scholarly journals AUDIT OF EVOLVING ROLES OF LAPAROSCOPY IN THE CURRENT SURGICAL PRACTICE AT CHRIS HANI BARAGWANATH ACADEMIC HOSPITAL: A 5 YEAR REVIEW

2021 ◽  
Vol 8 (5) ◽  
pp. 16-24
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Laparoscopic Surgery ◽  
Standard Of Care ◽  
Descriptive Statistics ◽  
Academic Hospital ◽  
Surgical Practice ◽  
The Past ◽  
Wide Range ◽  
Accepted Standard ◽  
The Mean

Background: Laparoscopic surgery (LS) is gaining momentum and has revolutionised the practice of surgery. Over the past thirty years, LS has been used to manage a wide range of surgical pathologies and has become a recognised and generally accepted standard of care. Aim: The aim of this study is to describe the evolution of LS in selected procedures.. Methods: Data were collected from theatre registries. Statistical analysis was performed using the software IMB SPSS. The data were analysed using descriptive statistics of mean and standard deviation for age, and percentage and frequencies for categories of variables . Results: Of the 3745 patients involved in the study, 59.1% were males and 40.9% were females. The mean age of the patients was 35.17±17.30 years. Laparoscopic surgery was represented in 43.2% of the procedures, with laparoscopic appendicectomy (46.73%) and laparoscopic cholecystectomy (32.69%) being the most commonly performed procedures.. Twenty-five adrenalectomies were performed over the study period, and of those 12 (52%) were performed laparoscopically. All the thymectomies (12) were performed thoracoscopically, with one conversion. Conclusion: The findings of this study suggest that there has been an increase in the overall incidence of laparoscopic surgery in selected procedures at CHBAH.

scholarly journals Management of Symptomatic Renal Cysts by Laparoscopy: Our Initial Experience

2020 ◽  
Vol 21 (2) ◽  
pp. 137-139
Author(s):  
Mohammad Mahfuzur Rahman Chowdhury ◽  
AKM Shahadat Hossain ◽  
Rifat Zaman ◽  
Prodyut Kumar Saha ◽  
Hafiz Al Asad ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Hospital Stay ◽  
Renal Cysts ◽  
Standard Of Care ◽  
Drain Tube ◽  
College Hospital ◽  
Medical College ◽  
Cyst Recurrence ◽  
The Mean

Introduction and objective: Over the last decade laparoscopic surgery has been popularized and developed to such an extent that it can be considered gold standard for many types of procedures in urology. Currently the majority of operations in urologic field can be performed by laparoscopy. This is because it is as effective as open surgery, but associated with less postoperative pain, shorter hospital stay, faster recovery and has better cosmetic result. The aim of the study is to evaluate the results of our experience of treating symptomatic renal cysts by laparoscopy. Materials and methods: This prospective study was conducted from January 2015 to December 2017 in the Department of Urology in a single unit of Dhaka Medical College Hospital. All the patients were admitted through out-patient department. Among them those who fulfilled the criteria were selected for laparoscopic surgery. All patients were diagnosed by ultrasonography and computed tomography to determine the Bosniak classification of the cyst & informed written consent was taken. Total five laparoscopic decortication of renal cysts were performed and the results of our experience were compared with data from published article. Pain and cyst recurrence were assessed during the follow-up. Results: Our study described the results of 05 laparoscopic decortication of renal cysts. All procedures were completed successfully by transperitoneal approach, with no major intraoperative and postoperative complications. There was a placement of drain tube in one patient. The mean (range) operative duration was 68 (40–110) min, affected by the site and number of cysts decorticated. The mean post operative hospital stay was 1.8 (1- 3) days. All patients were symptom-free and no sign of recurrence during the follow-up. Conclusion: Laparoscopic decortication of symptomatic renal cysts should be the standard of care and it is feasible with conventional laparoscopic instruments and gives a better cosmetic outcome. Bangladesh Journal of Urology, Vol. 21, No. 2, July 2018 p.137-139

scholarly journals Surgical glove use for specimen removal in laparoscopy, the cheapest available: a prospective study

2019 ◽  
Vol 50 (1) ◽  
pp. 94-99
Author(s):  
Shariful Islam ◽  
Vinoo Bheem ◽  
Anthony Maughn ◽  
Patrick Harnarayan ◽  
Dilip Dan ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Laparoscopic Surgery ◽  
Prospective Study ◽  
Surgical Glove ◽  
Retrieval Time ◽  
Surgical Gloves ◽  
Specimen Retrieval ◽  
Port Site Hernia ◽  
The Mean ◽  
A Prospective Study

Despite the proven benefits of laparoscopic surgery, it is indeed very costly. The aim of our study was to show an effective way to reduce one of the costs. Between January 2012 and December 2018, we used sterile unpowdered latex-free surgical gloves for specimen retrieval in 243 selected cases of laparoscopic cholecystectomy and appendectomy. The mean retrieval time was 6.7 ± 3.6 min. All procedures were performed safely. Minor wound infection was noted in three patients but there was no case of port site hernia in our series. We conclude that specimen retrieval using sterile, unpowdered, latex-free surgical gloves is safe, effective and cheap. No special additional preparation is required.

scholarly journals Sonohysterography: A Formidable Diagnostic Tool in the Evaluation of the Caesarean Scar Defect in Comparison to MRI

EMJ Radiology ◽  
2021 ◽  
pp. 83-89
Author(s):  
Saika Amreen ◽  
Cimona L. Saldanha ◽  
Naseer A. Choh ◽  
Yawar Yaseen ◽  
Tariq A. Gojwari
Keyword(s):  
Abnormal Uterine Bleeding ◽  
Obstetric Care ◽  
Uterine Bleeding ◽  
Defect Depth ◽  
Caesarean Scar ◽  
The Past ◽  
Wide Range ◽  
The Mean ◽  
Caesarean Scar Defect ◽  
Myometrial Thickness

Introduction: The use of the caesarean section (C-section) in obstetric care has exponentially increased in the past few decades. The caesarean scar defect (CSD) is a potential complication of C-section and is associated with a wide range of problems. The purpose of this study was to compare the evaluation of the CSD in non-pregnant women by sonohysterography (SHG) and MRI. Methods: This study was performed in patients having undergone a single C-section more than 6 months prior, presenting with abnormal uterine bleeding, dysmenorrhoea, or pelvic pain. Since ultrasonography and pelvic examination were inconclusive, these patients underwent MRI followed by saline infusion SHG. Measurements and characteristics of the ‘niche’ were acquired from both MRI and SHG and compared for analysis. Results: Patients with a single C-section presenting with prolonged bleeding, spotting, and dysmenorrhoea were included in this prospective study. SHG and MRI were used to measure scar thickness, width, depth, and adjacent myometrial thickness, in which the findings concurred. The mean defect depth was greater in patients with postmenstrual bleeding. Conclusion: SHG is noninferior to MRI, and SHG has the potential to assess the dynamic status of the CSD, with morphological clarity.

scholarly journals Critical Factors of CSR in India: An Empirical Evaluation

2013 ◽  
Vol 4 (3) ◽  
pp. 369-387 ◽  
Author(s):  
Rupal Tyagi ◽  
A.K. Sharma ◽  
Vijay Agrawal
Keyword(s):  
Empirical Evaluation ◽  
Profit Maximization ◽  
Descriptive Statistics ◽  
Financial Health ◽  
Strategic Decisions ◽  
Remarkable Change ◽  
The Past ◽  
Wide Range ◽  
Corporate Goals ◽  
One Way Anova

The past two decades have witnessed a remarkable change in the way businesses run and operate. Profit maximization is no longer remains the focus of businesses. The turn of events has pressurized firms to put serious efforts into a wide range of social responsibility activities and thus shift the corporate goals from socio - economic focus towards increasing shareholder value to the welfare of all stakeholders. The present study determines critical CSR factors that may influence the business and strategic decisions for the Indian corporations using survey instrument. Factor Analysis, one way ANOVA and Descriptive statistics were used for the analysis. The study reports that ‘Financial Health, Competency and Stakeholders are the basic pillars of every organization.

Abstract TMP90: Trends in Tracheostomy after Stroke: Analysis of the 1993-2013 Nationwide Inpatient Sample

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Abhinaba Chatterjee ◽  
Gino Gialdini ◽  
Santosh Murthy ◽  
Hooman Kamel ◽  
Alexander E Merkler
Keyword(s):  
Nationwide Inpatient Sample ◽  
Secondary Analysis ◽  
Descriptive Statistics ◽  
Multivariate Logistic Regression ◽  
Severe Stroke ◽  
The Past ◽  
Exact Confidence Intervals ◽  
The Mean ◽  
Stroke Type ◽  
Procedure Codes

Background: Tracheostomy is a potentially life-sustaining procedure for patients with severe stroke, yet trends in its use are not well known. Methods: Patients presenting with ischemic stroke (IS), intracerebral hemorrhage (ICH), or subarachnoid hemorrhage (SAH) were identified from the 1993 to 2013 Nationwide Inpatient Sample using previously validated ICD-9-CM codes. Our outcome was tracheostomy, also defined using previously validated procedure codes. Survey weights and descriptive statistics with exact confidence intervals [CI] were used to report rates of tracheostomy, stratified by stroke type. In a secondary analysis, we used multivariate logistic regression to assess rates of tracheostomy stratified by age, race, and sex. Results: From 1993-2013, 13,729,365 patients (95% CI, 13,103,569-14,355,160) were hospitalized in the U.S. with IS, ICH, or SAH. Among these patients, 230,555 (1.7%; 95% CI, 1.6-1.8%) received a tracheostomy. The mean age of patients undergoing tracheostomy was 58.9 (±19.8) years. Rates of tracheostomy use were 1.1% (95% CI, 1.0-1.5%) after IS, 3.8% (95% CI, 3.6-4.0%) after ICH, and 6.2% (95% CI, 5.8-6.6%) after SAH. Tracheostomy was more common in men (OR, 1.32; 95% CI, 1.30-1.35), non-whites (OR, 2.04; 95% CI, 2.00-2.09), and those ≤60 years of age (OR, 2.33; 95% CI, 2.30-2.37). The overall rate of tracheostomy use after any type of stroke increased from 1.2% in 1993 to 2.0% in 2013 (p <0.001). This trend was more pronounced in patients with ICH and SAH than in patients with IS (Figure 1). Tracheostomy use increased annually by 0.9% (p <0.001) among patients ≤60 years of age versus 1.7% (p <0.001) among patients >60 years of age, and by 2.7% (p <0.001) among men versus 0.02% (p <0.05) among women. Conclusion: Over the past two decades, the use of tracheostomy appears to be increasing among patients admitted with stroke.

scholarly journals Comparison of single incision laparoscopic cholecystectomy with conventional laparoscopic cholecystectomy using conventional laparoscopic instrument: a prospective observational study

2017 ◽  
Vol 4 (2) ◽  
pp. 514
Author(s):  
Samir Deolekar ◽  
Bhushankumar A. Thakur ◽  
Bhushan Jajoo ◽  
Parnika R. Shinde
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Laparoscopic Surgery ◽  
Blood Loss ◽  
Single Incision ◽  
Operating Time ◽  
Operative Blood Loss ◽  
Conventional Laparoscopic Cholecystectomy ◽  
Conventional Laparoscopic ◽  
Single Incision Laparoscopic Cholecystectomy ◽  
The Mean

Background: Laparoscopic surgery is one of the most significant surgical advances of twentieth century. Laparoscopic cholecystectomy is criterion standard for the treatment of benign gall bladder diseases, and it is the most common laparoscopic surgery worldwide. The aim of the study was to compare the intra-operative and post-operative complication, conversion rate and outcome of single incision laparoscopic cholecystectomy and conventional laparoscopic cholecystectomy on short term follow up.Methods: This prospective analytical observational design study was carried out in Tertiary Health care centre.  As per convenience sampling 60 consecutive patients of cholelithiasis. Data obtained was analyzed and inferences were drawn regarding the outcomes of the SILC in terms of cosmesis, post-operative pain and any other complications and compare the outcomes against the conventional four port laparoscopic cholecystectomy.Results: In our study we found the mean operating time for SILC was 90.5±16.37 minutes, whereas the mean operating time for CLC was 74±17.83 (p = 0.0004). Intra-operative blood loss for SILC and CLC was comparable and statistically insignificant. Pain in the SILC group was found to be significantly low than CLC group (p ≤0.0001).  The median cosmetic scale score for SILC group was 20 with range 13-21 and in conventional laparoscopic cholecystectomy group it was 16 with range 12-18 (p <0.0001).Conclusions: The major advantage of SILC is cosmetic satisfaction, while the disadvantages of SILS are longer operative time. There was no statistically significant difference in the intra-operative blood loss and conversion rate, and complications in both the techniques. Single incision laparoscopic cholecystectomy (SILC) was developed with the aim of reducing the invasiveness of traditional laparoscopy.

scholarly journals Initial Japanese Experience of Laparoscopic Cholecystectomy Using a New Robot-Assisted System

2018 ◽  
Vol 103 (3-4) ◽  
pp. 171-176
Author(s):  
Hirotaka Okamoto ◽  
Suguru Maruyama ◽  
Hideki Fujii
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Laparoscopic Surgery ◽  
Operative Time ◽  
Common Disease ◽  
Robot Assisted ◽  
Advantages And Disadvantages ◽  
Laparoscopic Operation ◽  
Port Access ◽  
The Mean ◽  
The Right

The object of this paper is to clarify the feasibility and safety of robot-assisted laparoscopic cholecystectomy. Acute or chronic cholecystitis is the most common disease in patients, caused by cholecystolithiasis. Minimally invasive laparoscopic surgery is often performed for treatment of cholelithiasis. We performed robot-assisted laparoscopic cholecystectomy for the treatment of 5 patients with cholecystolithiasis. The patient underwent laparoscopic cholecystectomy using the ViKY Endo-Control System (ViKY, EndoControl, Grenoble, France). The robot-controlled laparoscopic holder was placed at the right axilla. The laparoscopic operation was performed via conventional 4-port access using the ViKY system with voice activation. All patients were treated successfully by this robot-assisted laparoscopic procedure, without any complications. Mean docking time using the ViKY was 16 minutes, mean resection time of the gallbladder was 62.2 minutes, operative time was 94.6 minutes, and the mean amount of the blood loss was minimal. Our initial experience demonstrated that robot-assisted laparoscopy was feasible and safe in patients with cholecystolithiasis, providing patient advantages. We also discuss the advantages and disadvantages of robot-assisted laparoscopic surgery.

Reproducibility of the multiple inert gas elimination technique

1987 ◽  
Vol 62 (4) ◽  
pp. 1740-1746 ◽  
Author(s):  
P. D. Wagner ◽  
G. Hedenstierna ◽  
G. Bylin ◽  
L. Lagerstrand
Keyword(s):  
Blood Flow ◽  
Coefficient Of Variation ◽  
Measurement Errors ◽  
Inert Gas ◽  
The Past ◽  
Wide Range ◽  
Dispersion Indices ◽  
The Mean ◽  
Additional Variance ◽  
Excellent Reproducibility

Although measurement errors in the multiple inert gas elimination technique have a coefficient of variation of approximately 3%, small biological fluctuations in ventilation, blood flow, or other variables must contribute additional variance to this method of assessing ventilation-perfusion (VA/Q) mismatch. To determine overall variance of computed indices of VA/Q mismatch, an analysis of variance was carried out using a total of 400 duplicate pairs of inert gas samples obtained from canine (N = 118) and human (N = 282) studies in the past 2 years. In both sets VA/Q mismatch ranged from minimal (2nd moment of ventilation and blood flow distributions, log SDV and log SDQ, respectively approximately equal to 0.3 each) to severe (log SDV and log SDQ approximately equal to 2.0). Differences between duplicate log SD values were computed and found to be a constant fraction of the mean log SD of each duplicate pair, averaging 13% for both canine and human ventilation and blood flow data. The resultant coefficient of variation for a single measurement of log SD about its mean averaged 8.6% for all data combined. This analysis demonstrates excellent reproducibility of these dispersion indices over a wide range of conditions, and if the mean of duplicate values is used, thus reducing variability by square root 2 to 6.1%, log SD can be estimated with an approximately 95% confidence limit of +/- 12%.

scholarly journals Health Behaviors among Male and Female University Students in Cambodia: A Cross-Sectional Survey

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Say Sok ◽  
Khuondyla Pal ◽  
Sovannary Tuot ◽  
Rosa Yi ◽  
Pheak Chhoun ◽  
...  
Keyword(s):  
Gender Differences ◽  
University Students ◽  
Health Behaviors ◽  
Sexual Behaviors ◽  
Female Students ◽  
Moderate Intensity ◽  
Male And Female ◽  
The Past ◽  
Wide Range ◽  
The Mean

Students go through a transition when they enter university, which involves major individual and contextual changes in every domain of life that may lead to several behavioral and health problems. This study examined a wide range of health behaviors and practices among 1,359 male and female students recruited from two public universities in Cambodia using a multistage cluster sampling method. Health-related information in different domains were collected using a structured questionnaire. We compared the variables in male and female students. Of the total, 50.8% were male and the mean age was 21.3 (SD = 2.3) years. The majority (79.5%) reported not having any vigorous-intensity activities, 25.9% not having moderate-intensity activities, and 33.5% not having walked continuously for 10 min over the last week. More than one-third (38.3%) reported drinking alcohol, 1.1% smoking tobacco, and 0.4% using an illicit drug in the past 12 months. About one in ten (10.6%) reported having sexual intercourse; of whom, 42.4% reported not using a condom in the last intercourse, and the mean number of sexual partners was 2.1 (SD = 2.4) in the past 12 months. Only 7.1% reported having been diagnosed with a sexually transmitted infection (STI) in the past 12 months; of whom, 60% sought for treatment for the most recent STI. About one-third (33.6%) reported eating fast food at least once over the last week. More than half (55.6%) had one to two servings of fruits or vegetables daily, and 9.9% did not eat any fruits or vegetables over the last week. Gender differences were observed in physical activities, dietary intakes, cigarette smoking, alcohol drinking, and sexual behaviors. Findings from this study indicate that public health and education policies should promote healthy behaviors among university students. The interventions may take advantage of and expand upon the positive health behaviors and consider gender differences.

scholarly journals Advanced laparoscopic surgery: our initial experience at Nepal Medical College

2016 ◽  
Vol 18 (3) ◽  
pp. 17
Author(s):  
Dr Nishes ◽  
Dr Subash ◽  
Prof Pranil
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Laparoscopic Surgery ◽  
Standard Of Care ◽  
Operative Management ◽  
Rapid Expansion ◽  
Resource Poor Setting ◽  
Laparoscopic Technique ◽  
Medical College ◽  
Laparoscopic Procedures ◽  
Laparoscopic Techniques

If we consider the last century of history of surgery, few advances can be compared to the changes engendered by the introduction of minimally invasive surgery, which in the last decade has represented a revolution in surgical practice and patient care. Since 1987, when the first laparoscopic cholecystectomy was performed, laparoscopic procedures have been the standard of care for many routine diagnostic and therapeutic procedures. Laparoscopic techniques have become an integral part of the operative management in virtually every realm of general surgery. The success of the laparoscopic technique has been due mainly to patient demand, which has contributed to a rapid expansion in the number of laparoscopic procedures performedThe benefits conferred to patients by less invasive procedures like decreased pain, and shorter recovery time have to be weighed against overzealous application and the problems created by the lack of familiarity with new techniques and instruments. Basic laparoscopic procedures include laparoscopic cholecystectomy, laparoscopic appendectomy, and diagnostic laparoscopy. All other laparoscopic operations are defined as “advanced”. Learning curve and added expenses have been prohibitative in development of advanced laparoscopic surgery in resource poor setting like ours. However, advance laparoscopic surgery is here to stay. We must therefore have a concentrated effort to move towards offering these facilities to our patients.Despite the initial hiccups, some advanced laparoscopic surgeries are being performed and at Nepal Medical College, moving a step closer towards the gold standards in surgical management. Surgeons from various units and subspecialties work together and help each other and utilize each other’s limited experience. This spirit has been a great help to reach our way to develop ourselves despite our technical limitations. Our experience is limited but the outcomes so far are encouraging and we have tried to highlight the significance of framework. There is a long road ahead but a hood beginning is more than half done.

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