scholarly journals Port site hernia: Minor but severe complication of laparoscopic cholecystectomy.

2020 ◽  
Vol 27 (08) ◽  
pp. 1717-1721
Author(s):  
Ehsanullah Malik ◽  
Sania Bhatti ◽  
Muharram Ali Abbasi ◽  
Yasmeen Bhatti ◽  
Abdul Sattar Abro ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Operative Time ◽  
College Teaching ◽  
Port Site ◽  
Care Hospital ◽  
Site Infection ◽  
Case Series Study ◽  
Port Site Hernia ◽  
Duration Of Surgery ◽  
The Mean

Laparoscopic cholecystectomy is a gold standard procedure for the management of patients with cholelithiasis with fewer complications but still port site hernia is one of the severe complications if not treated properly may lead adverse result. This usually results from improper closure or infection of the musculoaponeurotic layers of the abdominal wall. The frequency of port site hernia is variable in literature and its association with infection and other co-morbidities is less explored. Objectives: To determine the frequency of port-site hernia after laparoscopic cholecystectomy at a tertiary care hospital Larkana and its association with infection and co-morbidities. Study Design: Descriptive Case Series study. Setting: Department of Surgery, Chandka Medical College Teaching Hospital, Larkana. Period: December 2018 to December 2019. Material & Methods: One hundred forty-eight patients undergoing elective laparoscopic cholecystectomies, who fulfilled the inclusion criteria and gave informed consent were selected for this study. All the patients were followed for 6 months. Data was recorded for age, gender, BMI, smoking and diabetes mellitus status. Infection and port site hernia were observed during the follow-up period. The SPSS version 21 was used for data analysis. Results: The majority of the patients 79 (53.4%) were above the age of 35 years. The mean age of the patients was 40.14 ±11.40 years. Females were younger than males. Among them 19 (12.8%) were males compared to 129 (87.2%) females. Mean BMI (kg/m2) of male patients were 25.98±3.53 and female patients were 24.80±3.04. The mean duration of surgery was 63.72 (+18.20) minutes, mostly accomplished is within 80mins (54.1%).  Out of 148 patients in 5 (3.4%) patients port site hernia was observed. In all these patients wound to get infected and surgery was for a prolonged period. A significant association has been found between port site hernia, operative time and port site infection. However, no significant association has been found between port site hernia and gender, age, smoking and Diabetes (P>0.05). Conclusion: The frequency of port site hernia is low but could be disastrous if the bowel gets obstructed. Using good technique and reducing operative time are effective measures in reducing the port site infection and the port site hernia.

Frequency of port site infection following gall bladder removal through Epigastric vs Umbilical port.

2021 ◽  
Vol 28 (03) ◽  
pp. 277-281
Author(s):  
Bushra Shaikh ◽  
Imamuddin Baloch ◽  
Azhar Ali Shah ◽  
Abdul Sami Mirani ◽  
Parkash Lal Lund ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gall Bladder ◽  
Wound Infection ◽  
Port Site ◽  
Site Infection ◽  
College Hospital ◽  
Medical College ◽  
Duration Of Surgery ◽  
Group A ◽  
Group B

Objective: To compare the frequency of port site wound infection following gall bladder removal through umbilical and epigastric port in laparoscopic cholecystectomy. Study Design: Randomized Control Trial. Setting: Surgical Unit 2, Ghulam Muhammad Mahar Medical College, hospital Sukkur. Period: 1st November 2019 to 30th October 2020. Material & Methods: All cases who underwent four port laparoscopic cholecystectomy were enrolled in two groups. All procedures were performed under general anesthesia. As the last event of surgery gall bladder was retrieved in a glove bag through umbilical port in group A and through epigastric port in group B, both under direct camera vision. Wound infection was considered if there was 3 to 5 grade of wound according to Southampton wound grading system (Figure-1) on 5th postoperative day. All demographics and outcome variables were recorded. Results: Age ranged from 20 to 60 years with mean age of 38.875±8.11 years, BMI 29.973±5.12 Kg/m2, duration of surgery 50.656±8.41 mins and Southampton score was 1.044±1.07 in Group A and mean age of 38.560±6.23 years, BMI 27.437±5.04 Kg/m2, duration of surgery 48.920±8.67 mins and Southampton score was 0.856±0.92 in Group B. In group A, 18 (5.7%)patients developed port site wound infection in contrast to 5 (1.6%) patients in group B (P= 0.006). Conclusion: We conclude that epigastric port retrieval of gall bladder following laparoscopic cholecystectomy results in less port site infection.

scholarly journals Experience of Laparoscopic Cholecystectomies in a Tertiary Care Hospital: a Retrospective Study

2020 ◽  
Vol 27 (4) ◽  
pp. E202043
Author(s):  
Aamir Hussain Hela ◽  
Haseeb Mohammad Khandwaw ◽  
Rahul Kumar ◽  
Mir Adnan Samad
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Retrospective Study ◽  
Bile Duct ◽  
Surgical Site Infection ◽  
Tertiary Care Hospital ◽  
Open Cholecystectomy ◽  
Tertiary Care ◽  
Care Hospital ◽  
Site Infection ◽  
The Mean

Introduction: Laparoscopic cholecystectomy is the most commonly performed surgical procedure of digestive tract. It has replaced open cholecystectomy as gold standard treatment for cholelithiasis and inflammation of gallbladder.  It is estimated that approximately 90% of cholecystectomies in the  United States are performed using a laparoscopic approach.  The aim of this study was to evaluate the outcome of Laparoscopic cholecystectomy in context to its complications, morbidity and mortality in a tertiary care hospital.  Methods: This retrospective study was conducted on 1200 patients, who underwent laparoscopic cholecystectomies, during the period from January 2019 to December 2019, at Government Medical College Jammu J & K, India and necessary data was collected and reviewed. Results: In our study, a total of 1200 patients were studied including 216 males (18%) and 984 females (82%). The mean age of the patients was 43.35±8.61. The mean operative time in our study was 55.5±10.60 minutes with range of 45 – 90 minutes. Conversion rate was 2.6%. 2 patients were re-explored. Bile duct injury was found in 6 patients (0.5%).  Conclusions: Gallstone disease is a global health problem. Laparoscopic cholecystectomy has now replaced open cholecystectomy as the first choice of treatment for gallstones. Gall stone diseases is most frequently encountered in female population. The risk factors for conversion to open cholecystectomy include male gender, previous abdominal surgery, acute cholecystitis, dense adhesions and fibrosis in Calot’ s triangle, anatomical variations, advanced age, comorbidity, obesity, suspicion of common bile duct stones, jaundice, and decreased surgeon experience. The incidence of surgical site infection has significantly decreased in laparoscopic cholecystectomy compared to open cholecystectomy. In our study we could not find any case of surgical site infection.

scholarly journals Multiple-layer Closure of Myoma Bed in Laparoscopic Myomectomy

2017 ◽  
Vol 1 (1) ◽  
pp. 22-27
Author(s):  
Sonam Singh
Keyword(s):  
Abdominal Mass ◽  
Port Site ◽  
Laparoscopic Myomectomy ◽  
Maximum Diameter ◽  
Care Hospital ◽  
Intracorporeal Suturing ◽  
Multiple Layer ◽  
Average Maximum ◽  
Duration Of Surgery ◽  
The Mean

ABSTRACT Objective To assess the feasibility and outcome of laparoscopic myomectomy and multiple-layer closure of myoma bed for management of myomas at a tertiary care hospital. Materials and methods Five hundred and ten patients from January 2011 to January 2017 with large and moderate size myomas were managed by laparoscopic myomectomy. Indications were subfertility, menorrhagia, and abdominal mass. Preoperative evaluation included history, clinical examination, and sonographic mapping. Myomas were enucleated and retrieved laparoscopically. Myoma beds were sutured in multiple layers by endoscopic intracorporeal suturing. Fluid as adhesion barrier was used. Results Three hundred and eighty two patients presented with subfertility, 69 with menorrhagia, and 59 with abdominal mass. The average maximum diameter of myoma was 9.1 cm. The mean duration of surgery was 90 minutes. The mean postoperative stay was 24 hours. No intraoperative complication occurred and the hospital course was uncomplicated. In seven cases, minilap incision was given for retrieval of myoma and suturing of the bed. Two patients had minor delayed wound healing of the morcellator port site. The patients did not report any complaints during follow-up except one patient who developed omental hernia at morcellator port site. There was no rupture of scar and very low adhesion scores in subsequent cesarean sections or second look scopies. Conclusion With proper multilayer closure of the myoma bed, laparoscopic myomectomy is feasible for moderate and even large myomas and has good outcomes in terms of fertility and alleviation of symptoms. How to cite this article Jain N, Singh S. Multiple-layer Closure of Myoma Bed in Laparoscopic Myomectomy. Int J Gynecol Endsc 2017;1(1):22-27.

scholarly journals OUTCOME OF LAPAROSCOPIC CHOLECYSTECTOMY IN PATIENTS WITH GALLSTONE DISEASE AT A SECONDARY LEVEL CARE HOSPITAL

2018 ◽  
Vol 31 (1) ◽  
Author(s):  
Ahmed TAKI-ELDIN ◽  
Abd-Elnaser BADAWY
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Hospital Stay ◽  
Operative Time ◽  
Open Cholecystectomy ◽  
Gallstone Disease ◽  
Care Hospital ◽  
Biliary Leakage ◽  
Port Site Hernia ◽  
Conversion To Open Cholecystectomy ◽  
Secondary Hospital

ABSTRACT Background: Laparoscopic cholecystectomy is the most commonly performed operation of the digestive tract. )It is considered as the gold standard treatment for cholelithiasis. Aim: To evaluate the outcome of it regarding length of hospital stay, complications, morbidity and mortality at a secondary hospital. Methods: Data of 492 patients who underwent laparoscopic cholecystectomy were retrospectively reviewed. Patients’ demographics, co-morbid diseases, previous abdominal surgery, conversion to open cholecystectomy, operative time, intra and postoperative complications, and hospital stay were collected and analyzed from patients’ files. Results: Out of 492 patients, 386 (78.5%) were females and 106 (21.5%) males. The mean age of the patients was 49.35±8.68 years. Mean operative time was 65.94±11.52 min. Twenty-four cases (4.9%) were converted to open surgery, four due to obscure anatomy (0.8%), 11 due to difficult dissection in Calot’s triangle (2.2%) and nine by bleeding (1.8%). Twelve (2.4%) cases had biliary leakage, seven (1.4%) due to partial tear in common bile duct, the other five due to slipped cystic duct stables. Mean hospital stay was 2.6±1.5 days. Twenty-one (4.3%) developed wound infection. Port site hernia was detected in nine (1.8%) patients. There was no cases of bowel injury or spilled gallstones. There was no mortality recorded in this series. Conclusions: Laparoscopic cholecystectomy is a safe and effective line for management of gallstone disease that can be performed with acceptable morbidity at a secondary hospital.

scholarly journals POSTOPERATIVE PORT-SITE PAIN AFTER GALL BLADDER RETRIEVAL FROM EPIGASTRIC VS UMBILICAL PORT IN LAPAROSCOPIC CHOLECYSTECTOMY: A RANDOMIZED CONTROLLED TRIAL

2021 ◽  
Vol 9 (09) ◽  
pp. 333-337
Author(s):  
Neel Ketu ◽  
Santosh Kumar ◽  
Prem Prakash
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gall Bladder ◽  
Tertiary Care ◽  
Port Site ◽  
Adult Patients ◽  
P Value ◽  
Care Hospital ◽  
Duration Of Surgery ◽  
Elective Laparoscopic Cholecystectomy ◽  
Site Pain

Objective: To determine whether gall bladder (GB) retrieval from umbilical port is associated with more pain at port site as compared to GB retrieval from epigastric port in adult patients undergoing four port elective laparoscopic cholecystectomy at a tertiary care hospital. Methods: Adult patients, who were undergoing elective laparoscopic cholecystectomy during a six-month period in 2010 at our institute, were randomized to either group A (n = 60, GB retrieval through epigastric port) or group B (n = 60, GB retrieval through umbilical port). VAS for pain was assessed by a registered nurse at 1, 6, 12, 24 and 36 h after surgery. Results: The VAS for pain at umbilical port was less than epigastric port at 1, 6, 12, 24 and 36 h after surgery (5.9 ±1.1 vs. 4.1± 1.5, 4.6± 0.94 vs. 3.5± 1.05, 3.9± 0.85 vs. 2.4± 0.79, 3.05± 0.87 vs. 2.15± 0.87, respectively) and the difference was statistically significant (p-value < 0.001). Multiple linear regression was done for port site pain at 24 h and the VAS at umblical port was less than epigastric port with VAS difference of 0.9 after adjusting for age, sex, duration of surgery and additional analgesia use (r 2 =0.253, p-value < 0.001). Conclusion: Gall bladder retrieval from umbilical port is associated with lower port site pain than GB retrieval from epigastric port in patients undergoing elective laparoscopic cholecystectomy. We recommend umbilical port for gall bladder retrieval.

scholarly journals A STUDY OF PORT SITE COMPLICATIONS AFTER LAPAROSCOPIC CHOLECYSTECTOMIES AT TERTIARY CARE HOSPITAL IN WESTERN RAJASTHAN

2019 ◽  
Vol 3 (7) ◽  
Author(s):  
Surendra Saini ◽  
Manish Kumar Saini
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Tertiary Care ◽  
Quality Of Healthcare ◽  
Port Site ◽  
Care Hospital ◽  
Medical College ◽  
Port Site Hernia ◽  
Elective Laparoscopic Cholecystectomy

Background: Port site complications though rare, shall be evaluated and studied so as to improve the quality of healthcare. Materials and Methods: This prospective study was conducted in the Department of General Surgery, Sardar Patel Medical College & P.B.M. Hospital, Bikaner, Rajasthan. 200 patients of all age group and both sexes with symptomatic cholelithiasis undergoing laparoscopic cholecystectomy. Result: Out of 200 patients studied only 1 patient presented with port site hernia in the follow up and 13 patients presented with port site infection. No other complication was detected   after laparoscopic cholecystectomies. Conclusion:  It is concluded that port site complications are rare in elective laparoscopic cholecystectomy and can be further reduced by proper selection of patients, and strictly following basic principles of laparoscopic cholecystectomy. Keywords: Laparoscopic surgeries, Port site infections, Complications

scholarly journals SURGICAL AUDIT - LAPAROSCOPIC CHOLECYSTECTOMY IN A FREE CAMP AT PRIVATE SECTOR HOSPITAL

2020 ◽  
Vol 11 (2) ◽  
pp. 16-20
Author(s):  
Dr. Abdul Ghani Soomro
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gall Bladder ◽  
Hospital Stay ◽  
Open Cholecystectomy ◽  
Port Site ◽  
Bladder Injury ◽  
Safe Procedure ◽  
Trocar Site ◽  
Port Site Hernia ◽  
Surgical Audit

BACKGROUND & OBJECTIVE: Laparoscopic Cholecystectomy is usual method for the treatment of gall bladder stone disease and is practiced all over the world due to many benefits like fasten the recovery time. Furthermore, it reduced the post-operative pain and period of hospital stay. To conduct Surgical Audit and evaluate safety of Laparoscopic cholecystectomy. METHODOLGY: This prospective study was conducted in a private hospital at Hyderabad during free camps of Laparoscopic Cholecystectomy. Four camps were arranged in 2016 - 2019. Total number of 190 patients  underwent Laparoscopic Cholecystectomy during the study period. The patient's age falls between 12–65 years. A detailed history, relevant investigation and Cardiac fitness were evaluated. All patients underwent four ports Lap-Chole. Data was collected assessed and audit was performed and safety was evaluated. RESULTS: Total 190 patients operated females 88.45% and males 11.55%. 115 (60.50%)were in  the range of 30-35 years followed by 55 (28.95%)patients in the range of 40-50 years.8 (4.20%) patients were converted to open cholecystectomy, 4 due to bleeding from liver bed, 3 patients due to difficult dissection in calots triangle and 1 due to Empyema of gall bladder.10 patients (5.50%) had Trocar site bleeding, 10 patients (5.50%) had gall bladder injury, in 4 cases had spillage of stones and 72 patients (38.50%) developed umbilical port site infection 1 patient develop port site hernia. No mortality was recorded in this study. CONCLUSION: Our Surgical Audit proves that Laparoscopic Cholecystectomy is a safe procedure on the basis of only 4.2% intra operative and 5.5% postoperative complications and gaining wide spread popularity among our population due to less pain, less hospital stay. We recommend other private hospitals to extent such services to our poor population with symptomatic cholelithiasis.

Knowledge and Attitude Regarding Cervical Cancer Screening in Women attending Obstetrics and Gynaecological Opd at Birat Medical College Teaching Hospital

2020 ◽  
Vol 5 (2) ◽  
pp. 1055-1059
Author(s):  
Raj Deb Mahato ◽  
Amit Deo ◽  
Hanoon Pokharel
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Tertiary Care ◽  
Negative Attitude ◽  
College Teaching ◽  
Care Hospital ◽  
Medical College ◽  
The Mean ◽  
Knowledge And Attitude

Introduction: Cervical cancer is the most common Gynaecological cancer in Nepal which is preventable if appropriate screening and prevention measures are employed. Considerable reduction in cervical cancer incidence and cervical cancer related deaths can be achieved by effective screening. However, lack of knowledge and awareness can result in underutilization of the preventive measures.  Objectives: The objective of this study was to assess the knowledge and attitude regarding cervical cancer screening in women visiting Obstetrics and Gynaecology OPD at tertiary care Hospital in Eastern Nepal.  Methodology: A cross-sectional questionnaire-based study was conducted in Obstetrics and Gynaecology outpatient department of Birat Medical College Teaching Hospital from 1 January 2019 to 31 December 2019. Women were enrolled in the study by convenient sampling methods. Structured questionnaire was used to collect the data. The collected data was entered in Microsoft excel and analyzed by using SPSS version 22.  Results: Among 374 participants, the mean age was 31.13 years. More than three fourth (89.6%) of participants were literate. Regarding occupation, 89.8% of participants were housewives, and 82.9 % of participants were married. As per the findings, only 43.27 % of participants i.e. less than the mean, had adequate knowledge of cervical cancer and its screening. 65.50 % of participants had a negative attitude towards cervical cancer screening. Literate participants had good knowledge and positive attitude regarding cervical cancer screening than illiterate participants (P value less than 0.05).  Conclusion Considerable proportions of participants had inadequate knowledge and negative attitude regarding cervical cancer screening in Gynaecological patients visiting tertiary care Hospital in Eastern Nepal.

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