivacaine) are commonly used drugs which help to reduce postoperative bleeding and pain respectively, improving outcome of surgery. Objective: To compare the postoperative blood loss and pain with or without Intra-articular tranexamic acid and multimodal cocktail respectively in patients undergoing total knee replacement Material and Methods: A total of 96 patients of either gender presenting to Orthopaedics department of Government Medical College, Amritsar, with knee osteoarthritis and planned to undergo total knee replacement were enrolled. Patients were divided into 3 groups. Group A being the control group was not given tranexamic acid [TXA] but only standard drugs for anesthesia. Group B patients were given 3gm intra-articular injection of tranexamic acid. Group C patients were given a multimodal cocktail (mixture of ketorolac, tramadol and bupivacaine. TKR was done and patients were followed-up for 72 hours. Blood loss and pain score after every 24 hours for 72 hours were noted. Intra-articular injections were given just before wound closure. Results: The mean age of patients in control group was 48.92±13.22years, in TXA group was 52.31±14.69 years and in cocktail group was 50.22±9.63years. The male to female ratio was 11:21, 14:18 and 10:22 in three groups respectively. The total blood loss during first 72 hours was 1030.1±177.27ml in control group, 453.7±80.4ml in TXA group while 607.7±122.5ml in cocktail group. The difference was significant in all three groups and also between TXA and cocktail group (p<0.05). The mean postoperative pain score during first 72 hours was 4.4±2.3in control group, 2.4±1.5 in TXA group while 1.8±1.0in cocktail group. The difference was significant in all three groups (p<0.05) but insignificant between TXA and cocktail group (p>0.05). Conclusion: Results showed that intra-articular injection of TXA is beneficial in reducing blood loss and postoperative pain in comparison to control group. While pain was better controlled with the multimodal cocktail compared to TXA group and control group. Keywords: Post-operative blood loss, Intra-articular injection, tranexamic acid, cocktail, total knee replacement

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