Laparoscopic versus open surgical management of idiopathic varicocele: a study on 100 patients

Background: Idiopathic varicocele is common condition encountered in surgical practice requiring surgical correction. Open surgical technique had been in use for long but laparoscopic varicocelectomy is another choice for its management.Methods: This is a prospective study on 100 patients. 70 patients were subjected to laparoscopic and 30 to open inguinal varicocelectomy.Results: Majority of patients were between 16 to 25 years of age. 55% were asymptomatic and 10% had infertility. Grade II varicocele was observed in 50% patients. All patients had left side involvement with bilateral varicocele in 2% patients. Mean operating was 13.8 min in unilateral and 17.3 min in bilateral laparoscopic varicocelectomy whereas it was 27.55 min in unilateral and 49.7 min in bilateral open varicocelectomy. 5.7% and 6.6% had secondary hydrocele and hospital stay was 1.25 and 3.4 days in laparoscopic and open group respectively.Conclusions: Laparoscopic varicocelectomy is safe, effective procedure with less post-operative pain and analgesic requirement. It also has shorter operating time and post-operative hospital stay. Procedures like opposite varicocele, herniotomy, adhesiolysis or orchiopexy can also be done.

Download Full-text

Coblation tonsillectomy: our experience as a day care procedure

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20211566 ◽

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

Background: 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.Methods: 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.Results: 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.Conclusions: 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.

Download Full-text

Tension free, mesh free inguinal hernia repair: a prospective study of Desarda’s technique

International Surgery Journal ◽

10.18203/2349-2902.isj20201382 ◽

2020 ◽

Vol 7 (4) ◽

pp. 1116

Author(s):

Hosni Mubarak Khan ◽

B. S. Ramesh ◽

Viraja Bobburi

Keyword(s):

Prospective Study ◽

Hospital Stay ◽

Operating Time ◽

Oblique Muscle ◽

Medical College ◽

Inguinal Hernias ◽

Absorbable Sutures ◽

Mesh Free ◽

The Mean ◽

A Prospective Study

Background: The Desarda repair for inguinal hernias is a new tissue-based technique. Application of the external oblique muscle aponeurosis in the form of un-detached strip has been established as a new concept in tissue-based hernia repair.Methods: A prospective study was conducted among 126 cases with 148 inguinal hernias repaired by Desarda’s technique for a period of 3 years in Dr. B. R. Ambedkar Medical College and Hospital, Bangalore, Karnataka, India. The details pertaining to duration of hospital stay, pain, ambulation and complications were recorded.Results: The mean age of the patients was 38.4 years. Mean operating time was 62.5 min for unilateral and 123 min for bilateral hernias. About 97.8% patients were ambulatory within 6.42 hours and were freely mobile within 19.26 hours after surgery. About 96.4% patients returned to work within 6-14 days. About 91.26% patients were discharged on same day. The mean hospital stay duration of the patients was 1.11 days. Postoperative pain on movement out of bed was described as mild and tolerable in 92.6% patients on day 1. Two patients had seroma that subsided on its own. There were no long-term complications, recurrence of the hernias or chronic groin pain.Conclusions: The results of this new technique (Desarda repair) using continuous absorbable sutures appear promising. The continuous suturing saves time and just one packet of suture material without mesh saves cost.

Download Full-text

A Prospective Study on Laparoscopic Intervention in Acute Appendicitis in a Teritiary Care Hospital, North Andhra

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2021/382 ◽

2021 ◽

Vol 8 (24) ◽

pp. 2034-2039

Author(s):

Janni Laxman ◽

Patnala Mohan Patro ◽

Janardana Rao K.V.

Keyword(s):

Acute Appendicitis ◽

Prospective Study ◽

Hospital Stay ◽

Clinical Outcomes ◽

Laparoscopic Appendectomy ◽

Operating Time ◽

Open Appendectomy ◽

Late Presentation ◽

Age Group ◽

A Prospective Study

BACKGROUND We wanted to determine the various pre-operative and intra-operative factors responsible for conversion to open technique of appendectomy and compare the clinical outcomes of hospital-stay and operating time between open appendectomy and laparoscopic appendectomy. METHODS Patients presented to General surgery Department of GITAM Institute of Medical Sciences and Research with features suggestive of acute appendicitis from September 2017 to November 2019 were included in this study. This is a prospective study which included a total of 100 patients. These patients were divided into two groups of 50 each. One group of patients with early presentation with symptoms of less than 3 days of duration, another group with late presentation of 3 or more days of onset of symptoms were included. In this study we wanted to compare the clinical outcomes of hospital stay and operating time between open appendectomy and laparoscopic appendectomy. RESULTS In this study, majority of patients belong to age group 20 - 44 years who had delayed presentation to hospital, in contrast to patients who presented early involved the age group of 21 – 30 years. In this study, pain abdomen was the commonest symptom (100 %) with which patient presented. The other symptoms were nausea/vomiting (72 %), fever (63 %). Seven patients presented with diarrhea. CONCLUSIONS Our data suggest that laparoscopic appendectomy is associated with improved clinical outcomes even in patients who had late presentation. KEYWORDS Appendicitis, Laparoscopic, Gangrenous

Download Full-text

Robotically Assisted Hysterectomy versus Vaginal Hysterectomy for Benign Disease: A Prospective Study

Minimally Invasive Surgery ◽

10.1155/2013/429105 ◽

2013 ◽

Vol 2013 ◽

pp. 1-4 ◽

Cited By ~ 3

Author(s):

M. Carbonnel ◽

H. Abbou ◽

H. T. N’Guyen ◽

S. Roy ◽

G. Hamdi ◽

...

Keyword(s):

Blood Loss ◽

Prospective Study ◽

Hospital Stay ◽

Vaginal Hysterectomy ◽

Operative Time ◽

Group Versus ◽

Length Of Hospital Stay ◽

Benign Disease ◽

Post Surgery ◽

A Prospective Study

Objectives. A prospective study was carried out to compare vaginal hysterectomy (VH) and robotically assisted hysterectomy (RH) for benign gynecological disease.Materials and Methods. All patients who underwent hysterectomy from March 2010 to March 2012 for a benign disease were included. Patients’ demographics per and post surgery results were collected from medical files. A questionnaire was also conducted 2 months after surgery.Results. Sixty patients were included in the RH group and thirty four in the VH one. Operative time was significantly longer in the RH group ( versus min; ). Blood loss and length of hospital stay were significantly reduced: versus ml; , and versus days; , respectively. Less pain was reported at D1 and D2 by RH patients, and levels of analgesia were lower compared to those observed in the VH group. No differences were found regarding the rate of conversion to laparotomy, intra- or postoperative complications.Conclusion. Robotically assisted hysterectomy appears to reduce blood loss, postoperative pain, and length of hospital stay, but it is associated with longer operative time and higher cost. Specific indications for RH remain to be defined.

Download Full-text

EP.WE.162Correct consenting for Vascular Patient

British Journal of Surgery ◽

10.1093/bjs/znab308.023 ◽

2021 ◽

Vol 108 (Supplement_7) ◽

Author(s):

Hasan Khalaf ◽

A. Behbahani ◽

Aideen Walsh

Keyword(s):

Patient Satisfaction ◽

Prospective Study ◽

Teaching Hospital ◽

Practice Guideline ◽

Surgical Practice ◽

Wide Range ◽

Effective Relationships ◽

Questionnaire Form ◽

A Prospective Study ◽

Vascular Patient

Abstract Introduction Surgeons must establish and maintain effective relationships with patients and, where appropriate, with their supporters. Before surgery, surgeons should strive to have an honest and sensitive discussion with patients about their options for treatment that leads to informed and deliberate consent. The aim of this study is to compare our consent practice in the vascular department in Royal Stoke Teaching Hospital against consent guideline in the Best surgical practice and to if we are meeting patient satisfaction. Method A prospective study of 30 patients from 21/09/2020 to 21/10/2020. Questionnaire form was designed based on the best surgical practice guideline and was given to the patient to fill. We include patients admitted for elective vascular procedures, wide range ages. The questionnaire Results Most of the of the patient (90%) were consented by the professionals who provide the treatment. 63% of the patients asked for further information in the form pf leaflets or websites. 70% of them request to know the recent guidelines of their procedures. Only 13% of them had a copy of the consent prior to surgery. Recommendations We must provide the patients with further information, Recent guidelines, and a copy of the consent to take home prior to surgery day. This can be achieved by consenting them before the operation day.

Download Full-text

Necrotizing Fasciitis

Indian Journal of Plastic Surgery ◽

10.4103/0970-0358.121978 ◽

2013 ◽

Vol 46 (03) ◽

pp. 472-478 ◽

Cited By ~ 12

Author(s):

Jagdish Sadasivan ◽

Nanda Kishore Maroju ◽

Anandh Balasubramaniam

Keyword(s):

Hospital Stay ◽

Necrotizing Fasciitis ◽

Large Body ◽

Common Condition ◽

Prolonged Hospital Stay ◽

Surgical Practice ◽

Indian Context ◽

Surgical Infections ◽

Prolonged Hospital ◽

Indian Perspective

ABSTRACTNecrotizing fasciitis (NF) is among the most challenging surgical infections faced by a surgeon. The difficulty in managing this entity is due to a combination of difficulty in diagnosis, and also of early as well as late management. For the patient, such a diagnosis means prolonged hospital stay, painful dressings, an extended recovery, and in some unfortunate cases even loss of limb or life. Necrotizing fasciitis is a fairly common condition in surgical practice in the Indian context resulting in a fairly large body of clinical experience. This article reviews literature on MEDLINE with the key words ′′necrotizing,′′ ′′fasciitis,′′ and ′′necrotizing infections′′ from 1970, as well as from articles cross referenced therein. The authors attempt to draw comparisons to their own experience in managing this condition to give an Indian perspective to the condition.

Download Full-text

Endoscopic, Single-Session Management of Encrusted, Forgotten Ureteral Stents

Medicina ◽

10.3390/medicina55030058 ◽

2019 ◽

Vol 55 (3) ◽

pp. 58 ◽

Cited By ~ 2

Author(s):

Volkan Ulker ◽

Orcun Celik

Keyword(s):

Hospital Stay ◽

Treatment Options ◽

Operating Time ◽

Operation Time ◽

Ureteral Stents ◽

Single Session ◽

Extracorporeal Shock Wave ◽

Clavien Grade ◽

Grade Ii ◽

The Mean

Background and Objectives: Remained or forgotten ureteral double-J stents may cause serious complications. Removing of an encrusted, forgotten stent can be challenging. We present our experience with heavily encrusted ureteral stents and discuss the endourologic treatment options as well as their effectivity. Materials and Methods: Eleven men and six women (mean 48.58 ± 14.48 years of age) with 18 encrusted forgotten stents (mean 16.4 ± 13.25 months of indwelling) were treated at our clinic. All patients underwent the operation after negative urine cultures were obtained. Their medical records were retrospectively reviewed and analyzed in terms of number of interventions required to remove the stent, operation time, complications, hospital stay and stone-free rate. Results: According to the Forgotten-Encrusted-Calcified (FECal) classification, the most common form of stent encrustation was grade III (64.7%) and 17.6% of the stents were fragmented. Four of 17 patients were initially treated with extracorporeal shock-wave lithotripsy. The patients required a mean of two endoscopic interventions for removing the encrusted stent and all stents were removed endoscopically in a single session. The mean operating time was 63.3 ± 41.8 minutes. Cystolithotripsy followed by ureteroscopy was the most common intervention (41.1%). Of the 17 patients, peroperative and postoperative complications were Clavien grade I in two, grade II in two and grade IIIb in one. The mean hospital stay was 1.3 ± 0.99 days. All patients were stone-free after a month of stent removal. Conclusions: The endourological removal of the encrusted forgotten stents in a single session is feasible and effective with a minimal morbidity. The treatment strategy should be to minimize the number of interventions.

Download Full-text

PRIMARY UNREAMED NAILING IN GRADE I, II AND IIIA OPEN FRACTURES OF THE TIBIA SHAFT: A PROSPECTIVE STUDY OF THE OUTCOMES IN 80 PATIENTS

Journal of Musculoskeletal Research ◽

10.1142/s021895771850015x ◽

2018 ◽

Vol 21 (03n04) ◽

pp. 1850015

Author(s):

S. K. Rai ◽

S. K. Nath ◽

Manoj Kashid ◽

Sunitkumar Wani

Keyword(s):

Prospective Study ◽

Bone Healing ◽

Deep Infection ◽

Tibial Shaft ◽

Shaft Fractures ◽

Unreamed Nailing ◽

Grade Ii ◽

A Prospective Study ◽

Mean Time ◽

Tibial Shaft Fractures

Introduction. To evaluate the incidences of union, nonunion and infection in the treatment of open tibial shaft fractures of Gustilo–Anderson types I, and IIIA treated with primary unreamed solid intramedullary locked nail (UTN). Materials and Methods. It is a prospective study of 80 open tibial shaft fractures. According to the AO classification, 36 patients (44%) were of type A, 29 (36%) were of type B and 15 (18%) were of type C. According to the Gustilo–Anderson classification, 31 patients (38.7%) were of grade I, 24 (30%) were of grade II and 25 (31%) were of grade IIIA. For the definitive stabilization of the fracture was used a UTN. Results. Bone healing was achieved in 98.4% of the cases, with a mean time of 24.2 weeks, ranging from 14 weeks to 110 weeks. Union without infection was seen in 70 patients (87%) and nonunion was seen in five patients (6%). Deep infection was seen in three patients (3.7%) and malunion was seen in two patients (2.5%). Conclusion. The treatment of open tibial shaft fractures with unreamed solid intramedullary locked nail allows high rates of bone healing and low rates of nonunion and deep infection, and if the presence of infection is excluded, then the results of unreamed nailing and reamed nailing are the same.

Download Full-text