scholarly journals Port site complications following laparoscopic surgeries: a prospective study

2018 ◽  
Vol 5 (2) ◽  
pp. 598
Author(s):  
Madan Mohan Mudgal ◽  
Pradeep Kumar Kothiya ◽  
Naveen Kushwah ◽  
Raghvendra Singh
Keyword(s):  
Laparoscopic Surgery ◽  
Hypertrophic Scar ◽  
Minimal Invasive Surgery ◽  
Minimal Invasive ◽  
Port Site ◽  
Age Group ◽  
Site Infection ◽  
Visceral Injury ◽  
Verres Needle ◽  
A Prospective Study

Background: Port site complications are bothersome complications which undermine the benefits of minimal invasive surgery, not only does it add to the morbidity of the patient but also spoil the reputation of the surgeon. Aims and objective of the study was to determine the morbidity associated with the port site complications in laparoscopic surgery and to identify risk factors for complications.Methods: Three hundred patients having age between 15-50 years admitted for elective laparoscopic procedure were studied. All the patients had preoperative workup and general anaesthesia was given with endotracheal intubation. The patients were observed for any port-site complication during operation and in the immediate and postoperative till three months.Results: Female preponderance (77.34%) was observed with maximum patients belonging to age group of 41-50 years (31.7%). Majority of the patients were in the BMI range of 18.5-25kg/m2 (53.33%). In 54.66% and45.33% patients Verres needle and Hasson’s (Open) method was used to create pneumoperitoneum. Cholecystectomy was the indication in 80% patients. Port site morbidity was observed in 8.67% patients. As an early port site complication, bleeding, surgical site infection, emphysema and visceral injury was observed in 6, 8, 4 and 1 patient respectively. As a late port site complication, 4 and 3 patients developed hernia and hypertrophic scar respectively.Conclusions: Port site complications are least in elective laparoscopic surgery.

scholarly journals A COMPARATIVE STUDY OF HAEMODYNAMIC AND RECOVERY CHARACTERISTICS OF DESFLURANE VERSUS SEVOFLURANE IN PATIENTS UNDER GOING LAPAROSCOPIC SURGERY

2019 ◽  
pp. 1-2
Author(s):  
Ankita Bhensdadia
Keyword(s):  
Laparoscopic Surgery ◽  
Invasive Surgery ◽  
Minimal Invasive Surgery ◽  
Early Mobilization ◽  
Hemodynamic Instability ◽  
Minimal Invasive ◽  
Blood Gas ◽  
Hemodynamic Stability ◽  
Inhaled Anesthetics ◽  
Care Surgery

Laparoscopic surgeries are minimal invasive surgery very popular now a days as a day care surgery as it provide early mobilization, shorter hospital stay. The main drawback is intra-operative hemodynamic instability due to pneumoperitoneum. Therefore, anesthesiologist must choose anesthetic agent which provide hemodynamic stability and rapid recovery. Inhaled anesthetics with low blood: gas partition contributes to faster induction and emergence from anesthesia. Both Desurane and Sevourane have low blood: gas partition coefcient 0.42 and 0.65 respectively .We conducted the study to know which of these two agents contributes to faster recovery and hemodynamics. CONCLUSION- Desurane and Sevourane provide stable intraoperative hemodynamic, however early and intermediate recovery is signicantly faster in Desurane group than Sevourane grou

scholarly journals Clinical profile of malignancies of groin region in our area: a combined retrospective and prospective study

2021 ◽  
Vol 9 (4) ◽  
pp. 1005
Author(s):  
Arshad Bashir ◽  
Shabir Hussain Rather ◽  
Showket Ali Bhat ◽  
Naveed Nabi ◽  
Muzzafar Zaman
Keyword(s):  
Squamous Cell ◽  
Minimal Invasive Surgery ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Minimal Invasive ◽  
Squamous Cell Carcinomas ◽  
Care Hospital ◽  
Age Group ◽  
Predisposing Factor ◽  
Management Protocol

Background: This study involved various malignancies affecting the groin area in all age group of patients and both genders. The aim of the study was to study the various types of malignancies affecting groin, viz. primary or metastatic, and to project their clinical profile.Methods: In this observational study, a total of 145 patients of groin malignancies were studied in department of General and Minimal Invasive Surgery and allied specialties in a tertiary care hospital. The study was retrospective from January 2005 to April 2012 and prospective from May 2012 till 2014. Results: Out of the total of 145 cases almost 95% were metastatic in the groin and primary groin cancers constituted only 4.9% of the cases. Out of 138 tumors that were metastatic in the groin 108 were squamous cell carcinomas followed by malignant melanoma in 28 cases. Most common predisposing factor for development of groin malignancy was use of kangri in our area.Conclusions: Most of the groin malignancies are metastatic to groin and primary cancers at groin are very rare. Kangri use in our part of the world, is the most important predisposing factor leading to squamous cell carcinoma. The management protocol followed in order to treat groin malignancy is surgery of the primary lesion and block dissection of groin.  

scholarly journals Port site hernia: What are the risk factors?

2019 ◽  
Vol 3 (1) ◽  
pp. 1
Author(s):  
Tayeb S. Kareem ◽  
Renas A. Farman
Keyword(s):  
Risk Factors ◽  
Laparoscopic Cholecystectomy ◽  
Laparoscopic Surgery ◽  
Retrospective Study ◽  
Incisional Hernia ◽  
Port Site ◽  
Age Group ◽  
Port Site Hernia ◽  
Open Port ◽  
Fascial Layer

<p><strong>Background &amp; Aim</strong>: The port site hernia is a type of incisional hernia that occurs at port sites after laparoscopic surgery. Various factors have been implicated in the development of port site hernia.</p><p>The aim of this study was to know the risk factors of the port site hernia.</p><p><strong>Patients &amp; Methods:</strong> A retrospective study of patients who underwent different elective laparoscopic procedures in Rizgary Teaching Hospital in Erbil in a period from March 2013 to September 2014.</p><p><strong>Results</strong>: Out of 300 patients only 8 (2.7%) patients developed port site hernia. The time of the hernia occurrence ranged from 3 weeks to six months postoperatively. Half of the hernias were found in cases of age group (60-80) years. Six (75%) of the cases were female patients. All 8 hernias developed after laparoscopic cholecystectomy. Six (75%) hernias developed after open port entrance technique. All hernias occurred when the fascia in 10 mm port was not closed. Seven hernias (87.5%) occurred in patients with BMI ranged (25-34).</p><p><strong>Conclusion:</strong> Age of the patients, technique of entrance, site and size of the port with unclosed fascial layer are important factors for developing port site hernia.</p>

scholarly journals 1137 Improving the Use of Pre-Operative Skin Antiseptics (Chlorhexidine Pink and Betadine) To Reduce Umbilical Port Site Infections Following Laparoscopic Cholecystectomy and Appendicectomy

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
A Adnan ◽  
S Sange ◽  
M Ahmed ◽  
S Kanchustambam
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Laparoscopic Surgery ◽  
Port Site ◽  
Site Infection ◽  
Surgical Team ◽  
Readmission Rates ◽  
Skin Preparation ◽  
Local Skin ◽  
Admission Rates ◽  
Post Surgery

Abstract Introduction Approximately 8% of patients who undergo laparoscopic surgery develop port site infections1. This would negatively impact recovery and increase rates of readmission. Patients’ skin is a major source of pathogens that results in surgical site infection (SSI). Therefore, optimisation of antiseptic skin preparations may decrease postoperative umbilical port site infection (UPSI). Method A retrospective analysis of 226 cases from August 2019 till October 2020 at East Lancashire Hospital NHS Trust was performed. The first cycle included 122 patients (58 cholecystectomies and 64 appendicectomies), and a further 104 patients (51 cholecystectomies and 53 appendicectomies) after emphasising on using chlorhexidine pink as skin preparation. The presence of UPSIs within 30 days post-surgery was recorded. Results In the first cycle, the local preparation that was used in patients with UPSI was chlorhexidine pink (21.4%) and betadine (78.6%). The surgical team were then educated regarding the benefits of chlorhexidine pink over betadine as local skin preparation. In the second cycle, 63.3% used chlorhexidine pink and 36.7% used betadine. After the above implementation, there was a reduction in the rate of UPSI (18.0% to 15.7%) and readmission rates (7.2% to 5.9%) in patients who had undergone laparoscopic cholecystectomy. In patients who had undergone laparoscopic appendicectomy, a similar trend in UPSI rates was identified as well (7.1% to 5.5%) and readmission rates (5.5% to 1.9%). Conclusions The incidence of UPSI was reduced with the use of chlorhexidine pink compared to betadine. This may have contributed to the decrease in UPSI cases and led to a reduction in re-admission rates.

scholarly journals Establishing pneumoperitoneum: Verres or Hasson? The debate continues

2011 ◽  
Vol 93 (1) ◽  
pp. 22-24 ◽  
Author(s):  
N Dunne ◽  
MI Booth ◽  
TCB Dehn
Keyword(s):  
Laparoscopic Surgery ◽  
Bowel Perforation ◽  
Complication Rates ◽  
Previous Surgery ◽  
Significant Difference ◽  
Verres Needle ◽  
A Prospective Study ◽  
Based Medicine ◽  
Open Port ◽  
Upper Gastrointestinal

INTRODUCTION The technique of establishing pneumoperitoneum for laparoscopic surgery remains contentious, with various different techniques available and each having its own advocates. The Verres needle approach has attracted much criticism and is seen to entail more risk, but is this view justified in the era of evidence-based medicine? PATIENTS AND METHODS Over a 6-year period, a prospective study was undertaken of 3126 patients who underwent laparoscopic surgery performed by two upper gastrointestinal surgeons. One surgeon preferred the Verres needle and the other an open technique. A database was created of all cases and complication rates of the different techniques ascertained. RESULTS Peri-umbilical Verres needle was used in 1887 cases (60.4%) with two complications encountered, both of which were colonic injuries, with an incidence of 0.1%. Open port insertion was used in 1200 cases (38.4%) with one complication, a small bowel perforation, to give an incidence of 0.08%. The Verres needle was used in alternative positions in 22 cases (0.75%) and, when used in the left upper quadrant (19 cases), there was one complication, a left hepatic lobe puncture, with an incidence of 5.26%. Our overall incidence of intra-abdominal injury was 0.13%, all in patients who had undergone previous abdominal surgery, and in the subgroup of patients with previous surgery the rate was 0.78%. There was no mortality. CONCLUSIONS Practice varies as to the method chosen to induce pneumoperitoneum, but our results show there is no significant difference between the technique chosen and incidence of complications, and this is supported in the literature.

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