scholarly journals Short Term Clinical Outcome of Micro Lumbar Discectomy in Tertiary Care Center

2021 ◽  
Vol 10 (2) ◽  
pp. 49-53
Author(s):  
Pramod Chaudhary ◽  
Prakash Kafle ◽  
Narendera Joshi ◽  
Ujwal Gautam
Keyword(s):  
Intervertebral Disc ◽  
Analogue Scale ◽  
Operative Time ◽  
Minimal Invasive ◽  
Lumbar Discectomy ◽  
Lumbar Microdiscectomy ◽  
Duration Of Hospital Stay ◽  
Prolapsed Intervertebral Disc ◽  
The Mean ◽  
Herniated Intervertebral Disc

Background: Minimal invasive open lumbar microdiscectomy has been associated with good success rate and low morbidity. The present study is aimed to evaluate the clinical outcome of patients who underwent open minimal invasive open lumbar microdiscectomy for herniated intervertebral disc. Materials and Methods: This is a prospective observational hospital based study of prolapsed lumbar intervertebral disc operated in the department of neurosurgery at Nobel Medical College Teaching Hospital, Biratnagar, Nepal from January 2018 to June 2021. All patients of lumbar herniated intervertebral disc subjected for surgery were included. Recurrent prolapsed intervertebral disc, Disc surgery requiring stabilization was excluded from the study. During surgery types of prolapsed intervertebral disc, level and operative time were noted. In the post-operative period Visual Analogue Scale was used to assess the change in severity of pain. Duration of hospital stay and the complications occurred were also noted. Results: The mean age of the study population was was 41.50 (±14.56) years ranging from 20 years to 79 years. The commonest lumbar prolapsed intervertebral disc was at L4-L5 level. The mean operative time was 42 minutes excluding the time for anaesthesia preparation. There was statistically significant difference (p<0.001) in pre-operative and post-operative Visual Analogue Scale. Mean duration of hospital stay was 5.58 (1.87) days. Conclusion: A through workup and surgical planning is associated with better outcome avoiding complications in minimal invasive open micro lumbar discectomy.  

scholarly journals Initial Clinical Outcomes of Percutaneous FullEndoscopic Lumbar Discectomy Using an Interlaminar Approach at the L4-L5

2017 ◽  
Vol 4 (20;4) ◽  
pp. E507-E512 ◽  
Author(s):  
Jun-ichiro Nakamura
Keyword(s):  
Hospital Stay ◽  
Clinical Outcomes ◽  
Disc Herniation ◽  
Operative Time ◽  
Small Sample ◽  
Lumbar Discectomy ◽  
Interlaminar Approach ◽  
Significant Difference ◽  
Endoscopic Discectomy ◽  
The Mean

Background: Percutaneous full-endoscopic discectomy (PED) is being increasingly used because of its potential to minimalize soft-tissue damage and decrease hospital stay. PED using the interlaminar approach (PED-IL) at L4-L5 is performed by only a few surgeons. To the best of our knowledge, the safety and efficacy of PED-IL at L4-L5, without experience in PED via a transforaminal approach (PED-TF) has not been previously reported. Objective: This study aimed to evaluate initial clinical outcomes and complications of PED-IL at L4-L5 without experience in PED-TF. Study Design: Retrospective evaluation. Setting: An urban minimally invasive spine hospital. Methods: Of a total of 50 patients (36 men and 14 women, ages ranging from 21-59 years, with the average age being 40.3 years old), 16 cases were performed at L4-L5 and 34 cases were performed at L5-S1. PED-IL was successfully completed in all cases, and no case required conversion to open surgery. The operative time, hospital stay, modified MacNab criteria, and visual analog scale (VAS) scores were examined at L5-S1 (range: 41-112). There was no significant difference in operative time between the L4-L5 and L5-S1 groups; the operative time was gradually decreased. The mean hospital stay was 2.9 days (range: 2-8 days). According to modified MacNab criteria, 20 cases (6 at L4-L5 and 14 at L5-S1) were excellent, 27 (10 at L4-L5 and 17 at L5-S1) were good, one at L5-S1 was fair, and 2 at L5-S1 were poor. Two perineurium tears occurred at L5-S1. There was no infection or recurrence of herniated nucleus pulposus (HNP). The clinical outcomes of PED-IL at L4-L5 were equal to those at L5- S1. Results: The mean operative time was 71.3 ± 19.3 minutes for all cases (range: 41-112 mins.),76.1 ± 16.8 minutes at L4-L5 (range: 52-102 mins.), and 70.5 ± 20.1 minutes at L5-S1 (range: 41-112 mins.). Limitations: A small sample size and a short follow-up period. Conclusions: The clinical outcomes of PED-IL at L4-L5 were equal to those at L5-S1. Therefore, PED-IL is suitable to be a standard method for any type of intracanalicular disc herniation. Keywords: Percutaneous full-endoscopic lumbar discectomy, interlaminar approach, clinical outcome, herniated nucleus pulpous, MacNab criteria, intracanalicular disc herniation, learning curve

scholarly journals LAPAROSCOPIC APPENDECTOMY;

2019 ◽  
Vol 26 (01) ◽  
Author(s):  
Sajid Malik ◽  
Kamran Zaib Khan ◽  
Iftikhar Ahmad
Keyword(s):  
Hospital Stay ◽  
Laparoscopic Appendectomy ◽  
Operative Time ◽  
Standard Procedure ◽  
Minimal Invasive ◽  
Time Duration ◽  
Duration Of Hospital Stay ◽  
Post Operative Pain ◽  
Scar Mark ◽  
Almost All

Background: Minimal invasive surgery (MIS) is a modern and safe improvement in field of laparoscopic surgery. Single incision laparoscopic appendectomy (SILA) is a major breakthrough in MIS and has become standard procedure for acute appendicitis in place of conventional three port laparoscopic appendectomy (CTLA). Objectives: To see the potential advantages in terms of operative time, duration of hospital stay, post-operative pain and cosmetic results in SILA and CTLA groups. Study Design: Randomized control study. Setting: Department of General Surgery in Allama Iqbal Medical College/ Jinnah Hospital Lahore. Period: July 2016 to June 2017. Materials and Methods: 48 patients were divided in two groups; group SILA (cases) and CTLA (control). Each group comprised 24 patients. All cases were performed by consultant who were competent enough and trained in MIS. Results: We found that there was statistically no difference in operative time (p>0.05) and post-operative pain (p>0.05) of both procedures but statistically significant outcome was observed in duration of hospital stay (p<0.005) and cosmetic result (p< 0.005). Post-operative analgesia usage was same in both groups with similar outcome of control. Surgical wound healed in all patients of both groups without complication but noticeably had shown no scar mark on three months follow up in patients of SILA group. Almost all patients in SILA group were discharged on same day on oral diet. Conclusion: This study showed that results of SILA are better in terms of cosmoses and less duration of hospital stay in the presence of non-significant operative time of two procedures. Staying with promise of minimizing in MIS to SILA, cosmetic satisfaction and minimal hospital stay are its comprehensible advantages.

scholarly journals Anatomy of Rouviere’s Sulcus and Its Association with Complication of Laparoscopic Cholecystectomy

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Abhijeet Kumar ◽  
Rupesh Shah ◽  
Narendra Pandit ◽  
Suresh Prasad Sah ◽  
Rakesh Kumar Gupta
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Prospective Observational Study ◽  
Operative Time ◽  
Gall Stone ◽  
Anatomical Landmark ◽  
External Edge ◽  
Duration Of Hospital Stay ◽  
The World ◽  
Release Group ◽  
The Mean

Background and Objective(s). Rouviere’s sulcus (RS) is an important anatomical landmark. The aim of this study was to find the distribution of anatomical characteristics of RS seen during laparoscopic cholecystectomy in the population of our part of the world and its association with complications. Methods. This is a prospective observational study involving patients of age ≥16 years who underwent laparoscopic cholecystectomy for uncomplicated gall stone at BPKIHS between May and July 2019. Result. 230 cases were analyzed, and RS was present in 90.4%. Open sulcus type was the commonest (54%), followed by scar type (22.9%), closed sulcus type (12.5%), and slit type (10.6%), respectively. In 59.1% of cases, it was oblique to the anterior, inferior, and external edge of the liver, while in the remaining cases, it was transverse. The mean ± SD values for operative time and duration of hospital stay in the RS visible and the RS not visible groups were 29.16 ± 8.736 and 42.9 ± 23.646 minutes, and 1.26 ± 0.440 and 1.90 ± 0.910 days, respectively (p value ≤0.001). One minor complication occurred in each group: RS initially visible group and RS visible on the adhesion release group, while 3 minor complications occurred in the RS not visible group. Only one major complication occurred in the RS not visible group. Conclusion. Identification of RS by operating surgeons is a predictor of safe laparoscopic cholecystectomy.

scholarly journals FUNCTIONAL OUTCOME FOLLOWING ANATOMICAL LOCKING COMPRESSION PLATE BY OPEN TECHNIQUE AND MINIMAL INVASIVE PERCUTANEOUS OSTEOSYNTHESIS (MIPO) TECHNIQUE IN MID SHAFT CLAVICLE FRACTURE

2019 ◽  
Vol 3 (10) ◽  
Author(s):  
Dr. Rahul Bade ◽  
Dr. Sanjay S. More ◽  
Dr. Divyang Parmar
Keyword(s):  
Operative Time ◽  
Clavicle Fracture ◽  
Minimal Invasive ◽  
Locking Compression Plate ◽  
Age Group ◽  
Open Technique ◽  
Compression Plate ◽  
Group A ◽  
The Mean ◽  
Group B

INTRODUCTION: Clavicle fractures are common injuries in adults, accounting for 5% of all fractures and 44% of all shoulder fractures. Furthermore, there is an increasing incidence of complex fracture patterns after high-energy trauma. Incidence in males is usually highest in second and third decade which decreases thereafter as per age. Clavicles mid shaft fractures have classically been treated non-operatively. However, factors including severity of displacement, degree of comminution, and greater than 2 cm of shortening have been reported in the literature to predispose patients to unsatisfactory outcomes with non-operative treatment. Minimally invasive surgery is increasingly being used for the treatment of mid shaft clavicle fracture. The two most commonly used implant are titanium elastic nail (TEN) and locking compression plate (LCP). Minimally invasive percutaneous plate osteosynthesis (MIPPO) is widely used for long bone fracture. MATERIAL AND METHODS: The patients were selected randomly and were divided in the following two groups of 15 patients each: Group A: 15 patients treated by anatomical locking compression plate (LCP) by open technique. Group B: 15 patients treated by minimal invasive percutaneous osteosynthesis (MIPO) technique. Follow up period were 1 months, 2months and 6months. Functional outcome was evaluated using the constant shoulder score, which is scored from 0 to 100, with a lower score representing a higher level of functional disability. RESULTS: Majority of the patients (40%) in Group A were in the age group of 31-40 years followed by 26.7% in the age group of 21-30 years, 20% in the age group 41-50 years and 13.3% in the age group of 51-60 years. The mean age of the patients was 36.2 ± 9.09 years. Majority of the patients in both groups were male. There were 80% and 73.3% male patients in Group A and Group B respectively whereas female patients constituted 20% and 26.7% of the study group respectively. In Group A, 7 (46.7%) patients had operative time of 80-100 minutes whereas 6 (40%) and 2 (13.3%) patients had operative time of 100-120 and 120-140 minutes respectively. The mean operative time was 104.9 ± 13.52mins. In Group B, 6 (40%) patients had operative time of 80-100 minutes whereas 8 (53.4%) and 1 (6.6%) patients had operative time of 100-120 and 120-140 minutes respectively. The mean operative time was 106.5 ± 11.72mins. There was no significant association between the groups as per Student t-test (p>0.05). CONCLUSION: Operative treatment with a LCP for clavicle shaft fractures can be used to obtain stable fixation. Particularly, MIPPO of displaced mid shaft clavicular fractures resulted in a better cosmetic than conventional open reduction, although the functional outcomes were no different between the two groups.

Cost-Effectiveness of Lumbar Discectomy for the Treatment of Herniated Intervertebral Disc

Spine ◽  
1996 ◽  
Vol 21 (9) ◽  
pp. 1048-1054 ◽  
Author(s):  
Alex D. Malter ◽  
Eric B. Larson ◽  
Nicole Urban ◽  
Richard A. Deyo
Keyword(s):  
Cost Effectiveness ◽  
Intervertebral Disc ◽  
Lumbar Discectomy ◽  
Herniated Intervertebral Disc

scholarly journals Isolation of <i>Gemella morbillorum</i> in Herniated Intervertebral Disc Tissue in a Lumbar Discectomy Patient: A Case Report

2017 ◽  
Vol 05 (03) ◽  
pp. 99-104
Author(s):  
Niroshima Dedunu Withanage ◽  
Lohini Vijayendran Athiththan ◽  
Sunil Perera ◽  
Sujatha Pathirage ◽  
Hemantha Peiris
Keyword(s):  
Case Report ◽  
Intervertebral Disc ◽  
Lumbar Discectomy ◽  
Disc Tissue ◽  
Herniated Intervertebral Disc

scholarly journals EVALUATION THE SIGN OF UNION, DURATION OF SURGERY AND POST-OPERATIVE SKIN COMPLICATION IN MID SHAFT CLAVICLE FRACTURE.

2019 ◽  
Vol 3 (10) ◽  
Author(s):  
Dr. Sanjay S. More ◽  
Dr. Rahul Bade ◽  
Dr. Divyang Parmar
Keyword(s):  
Operative Time ◽  
Clavicle Fracture ◽  
Minimal Invasive ◽  
Open Technique ◽  
Group A ◽  
Clavicle Fractures ◽  
The Mean ◽  
Group B ◽  
Radiological Union

INTRODUCTION: It is impossible to support and immobilize a fracture of middle 3rd of clavicle in an adult by external means with figure-of-eight bandages. Clavicle fractures accounts for approximately 2.6% of all fractures in adults2 10% to 15% in children and comprise about 30 -40% of all shoulder girdle injuries and 5% fractures occurs in medial end. The goal of clavicle fracture treatment is to achieve bony union while minimizing dysfunction, morbidity, and cosmetic deformity. Definitive indications for acute surgical intervention include skin tenting, open fractures, the presence of neurovascular compromise, multiple trauma, or floating shoulder. Outside of these indications, the management of displaced fractures of the mid shaft (Edinburgh type 2B) remains somewhat controversial. Recent literature is challenging the traditional belief that mid- shaft clavicle fractures uniformly heal without functional deficit.   MATERIAL AND METHODS: Patients included were cases of mid shaft clavicle fractures. 30 patients with mid shaft clavicle fractures were included in the study.All patients above 18 years of age were included in the study falling into Robinson’s type 2 B1 (Mid shaft simple displaced and single butterfly fragment fracture), type 2 B2 (Mid shaft segmental fracture) classification. The patients were selected randomly and were divided in the following two groups of 15 patients each: Group A: 15 patients treated by anatomical locking compression plate (LCP) by open technique. Group B: 15 patients treated by minimal invasive percutaneous osteosynthesis (MIPO) technique. All patients were operated as early as possible once the patient was declared fit for the surgery by the physician. Open reduction and internal fixation with LCP was done. RESULTS: A total of 30 patients were included in the study. In group A 15 patients treated by anatomical locking compression plate (LCP) by open technique and in group B 15 patients treated by minimal invasive percutaneous osteosynthesis (MIPO) technique. In Group A, 7 (46.7%) patients had operative time of 80-100 minutes whereas 6 (40%) and 2 (13.3%) patients had operative time of 100-120 and 120-140 minutes respectively. The mean operative time was 104.9 ± 13.52mins. In Group B, 6 (40%) patients had operative time of 80-100 minutes whereas 8 (53.4%) and 1 (6.6%) patients had operative time of 100-120 and 120-140 minutes respectively. The mean operative time was 106.5 ± 11.72mins. The mean duration for radiological union in Group A was 12.7 ± 4.61 weeks. Majority of the patients (60%) achieved radiological union in <12 weeks while 6 (40%) patients achieved union in 12-24 weeks. In Group B, majority of the patients (66.7%) achieved radiological union in <12 weeks while 5 (33.3%) patients achieved union in 12-24 weeks. The mean duration for radiological union in Group B was 12.1 ± 6.68 weeks. CONCLUSION: MIPOs can used to preserve the biology at the fracture site, to maximise the healing potential of the bone, and to facilitate early and pain free recovery and MIPPO technique with the application of LCP offered an ideal combination in terms of bone fixation and soft-tissue sparing.

scholarly journals A Single Surgeon’s Experience of Total Extra Peritoneal Repair Vs Transabdominal Preperitoneal Repair- A Prospective Cohort Study

2021 ◽  
Author(s):  
Tharun Ganapathy Chitrambalam ◽  
Koshy Mathew Panicker ◽  
Jeyakumar Sundaraj ◽  
Sidhu Rajasekhar ◽  
Pradeep Joshua Christopher
Keyword(s):  
Inguinal Hernia ◽  
Postoperative Pain ◽  
Hospital Stay ◽  
Pain Score ◽  
Operative Time ◽  
P Value ◽  
Tep Repair ◽  
Duration Of Hospital Stay ◽  
Tapp Repair ◽  
The Mean

Introduction: Hernia surgery has evolved over a period of 2500 years from the Bassini-Shouldice era to conventional Lichenstein’s meshplasty to the laparoscopic era. Since, inception of the laparoscopic approach 25 years ago, there were several advancements in the techniques of inguinal hernia repairs. The two most commonly practiced laparoscopic approaches are the Total Extra Peritoneal (TEP) and Transabdominal Preperitoneal (TAPP) repair. Aim: To compare the outcomes for TEP and TAPP approaches in laparoscopic inguinal hernia surgery in terms of operative time consumed, postoperative pain, duration of hospital stay, complications and recurrence rate when performed by a single surgeon. Materials and Methods: A prospective interventional cohort study was carried out among 70 patients with uncomplicated inguinal hernia. Patients were divided equally into two groups of 35 patients and underwent TAPP and TEP repairs depending on group randomisation. All surgeries were performed by the same surgeon. Factors including operative time, postoperative pain, duration of hospital stay, complications and recurrence were documented and compared for both the groups. The statistical analysis was done using Statistical Package for the Social Sciences (SPSS) software version 21. Unpaired t-test was used to compare the mean between the two groups. The p-value of <0.05 was considered to be statistically significant. Results: The mean operative time measured in minutes for TEP repair was 31.03 minutes and TAPP repair was 42.26 showing a difference of 11.23 minutes which was statistically significant (p-0.001). The mean Standard Deviation (SD) pain score at 24 hours for TEP repair was 2.43 (1.195) and TAPP repair was 3.43 (0.917). The mean (SD) pain score at 48 hours for TEP repair was 1.31 (1.051) and TAPP repair was 2.20 (0.901). The mean (SD) pain score at one week for TEP repair was 0.37 (0.690) and TAPP repair was 0.91 (0.781). The mean (SD) duration of hospital stay in TEP repair was 2.60 days (0.553) when compared to 3.49 days (0.658) in TAPP repair. All the results were statistically significant with a p-value of 0.001. Conclusion: TEP repair had superior outcomes in terms of reduction in operative time, less postoperative pain and shorter hospital stay than TAPP repair.

Sign in / Sign up

Export Citation Format

Share Document