SINGLE INCISION LAPAROSCOPIC ASSISTED APPENDECTOMY IN VEDANTA INSTITUTE OF MEDICAL SCIENCES, AN EXPERIENCE OF 50 CASES.

2019 ◽  
Vol 3 (10) ◽  
Author(s):  
Dr. Rajesh Kumar P. Shrivastava
Keyword(s):  
Postoperative Pain ◽  
Visual Analogue Scale ◽  
Hospital Stay ◽  
Analogue Scale ◽  
Operative Time ◽  
Single Incision ◽  
Length Of Hospital Stay ◽  
Normal Activity ◽  
Clinical Findings ◽  
Post Operative Pain

Introduction:  Laparoscopic appendectomy (LA) has advantage to diagnose and to also treat appendicitis at the same time also it has a less postoperative pain and a faster return to work and normal activity. In a classic LA, three to four incisions are required for trocars placement. Technique of Single Incision Laparoscopic Appendicectomy (SILA) has been developed to reduce abdominal trauma, improve cosmesis, reductions in postoperative pain and hospital stay. Aim of this prospective study was to test the feasibility, safety and potential advantages of SILA Material and Methods: Patients over the age of 18 with a diagnosis of acute abdomen, later on confirmed to acute appendicitis based on clinical findings, imaging and laboratory tests were included in the study. Outcome of the patient was assessed in the form of operative time, length of hospital stay and postoperative complications. Prophylactic antibiotics were given pre-operatively to all the patients included in the study. Technique was evaluated for operative time, post-operative pain, post-operative length of stay and complication rate. Post-operative pain was evaluated at 12 hrs, day 1 and day 2 post-operatively by using a visual analogue scale (VAS) which ranged from 0 to 10. Patients were evaluated on the 7th and 14th postoperative day for analysis of recovery, any surgical site infection, abscess formation, abdominal tenderness and aesthetic satisfaction. Results: Mean age in years was 27±10.48 tears. There were 22 (44%) male and 28(56%) female. Mean duration of SILA procedure was 38±3.8 minutes. Hospital stay in days was 1.8±1.1. Patient returned back to work in 9±2.4 days. Post-operative pain was evaluated at 12 hrs, day 1 and day 2 post-operatively by using a visual analogue scale (VAS) which ranged from 0 to 10. After 12 hours score was 6.5, at day 1 4.0 and at day 2 it was 1.5. Conclusion: Single incision appendicectomy operative time is less, pain is less and hospital stay is reduced thereby increasing the patient satisfaction and this technique is effective in terms of pain and hospital stay. Keywords: LA, SILA, VAS

Single-Incision Laparoscopic Inguinal Hernioplasty Versus Conventional Laparoscopic Inguinal Hernioplasty

2017 ◽  
Vol 24 (2) ◽  
pp. 171-182 ◽  
Author(s):  
Shanshan Luo ◽  
Shike Wu ◽  
Hao Lai ◽  
Xianwei Mo ◽  
Jiansi Chen
Keyword(s):  
Inguinal Hernia ◽  
Postoperative Pain ◽  
Hospital Stay ◽  
Operative Time ◽  
Single Incision ◽  
Meta Analysis ◽  
Length Of Hospital Stay ◽  
Cochrane Library ◽  
Inguinal Hernioplasty ◽  
Conventional Laparoscopic

Purpose: Additional studies comparing single-incision laparoscopic inguinal hernioplasty (SILH) and conventional laparoscopic inguinal hernioplasty (CLH) have been published, and this study updates the meta-analysis of this subject. Methods: Two reviewers independently searched the PubMed, Embase, Google Scholar, and Cochrane Library electronic databases to locate original articles that compared SILH and CLH for inguinal hernia that were published until October 2015. Operative time, conversions, complications, length of hospital stay, recurrence, postoperative pain at 24 hours, and postoperative pain at 7 days were compared using Stata software, version 12.0. Results: Sixteen studies were selected for this analysis, which included a total of 1672 patients (907 in SILH and 765 in CLH). SILH showed a longer operative time; however, conversions, complications, length of hospital stay, recurrence, postoperative pain at 24 hours, and postoperative pain at 7 days were similar between the 2 groups. Conclusions: Our meta-analysis has shown that inguinal hernia repair using SILH is as safe as CLH. However, based on our evidence, we currently believe that SILH is not an efficacious surgical alternative to CLH for inguinal hernias due to the fact that it does not provide significant benefit in postoperative pain and cosmetic outcomes. However, large-scale, well-designed, and multicenter studies will be needed to further confirm the results of this study.

Single-Incision Laparoscopic Cholecystectomy for Day Surgery Procedure: Are We Prepared?

2012 ◽  
Vol 78 (4) ◽  
pp. 436-439 ◽  
Author(s):  
ÓScar Vidal ◽  
Mihai Pavel ◽  
Mauro Valentini ◽  
Cesar GinestÀ ◽  
Josep MartÍ ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Postoperative Pain ◽  
Visual Analogue Scale ◽  
Analogue Scale ◽  
Single Incision ◽  
Outpatient Surgery ◽  
Length Of Hospital Stay ◽  
Day Surgery ◽  
Single Incision Laparoscopic Surgery ◽  
A Prospective Study

Single-incision laparoscopic surgery (SILS) for cholecystectomy is a well-established procedure and represents the next step in developing the concept of fast track surgery. This report describes our experience with SILS cholecystectomy in patients that stay overnight. Between February 2009 and July 2010, patients referred for cholecystectomy to the day surgery unit who agreed to undergo SILS were included in a prospective study. All operations were performed by the same surgical team specially trained in this type of surgery and the same operative technique was used in all cases. Postoperative pain and nausea were assessed using a 10-cm visual analogue scale on a self-completion questionnaire on the night of operation and the morning of discharge. A total of 107 patients (58% women, mean age 56 years) with symptomatic gallstones were included in the study. SILS was successfully performed in all patients and no patient required conversion to an open procedure. There were no significant differences in the median visual analogue scale for postoperative pain and nausea between the night of surgery and the next morning. The mean length of hospital stay was 23 hours, and 98 per cent of patients were satisfied with the results of surgery and would be willing to undergo the same procedure again. SILS cholecystectomy is a valid alternative to standard laparoscopic cholecystectomy as an outpatient surgery or overnight stay procedure. According to these promising results, SILS cholecystectomy could be included in a major ambulatory surgery program.

scholarly journals A comparative study of open (Milligan-Morgan) versus closed (Ferguson) haemorrhoidectomy with and without internal sphincterotomy

2019 ◽  
Vol 6 (2) ◽  
pp. 443
Author(s):  
Rita Singh ◽  
T. Rudra Prasad Reddy ◽  
T. Santosh Kumar
Keyword(s):  
Visual Analogue Scale ◽  
Hospital Stay ◽  
Analogue Scale ◽  
Operative Time ◽  
Operating Time ◽  
Open Group ◽  
Open Technique ◽  
Internal Sphincterotomy ◽  
Post Operative Pain ◽  
Positive Effect

Background: Normal anal canal contains cushion of submucosa with vascular tissues. When cushions become abnormal , cause symptoms. This clinical condition is known as haemorrhoids. Haemorrhoidectomy is surgery for haemorrhoids, which can be performed by Milligan-Morgan (open technique) or Ferguson (close technique) methods. This study is conducted to compare different surgical modalities of treatment for haemorrhoids.Methods: In total, 232 patients suffering from haemorrhoids with or without fissures were included in the study. Patients were categorized into two groups. Patients undergoing open technique were designated as open group, similarly patients undergoing close technique were designated as close group. In both groups for few patients internal sphincterotomy (I.S.) was performed. Post-operative pain was assessed by visual analogue scale in all groups, per operative haemorrhage was assessed by number of swabs used during surgery and VAS estimation, operating time and post-operative hospital stay were recorded.Results: 136 patients were suffering from haemorrhoids with fissures. Of these 84 patients were operated by open technique and 52 patients by close technique. In all 136 patients, internal sphincterotomy was performed. Remaining 96 patients were suffering from only haemorrhoids. Of these 30 patients were treated by open technique with I.S., 30 patients were treated by close technique only. 25 patients were treated by close technique with I.S. and 10 patients were treated by close technique without I.S. Close group and open group with I.S. experienced less pain compared to without I.S. in both groups. Per operative haemorrhage and hospital stay in close group was less . Operative time in open group was less compared to close group.Conclusions: Ferguson procedure is found to cause less post-operative discomfort. Addition of internal sphincterotomy is having a positive effect in reducing post-operative pain.

Operative Outcomes of Single-Incision Laparoscopic Hysterectomy vs Conventional Laparoscopic Total Hysterectomy: A Prospective Randomized Controlled Study

2021 ◽  
pp. 155335062110418
Author(s):  
Adel Fathi ◽  
Mahmoud M. Saleh ◽  
Mosab Shetiwy ◽  
Islam A. Elzahaby ◽  
Omar Farouk ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Postoperative Pain ◽  
Hospital Stay ◽  
Operative Time ◽  
Single Incision ◽  
Laparoscopic Hysterectomy ◽  
Controlled Study ◽  
Total Hysterectomy ◽  
Conventional Laparoscopic ◽  
Randomized Controlled

Background. Over time, there was an emerging need to shift from laparotomy to minimally invasive laparoscopic surgery, with the success of laparoscopic surgery in the last decade in gyne-oncology. Patients and Methods. This is a prospective randomized controlled trial conducted in Surgical Oncology Unit, Oncology Centre, Mansoura University, in the period between February 2016 and October 2019. Fifty female patients planned for total hysterectomy were randomized into two equal groups; the first underwent conventional laparoscopic hysterectomy (CLH), while the second underwent single-incision laparoscopic hysterectomy (SILH). Results. The mean operative time in the SILH group was 120.00 ± 28.72 minutes vs 103.20 ± 23.04 minutes in the CLH group ( P= .027). Median hospital stay in the SILH group was 1 day (range: 1–3 days), the same as that in the CLH group, with no statistical significance ( P= .384). Postoperative pain assessment using the Visual Analogue Scale (VAS) after 6 hours had a median score of 6 (2–8) in the SILH group and 6 (4–7) in the CLH group with significant increase in experienced pain in the SILH group ( P= .004), while no significant difference was noted after 12 hours and 24 hours in both SILH and CLH groups. Conclusion. Single-incision laparoscopic hysterectomy (SILH) has similar outcomes when compared to conventional laparoscopic hysterectomy as regard blood loss, hospital stay, conversion to laparotomy, intraoperative and postoperative complications with the disadvantages of longer operative time, increased surgeon’s workload, and relatively more postoperative pain.

scholarly journals Intercostal nerve cryoablation versus thoracic epidural for postoperative analgesia following pectus excavatum repair: a systematic review and meta-analysis

2020 ◽  
Vol 31 (4) ◽  
pp. 486-498
Author(s):  
Jean H T Daemen ◽  
Erik R de Loos ◽  
Yvonne L J Vissers ◽  
Maikel J A M Bakens ◽  
Jos G Maessen ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Epidural Analgesia ◽  
Hospital Stay ◽  
Pectus Excavatum ◽  
Operative Time ◽  
Meta Analysis ◽  
Length Of Hospital Stay ◽  
Intercostal Nerve ◽  
Nuss Procedure ◽  
Thoracic Epidural

Abstract OBJECTIVES Minimally invasive pectus excavatum repair via the Nuss procedure is associated with significant postoperative pain that is considered as the dominant factor affecting the duration of hospitalization. Postoperative pain after the Nuss procedures is commonly controlled by thoracic epidural analgesia. Recently, intercostal nerve cryoablation has been proposed as an alternative method with long-acting pain control and shortened hospitalization. The subsequent objective was to systematically review the outcomes of intercostal nerve cryoablation in comparison to thoracic epidural after the Nuss procedure. METHODS Six scientific databases were searched. Data concerning the length of hospital stay, operative time and postoperative opioid usage were extracted. If possible, data were submitted to meta-analysis using the mean of differences, random-effects model with inverse variance method and I2 test for heterogeneity. RESULTS Four observational and 1 randomized study were included, enrolling a total of 196 patients. Meta-analyses demonstrated a significantly shortened length of hospital stay [mean difference −2.91 days; 95% confidence interval (CI) −3.68 to −2.15; P < 0.001] and increased operative time (mean difference 40.91 min; 95% CI 14.42–67.40; P < 0.001) for cryoablation. Both analyses demonstrated significant heterogeneity (both I2 = 91%; P < 0.001). Qualitative analysis demonstrated the amount of postoperative opioid usage to be significantly lower for cryoablation in 3 out of 4 reporting studies. CONCLUSIONS Intercostal nerve cryoablation during the Nuss procedure may be an attractive alternative to thoracic epidural analgesia, resulting in shortened hospitalization. However, given the low quality and heterogeneity of studies, more randomized controlled trials are needed.

scholarly journals PREOPERATIVE KETOROLAC EFFECT ON POSTOPERATIVE PAIN ON TURP PATIENTS

2013 ◽  
Vol 20 (2) ◽  
Author(s):  
Choirul Hadi ◽  
Trisula Utomo
Keyword(s):  
Postoperative Pain ◽  
Visual Analogue Scale ◽  
Analogue Scale ◽  
Prostatic Hyperplasia ◽  
Transurethral Prostatectomy ◽  
Cross Sectional ◽  
Vas Score ◽  
Group I ◽  
Post Operative Pain ◽  
Group Ii

Objective: The aim of this study is to study the effect of preoperative Ketorolac on postoperative pain after transurethral prostatectomy at Sardjito Hospital Yogyakarta. Material & Methods: This is a cross sectional, analytic, prospective study. We divided benign prostatic hyperplasia patients, from October 2011 until February 2012 into two groups. Group I was given Ketorolac 30 mg intravenously twice daily starting one day before operation and in the morning before procedure. Group II did not receive Ketorolac preoperatively. Patients underwent transurethral operation with spinal anesthesia. We assessed postoperative pain at 24 hours using Visual Analogue Scale (VAS). Results: Twenty four patients were included in this study with mean age 66 years old with the youngest 45 years old and the oldest 80 years old (SD 8,77744). Group I (17 patients), VAS score 1 to 7 with median 3 and mean 3,4118 (SD 1,66053). Group II (7 patients) VAS score 1 to 8 with median 3 and mean 3,8571 (SD 2,8357). We count it using Mann-Whitney U (p = 0,951). Conclusion: There is no significance difference in post-operative pain after transurethral prostatectomy with preoperative ketorolac administration.Keywords: Ketorolac, bupivacaine, visual analogue scale, transurethral prostatectomy.

scholarly journals Stitch less, clip less, three ports laparoscopic cholecystectomy: experience of 300 cases

2019 ◽  
Vol 7 (8) ◽  
pp. 2899
Author(s):  
Ritvik Resutra ◽  
Neha Mahajan ◽  
Rajive Gupta
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Postoperative Pain ◽  
Hospital Stay ◽  
Operative Time ◽  
Normal Activity ◽  
Duration Of Hospital Stay ◽  
Bile Duct Injuries ◽  
Early Return ◽  
Routine Work ◽  
Better Than

Background: 300 cases of cholelithiasis were operated by stitch less, clip less, three ports laparoscopic cholecystectomy at Maxx lyfe Hospital, near Bathindi morh, Sunjwan road, Jammu with effect from August 2017 to May 2019. The outcome measures in the form of safety of the technique, postoperative pain, need of postoperative analgesia, number of OT assistants needed, duration of hospital stay, recovery and return to routine work, cosmetic satisfaction of the patient were taken into consideration and were found to be better than in conventional four ports technique of laparoscopic cholecystectomy.Methods: In three port laparoscopic cholecystectomy, first 10 mm umbilical, second 5 mm subxyphoid and third 5 mm subcostal ports are used and telescope is passed into the peritoneal cavity through the umbilical port. Retraction of the gallbladder is done by the long grasping forceps through the 5 mm subcostal port, whereas dissection is accomplished through the subxyphoid port. The gallbladder is retrieved through the subxyphoid port.Results: Mean operative time was 40 minutes and mean duration of postoperative stay in the hospital was 18 hours. Days to return to normal activity was 4 days at an average.Conclusions: The 3-port laparoscopic cholecystectomy  technique is safe and has better outcomes in the form of less postoperative pain, less duration of hospital stay, early return to routine work and more cosmetic satisfaction as compared to the conventional 4-port technique, with no obvious increase in bile duct injuries and it can be a viable alternative in the field of minimally invasive surgery.

scholarly journals A COMPARATIVE AND RANDOMIZED STUDY BETWEEN TRANS ABDOMINAL PRE-PERITONEAL VERSUS TOTALLY EXTRA-PERITONEAL LAPAROSCOPIC TECHNIQUES OF INGUINAL HERNIA REPAIR

2020 ◽  
pp. 26-29
Author(s):  
Nikhil Agrawal ◽  
Swapnil Sen
Keyword(s):  
Inguinal Hernia ◽  
Postoperative Pain ◽  
Hernia Repair ◽  
Hospital Stay ◽  
Inguinal Hernia Repair ◽  
Operative Time ◽  
Length Of Hospital Stay ◽  
Statistical Hypothesis ◽  
Categorical Variables ◽  
Chi Squared

A hernia, an abnormal protrusion of an organ or tissue through a defect in its surrounding wall is a very common surgical problem. Approximately 75% of all hernias are usually groin hernias, among which 95% are inguinal region hernias. Various methods of repair have been employed which have progressed from open repair to various laparoscopic approaches. There is insufficient data to draw conclusions about the relative effectiveness of the two laparoscopic methods. Overall superiority of the two laparoscopic methods has not been demonstrated in available literature. AIM: The purpose of this study is to compare the clinical effectiveness and relative efficiency of laparoscopic TAPP and laparoscopic TEP for inguinal hernia repair. MATERIALS AND METHODS: Hospital based comparative randomised study on 100 patients admitted in General Surgical wards with Inguinal hernia at a tertiary care centre of Eastern India. Randomization in two groups was done by lottery system. A well designed proforma containing various parameters under study was used for data collection. Baseline information were collected via structured interview using predesigned questionnaire. For statistical analysis data were entered into a Microsoft excel spreadsheet and then analyzed by SPSS version 24 and GraphPad Prism version 5. Data had been summarized as mean and standard deviation for numerical variables and count and percentages for categorical variables. Two-sample t-tests for a difference in mean involved independent samples or unpaired samples. Paired t-tests were a form of blocking and had greater power than unpaired tests. A chi-squared test (χ2 test) was any statistical hypothesis test wherein the sampling distribution of the test statistic is a chi-squared distribution when the null hypothesis is true. Unpaired proportions were compared by Chi-square test or Fischer’s exact test, as appropriate. RESULTS: TAPP was associated with significantly higher incidence of haematoma, length of hospital stay, early postoperative pain and longer operative time as compared to TEP. Visceral injury and vascular injury were found more in TAPP as compared to TEP but this was not statistically significant. Seroma, port site hernia, persisting numbness and mesh/deep infection was higher in group-A (TAPP) as compared to group-B (TEP) but this was not statistically significant. Conversion to open procedure and persistent pain were comparable among the two methods. Hernia recurrence rates were higher in the TEP group in this study although it was statistically insignificant. CONCLUSION: TAPP was associated with significantly higher incidence of haematoma, length of hospital stay, early postoperative pain and longer operative time as compared to TEP.

scholarly journals Is the combination of corticosteroids plus NSAIDs improve the preemptive analgesia after third molars surgery? A systematic review and meta-analysis

2020 ◽  
Vol 9 (9) ◽  
pp. e968997979
Author(s):  
Gustavo Antonio Correa Momesso ◽  
Cleidiel Aparecido Araújo Lemos ◽  
Valthierre Nunes de Lima ◽  
Leonardo Alan Delanora ◽  
Joel Ferreira Santiago-Júnior ◽  
...  
Keyword(s):  
Systematic Review ◽  
Postoperative Pain ◽  
Visual Analogue Scale ◽  
Analogue Scale ◽  
Meta Analysis ◽  
Third Molars ◽  
Exclusion Criteria ◽  
Time Restrictions ◽  
Post Operative Pain ◽  
Inflammatory Drugs

This study aimed to perform a systematic review and meta-analysis to evaluate the preemptive action of the combination of corticosteroids and non-steroidal anti-inflammatory drugs (NSAIDs) or both drugs singly after third molars surgery. It was performed a search on the PubMed/MEDLINE, Scopus, and Cochrane databases, according to the PRISMA criteria, with no time restrictions up to March 2020. The postoperative pain was evaluated, qualitatively, through the visual analogue scale (VAS) and the number of rescue analgesics (NRA). The edema and trismus were evaluated in a qualitative way through linear measures. Besides that, a meta-analysis of the post-operative pain (VAS) was performed. It was found 103 articles, which four articles were selected according to the inclusion and exclusion criteria. A total of 208 patients was evaluated and the combination of corticosteroids and NSAIDs showed great behavior in the preemptive action after third molars surgery for all the parameters evaluated when compared to both drugs singly. Meta-analysis about the VAS showed that the combination of drugs reduced significantly the postoperative pain when compared to the NSAIDs singly (P<0.05). It was concluded that the combination of NSAIDs and corticosteroids improved postoperative pain, edema, and trismus after third molars surgery.

Dissection tonsillectomy: pattern of post-operative pain, medication and resumption of normal activity

1998 ◽  
Vol 112 (1) ◽  
pp. 41-44 ◽  
Author(s):  
P. Murthy ◽  
M. R. Laing
Keyword(s):  
Visual Analogue Scale ◽  
Return To Work ◽  
Prospective Study ◽  
Analogue Scale ◽  
Normal Activity ◽  
Pain Medication ◽  
Pain Scores ◽  
Normal Swallowing ◽  
Post Operative Pain ◽  
A Prospective Study

AbstractA prospective study of 99 adults undergoing tonsillectomy was carried out to determine the pattern of post-operative pain, intake of medication and timing of return to work and normal swallowing. The differences in the pain scores, as measured by a visual analogue scale, between every third consecutive day following post-operative day four were found to be highly significant (p<0.001). Sixty-six patients (66.6 per cent) required medication in the form of analgesics and/or antibiotics after the first post-operative day. Sixty-four out of a total of 82 patients (78.2 per cent) returned to work within 14 days of surgery. Ninety-six patients (97 per cent) reported normal swallowing within 14 days of surgery. These results suggest that the majority of adult patients undergoing tonsillectomy can be appropriately advised pre-operatively regarding the probable pattern and duration of post-operative pain and the timescales they can expect to return to work and normal swallowing.

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