Pediatric Laparoscopic Surgery: Four Years Experience in Dhaka Medical College Hospital

Purpose: Laparoscopy is gaining popularity over laparotomy in various surgical conditions. Now a day, an increasing number of diagnostic and therapeutic surgical procedures are being done laparoscopically. The aim of this study was to assess the safety and feasibility of laparoscopy in children.Materials and Methods: This retrospective study was carried out in the Department of Pediatric Surgery of Dhaka Medical College Hospital over a period of 52 (Fifty two) months from June 2009 to August 2013. A total of 123 patients were operated laparoscopically up to 12 years of age for different surgical conditions. Data was collected from the hospital records and analyzed retrospectively.Results: Out of these 123 laparoscopically performed cases, Appendectomy was performed in 39 cases, closure of internal inguinal ring for Inguinal Hernia was done in 36 patients, 20 patients underwent Cholecystctomy, 16 patients had laparoscopic procedures for impalpable Undescended Testis (UDT), 5 patients were operated for Adnexal Mass of which one case was converted into open procedure due to technical difficulties and 1 for Pancreatic Pseudo cyst. Diagnostic Laparoscopy was performed for 2 patients with Biliary Atresia and 4 patients for Ambiguous Genitalia. Median age of the patients was 6.08 years (ranging from 2 months to 12 years of age). The length of post operative hospital stay was 2-3 days. All the laparoscopic procedures for Inguinal Hernia and impalpable UDT were performed as day care surgery. Operative and post operative complications were minimal. Other advantages of the laparoscopic procedures were smaller incisions, incidental diagnosis of other associated pathology, lesser post operative pain, earlier oral feeding, quicker mobilization and a better cosmetic result.Conclusion: With the recent development of laparoscopic surgical techniques and equipments, laparoscopic surgical procedures are becoming popular day by day and can be performed safely for both diagnostic and therapeutic purposes in pediatric surgical patients.J. Paediatr. Surg. Bangladesh 4(1): 11-18, 2013 (January)

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Surgery at Cranio-vertebral (CV) Junction: Our Experience of 32 Cases

Journal of Bangladesh College of Physicians and Surgeons ◽

10.3329/jbcps.v29i2.7952 ◽

1970 ◽

Vol 29 (2) ◽

pp. 78-84

Author(s):

FH Chowdhury ◽

MR Haque ◽

NKSM Chowdhury ◽

MS Islam ◽

Z Raihan ◽

...

Keyword(s):

Surgical Procedures ◽

Surgical Techniques ◽

Clinical Findings ◽

Type I ◽

College Hospital ◽

Chiari Malformation Type I ◽

Female Ratio ◽

Medical College ◽

Neoplastic Lesion ◽

Wide Range

Cranio vertebral (CV) junction is one of the critical sites for surgery. It's anatomy, physiological aspects and pathological involvement varies in a wide range of margins. Common problems are developmental anomalies, traumatic involvement, inflammatory, infective and neoplastic lesion. Management of these problems varies a lot from each other. Aim of the article is to overview the pathologies in this area and to study presentations, investigations, surgical procedures and results of these pathologies. We prospectively analyzed 32 cases of Cranio-vertebral (CV) region surgery in the Department of Neurosurgery Dhaka Medical College Hospital and Mitford Hospital, Dhaka, from 2000 to 2008. In our series, male and female ratio was 7.2:1. Pathologies were atlanto- axial dislocation (AAD), Chiari malformation type –I, schwannoma, meningioma, hydatid cyst and tuberculosis. Common clinical findings were- neck pain, quadriparesis, quadriplegia, hand atrophy, autonomic dysfunction and hypertension. Various types of surgical procedures were done in this series according to the pathology. Death was in 01 case, neurological deterioration seen in one case, 2 cases were neurologically stable and 28 cases (87.5%) improved neurologically where one was non useful improvement (Frankel grade-C). Complete pre operative radiological study is a very important adjunct for a successful surgical result. Proper evaluation of patients with selection of appropriate surgical procedures along with safe surgical techniques are the necessary things for successful surgery in this area. DOI: http://dx.doi.org/10.3329/jbcps.v29i2.7952 (J Bangladesh Coll Phys Surg 2011; 29: 78-84)

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BLOOD TRANSFUSION

The Professional Medical Journal ◽

10.29309/tpmj/2011.18.02.2054 ◽

2011 ◽

Vol 18 (02) ◽

pp. 212-214

Author(s):

REHMATULLAH SOOMRO ◽

MUHAMMAD RIZWAN JAVED ◽

SARA AHMAD ALI

Keyword(s):

Surgical Procedures ◽

Medical College Hospital ◽

College Hospital ◽

Medical College ◽

Elective Surgical Procedures ◽

Transfusion Ratio ◽

A Prospective Study ◽

Surgical Unit ◽

Cross Matching ◽

Cross Match

Objective: To evaluate Blood Ordering and Transfusion ratios for elective surgical procedures. Study Design, Setting & Duration: This was a prospective study carried out at Muhammad Medical College Hospital Mirpurkhas from January 2007 to December 2007. Patients & Methods: A total of 1032 patients were included, both male & female. All patients who underwent elective surgical procedures in Surgical Unit, Muhammad Medical College hospital, Mirpurkhas from January 2007 to December 2007 were included in this study. Blood units cross matched and units transfused intra-operatively and post-operatively were recorded apart from patient demography and hepatitis profile. Results: A total of 1032 patients underwent elective surgical procedures during the study period. Total 1500 blood units arranged, among these only 74 units of blood were transfused. This means only 4.9% of blood was utilized while 95.1% of blood was not utilized. Cross-match to transfusion ratio (C/T) = 20.27, Transfusion probability (Tp) = 7.1 and Transfusion index (Ti) = 0.07. Conclusion: For elective surgical procedures, there is no need for routine cross matching of blood. However, one must confirm the availability of blood for Hepatitis B and Hepatitis C reactive patients, and for cases, where the bleeding is inevitable like transvesical / transurethral removal of prostate.

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Transabdominal Pre-Peritoneal (TAPP) Laparoscopic Inguinal Hernia Repair: Our Experience with 40 Cases

Journal of Surgical Sciences ◽

10.3329/jss.v24i1.52210 ◽

2020 ◽

Vol 24 (1) ◽

pp. 11-14

Author(s):

Md Mamunur Rahman ◽

Nelema Jahan ◽

Md Mozammel Hoque ◽

Md Saiful Islam ◽

Mohammad Shahidul Alam ◽

...

Keyword(s):

Inguinal Hernia ◽

Hernia Repair ◽

Inguinal Hernia Repair ◽

Study Data ◽

Long Term Results ◽

Wound Complications ◽

College Hospital ◽

Medical College ◽

Male Patients ◽

Surgical Conditions

Background: Groin hernias are the most common surgical conditions all over the world. Laparoscopic (TAPP) approach has been achieved as the best technique of inguinal hernia repair due to less postoperative pain, earlier return to activity and fewer wound complications. Objectives: To share our experience with Transabdominal preperitoneal (TAPP) hernia repair and its outcome. Methods: This prospective study was performed in Shaheed Suhrawardy Medical College Hospital between January 2016 to December 2017. Forty male patients with inguinal hernia were included in this study. Data was collected in a proforma regarding demographic and baseline characteristics, operative time, outcome of patients and were analyzed in tabulated form. Results: Total 40 patients were included in our study. Age ranged from 20-60 years (mean age ± SD 38.88±10.92 years). The maximum duration of TAPP hernia repair ranged from 100-120 minutes s(mean ± SD 109±16.3 minutes). Post-operative complications were severe pain (10%), infection (5%), scrotal oedema (5%). Conclusion: Laparoscopic TAPP hernia repair is associated with satisfactory short- and long-term results. Journal of Surgical Sciences (2020) Vol. 24 (1) : 11-14

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Crossed Testicular Ectopia in a 65-year-old man

Journal of Surgical Sciences ◽

10.3329/jss.v19i1.43777 ◽

2019 ◽

Vol 19 (1) ◽

pp. 39-41

Author(s):

Sharmin Islam ◽

SM Amjad Hossain ◽

Abdullah Al Mamun ◽

Syed Masud Reza ◽

Tushit Kumar Barua

Keyword(s):

Inguinal Hernia ◽

Contralateral Side ◽

Medical College Hospital ◽

Testicular Descent ◽

College Hospital ◽

Surgical Exploration ◽

Medical College ◽

Younger Age ◽

Impalpable Testis ◽

Testicular Ectopia

Crossed testicular ectopia (CTE) is an extremely rare anomaly in which deviation of testicular descent results in unilateral location of both testes. It usually presents as an inguinal hernia on the side of a fully descended testis and an impalpable testis with undeveloped hemiscrotum on the contralateral side. Most often the diagnosis of CTE is not made until surgical exploration. Few reports are available regarding CTE in infants or younger children. Though the patients of CTE usually present at a younger age, we report a case of crossed testicular ectopia in a 65-year-old male who was admitted in the department of surgery, Shaheed Suhrawardi Medical College Hospital (ShSMCH) with right sided inguinal hernia. Journal of Surgical Sciences (2015) Vol. 19 (1) : 39-41

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Chest Trauma Evaluation and Outcome of Management in a Tertiary Hospital - One Year Experience

Journal of Surgical Sciences ◽

10.3329/jss.v22i2.44075 ◽

2020 ◽

Vol 22 (2) ◽

pp. 110-117

Author(s):

Md Mahmudul Islam ◽

Khondkar AK Azad ◽

Md Aminul Islam ◽

Rivu Raj Chakraborty

Keyword(s):

Road Traffic Accident ◽

Traffic Accident ◽

Chest Trauma ◽

Road Traffic ◽

Tube Thoracostomy ◽

Rib Fracture ◽

Medical College Hospital ◽

College Hospital ◽

Medical College ◽

The Mean

Background: Chest trauma is responsible for 50% of deaths due to trauma. This kind of death usually occurs immediately after the trauma has occurred. Various therapeutic options have been reported for management of chest injuries like clinical observation, thoracocentesis, tube thoracostomy and open thoracotomy. Objective: To observe the pattern and outcome of management in chest trauma Methods: This is an observational study carried out in Casualty department of Chittagong Medical College Hospital (CMCH), Chittagong, between April 2015 to March 2016. Our study was included all patients, both sexes, following chest injury at Casualty units of Chittagong Medical College Hospital. All the data were recorded through the preformed data collection sheet and analyzed. Result: The mean age was found 37.7±18.1 years with range from 12 to 80 years. Male female ratio was 11.8:1. The mean time elapsed after trauma was found 6.1±3.1 hours with range from 1 to 72 hours. Almost one third (35.7%) patients was affecting road traffic accident followed by 42(27.3%) assault, 35(22.7%) stab injury, 15(9.7%) fall and 7(4.5%) gun shot . More than three fourth (80.5%) patients were managed by tube thoracostomy followed by 28(18.2%) observation and 2(1.3%) ventilatory support. No thoracotomy was done in emergency department. 42(27.2%) patients was found open pneumothorax followed by 41(26.6%) rib fracture, 31(20.1%) haemopneumothorax, 14(9%) simple pneumothorax, 12(7.8%) haemothorax, 6(3.9%) chest wall injury, 5(3.2%) tension pneumothorax, and 3(1.9%) flail chest. About the side of tube 60(39.0%) patients were given tube on left side followed by 57(37.0%) patients on right side, 9(5.8%) patients on both (left & right) side and 28(18.2%) patients needed no tube. Regarding the complications, 13(30%) patients had persistent haemothorax followed by 12(29%)tubes were placed outside triangle of safety, 6(13.9%) tubes were kinked, 6(13.9%) patients developed port side infection, 2(4.5%)tube was placed too shallow, 2(4.5%) patients developed empyema thoracis and 2(4.5%) patients developed bronchopleural fistula. The mean ICT removal information was found 8.8±3.6 days with range from 4 to 18 days. Reinsertion of ICT was done in 6(4.7%) patients. More than two third (68.2%) patients were recovered well, 43(27.9%) patients developed complication and 6(3.9%)patients died. More than two third (66.9%) patients had length of hospital stay 11-20 days. Conclusion: Most of the patients were in 3rd decade and male predominant. Road traffic accident and tube thoracostomy were more common. Open pneumothorax, rib fracture and haemopneumothorax were commonest injuries. Nearly one third of the patients had developed complications. Re-insertion of ICT needed almost five percent and death almost four percent. Journal of Surgical Sciences (2018) Vol. 22 (2) : 110-117

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