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 Closure of meningomyelocele defects using various types of keystone-design perforator island flaps

2021 ◽  
Vol 48 (3) ◽  
pp. 261-268
Author(s):  
Nandita Melati Putri ◽  
Narottama Tunjung ◽  
Patricia Marcellina Sadikin
Keyword(s):  
Retrospective Study ◽  
Operative Time ◽  
Defect Size ◽  
Island Flap ◽  
Defect Closure ◽  
Type Iii ◽  
Type Iv ◽  
Major Complications ◽  
Average Operative Time ◽  
Average Defect

Background Various methods have been described to close large meningomyelocele defects, but no technique has been proven superior to others. This study presents cases of meningomyelocele defect closure with a keystone-design perforator island flap.Methods A retrospective study was performed on 14 patients with meningomyelocele defects closed using various types of keystone flaps.Results The median age of the patients at surgery was 10.5 days (range, 1–369 days) and the average defect size was 22.5 cm2 (range, 7.1–55.0 cm2). The average operative time for defect closure was 89.6 minutes (range, 45–120 minutes). Type IV bilateral keystone flaps were used for four defects, type IV unilateral flaps for six defects, type IIA flaps for two defects, and type III flaps for two defects.Conclusions All the defects healed completely with no major complications. The keystone-design perforator island flap is a reliable, easy, and fast technique to close large meningomyelocele defects.

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.

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.

Comparison of surgical and pathological parameters after laparoscopic transperitoneal pelvic/para-aortic lymphadenectomies

2020 ◽  
Vol 30 (11) ◽  
pp. 1798-1802
Author(s):  
Anna Jacob ◽  
Andrea Plaikner ◽  
Achim Schneider ◽  
Giovanni Favero ◽  
Roberto Tozzi ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Learning Curve ◽  
Operative Time ◽  
Period 2 ◽  
Initial Learning ◽  
Operative Complications ◽  
Node Count ◽  
Laparoscopic Transperitoneal ◽  
Post Operative Complications

ObjectiveLymphadenectomy is an integral part of surgical staging and treatment for patients with gynecologic malignancies. Since its introduction, laparoscopic lymphadenectomy has proved feasible, safe, and oncologically adequate compared with open surgery while morbidity is lower and hospital stay considerably shorter. The aim of this study was to examine if surgical outcomes may be improved after the initial learning curve is complete.MethodsAn analysis of 2535 laparoscopic pelvic and/or para-aortic lymphadenectomies was performed between July 1994 and March 2018 by one team of gynecologic oncology surgeons but with the consistent supervision of a consultant surgeon. Data were collected prospectively evaluating operative time, intra-operative and post-operative complications, number of lymph nodes, and body mass index (BMI). Previously published data of 650 patients treated after introduction of the method (period 1, 1994–2003) were compared with the latter 524 patients (period 2, 2014–2018).ResultsThe median age of the 2535 patients was 43 years (IQR 34–57). The most common indication for pelvic and/or para-aortic lymphadenectomy was cervical cancer (n=1893). Operative time for para-aortic lymph node dissection was shorter in period 2 (68 vs 100 min, p<0.001). The number of harvested lymph nodes was increased for pelvic (19.2 (range 2–52) vs 21.9 (range 4–87)) and para-aortic lymphadenectomy (10.8 (range 1–52) vs 14.4 (range 4–64)), p<0.001. BMI did not have a significant influence on node count or operative time, with BMI ranging from 14.6 to 54.1 kg/m2. In contrast to period 1 (n=18, 2.9%), there were no intra-operative complications in period 2 (n=0, 0.0%, p<0.001) whereas post-operative complications were similar (n=35 (5.8%) in period 1; n=38 (7.6%) in period 2; p=0.32).ConclusionIn this large cohort of patients who underwent laparoscopic transperitoneal lymphadenectomy, lymph node count and peri-operative complications improved after the initial learning curve.

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.

Open and laparoscopic surgeries are associated with comparable 90 day morbidities and mortalities following ERAS protocols- A retrospective Study. (Preprint)

2020 ◽  
Author(s):  
BHAVIN VASAVADA ◽  
Hardik Patel
Keyword(s):  
Multivariate Analysis ◽  
Retrospective Study ◽  
Mortality Rate ◽  
Operative Time ◽  
Univariate Analysis ◽  
Morbidity And Mortality ◽  
Morbidity Rate ◽  
Blood Products ◽  
Asa Score

UNSTRUCTURED All the gastrointestinal surgeries performed between April 2016 to march 2019 in our institution have been analysed for morbidity and mortality after ERAS protocols and data was collected prospectively. We performed 245 gastrointestinal and hepato-biliary surgeries between April 2016 to march 2019. Mean age of patients was 50.96 years. 135 were open surgeries and 110 were laparoscopic surgeries. Mean ASA score was 2.40, mean operative time was 111 minutes, mean CDC grade of surgery was 2.56. 40 were emergency surgeries and 205 were elective surgeries. Overall 90 days mortality rate was 8.5% and over all morbidity rate was around 9.79% . On univariate analysis morbidity was associated significantly with higher CDC grade of surgeries, higher ASA grade, more operative time, more blood products use, more hospitalstay, open surgeries,HPB surgeries and luminal surgeries(non hpb gastrointestinal surgeries) were associated with higher 90 days morbidity. On multivariate analysis no factors independently predicted morbidity. On univariate analysis 90 days mortality was predicted by grade of surgeries, higher ASA grade, more operative time, more blood products use, open surgeries and emergency surgeries. However on multivariate analysis only more blood products used was independently associated with mortality There is no difference between 90 day mortality and moribidity rates between open and laparoscopic surgeries.

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