scholarly journals A Comparative Study of Conventional versus Endoscopic Septoplasty

Author(s):  
Ankita Singh ◽  
Nalini Bhat ◽  
Pallavi Bhandarkar ◽  
Ram Singh

Introduction The standard surgical treatment for symptomatic deviated septum is septoplasty. This is usually done conventionally using the headlight. However, in recent years the endoscopic method has emerged as an alternative technique. This study aims to compare results of conventional and endoscopic septoplasty Materials and Methods A study comprising of 44 patients, randomly divided in two groups, was undertaken to compare the efficacy of both the techniques. This study evaluated parameters like postoperative subjective improvement in symptoms, using the NOSE questionnaire, intra-operative blood loss, duration of surgery, post-operative pain and complications across the two groups. Further, cases were subgrouped according to the site of deviation as anterior, posterior or combined and the efficacy of these two methods for correcting different sites of deviation was assessed, using the same parameters. Results The endoscopic approach showed better overall clinical results, irrespective of the site of deviation. It was noted that correcting posterior deviations required shorter time and had lesser blood loss when operated using the endoscope whereas anterior deviations were dealt faster and had lesser bleeding by the conventional method. There was less pain and morbidity in the postoperative period in the endoscopic group as compared to conventional group. Discussion Historical perspective of the conventional and endoscopic septal surgery is mentioned. In review of literature on the four parameters of this study – Symptomatic improvement, intra-operative blood loss, post-operative pain and surgical complications, were compared with published reports. Conclusion Endoscopic septoplasty was found to have distinct advantages over the conventional method, more so for posterior septal deviations. It should be an option offered to all patients requiring septoplasty.

2019 ◽  
Vol 10 (6) ◽  
pp. 760-766
Author(s):  
Bharat R. Dave ◽  
Ajay Krishnan ◽  
Ravi Ranjan Rai ◽  
Devanand Degulmadi ◽  
Shivanand Mayi ◽  
...  

Study Design: Retrospective cohort study. Objectives: The aim of this study was to compare the results of cervical laminectomy (CL) performed with ultrasonic bone scalpel (UBS) or conventional method (CM). Method: This study comprised 311 CL performed by a single surgeon between January 2004 and December 2017. Group A (GpA) comprised 124 cases of CL performed using UBS, while Group B (GpB) comprised 187 cases of CL performed using CM. These 2 groups were compared in terms of demographic characteristics of patients, duration of surgery, estimated blood loss, and surgical complications. Results: GpA included 112 males and 12 females, mean age being 61.18 years. GpB comprised 166 males and 21 females, mean age being 62.04 years. Mean duration of surgery, estimated blood loss, and length of hospital stay was 65.52/70.87 minutes, 90.24/98.40 mL, and 4.80/4.87 days in GpA and GpB, respectively. Six patients were reported to have dural injuries in each group. In GpA, 2 cases of C5 palsy and 1 nerve root injury was observed, while in GpB, 3 cases of C5 palsy and no nerve root injury was reported. One patient had developed transient neurological deterioration postsurgery in GpA as against 11 patients in GpB. Conclusion: Neurological complications observed in CM leads to intensive care unit admission, additional morbidity, and additional expenditure, whereas UBS provides a safe, rapid, and effective means of performing CL, thereby decreasing the rate of surgical complications and postoperative morbidity.


Author(s):  
Kalpana Mehta ◽  
Om Prakash ◽  
Dharmendra Singh Fatehpuriya ◽  
Leena Verma

Background: In the present times, the emphasis on minimally invasive surgery has lead to a resurgence of interest and importance of VH for non-prolapsed indications i.e. non-decent vaginal hysterectomy (NDVH) as the scar less hysterectomy. It has several benefits over abdominal hysterectomy in terms of cosmetic advantages, lesser post-operative morbidity and faster recovery. The objectives of the study was to compare and assess various factors like operative duration of surgery, intra operative blood loss, intra operative and post-operative complications, post-operative analgesia requirement, post-operative ambulation and duration of post-operative hospital stay and to put forward best route of hysterectomy.Methods: Hundred cases fulfilling, the selection criteria were included in the study. Patients were randomly divided in two groups-NDVH (non-decent vaginal hysterectomy) and abdominal hysterectomy.Results: Operative time, intra operative blood loss and post-operative morbidity was less in NDVH groups.Conclusions: Non-decent vaginal hysterectomy is a better alternative to abdominal hysterectomy in cases with benign pathology of the uterus, uterine size <14 weeks, uterus with good mobility and adequate vaginal access.


1970 ◽  
Vol 15 (1) ◽  
pp. 6-9
Author(s):  
ABM Tofazzal Hossain ◽  
Md Arif Hossain Bhuyan ◽  
Shahnaz Afroza ◽  
Shaila Kabir ◽  
AHM Zahurul Huq

Objective: To define the advantages and disadvantages of CO2 laser tonsillectomy compared with conventional method. Study design: Retrospective review. Setting: Department of Otolaryngology & Head and Neck Surgery, Apollo Hospitals Dhaka. Materials and Methods: This study included fifty two patients with tonsillectomies from October 2007 to May 2008. The patients were diagnosed with history and clinical examination. Preoperative investigations have been done for general anaesthesia. Patients were intubated with laser reinforced endotracheal tube and fire precautions were taken. Laser tonsillectomy has been avoided below 10 years in our centre. 52 patients aged 10-35 years underwent tonsillectomy in a period of 10 months. Out of them 12 patients underwent laser tonsillectomies. The data of each patient included intra-operative blood loss, operation time, postoperative pain and postoperative healing. Results: All Patients were admitted for 24 hours. Intra operative blood loss was dramatically less with the use of CO2 laser than that of conventional method (5ml vs. 18ml). Profuse bleeding did not prolong this time especially in laser technique. The incidence of postoperative reactionary hemorrhage were not significantly different between two techniques. 2 patients suffered with secondary haemorrhage in conventional technique and in laser technique one patient had secondary haemorrhage. There was statistically significant difference in duration of operating time (15 vs. 40 min). Both methods of surgery had non-identical effect on post operative pain. Postoperative pain was less in laser technique than that of conventional technique in 7 days postoperative follow up. Leukocytic membrane formation and separation and final healing were earlier in laser technique than in conventional technique. Conclusion: CO2 laser is a safe and acceptable method for tonsillectomy. CO2 laser tonsillectomy reduces operation time and intraoperative blood loss. Postoperative pain is less than conventional technique and healing is also earlier in laser technique. Key Words: CO2 laser, tonsillectomy, ventilation.DOI: 10.3329/bjo.v15i1.4304 Bangladesh J of Otorhinolaryngology 2009; 15(1): 6-9


Author(s):  
Medha Kanani

Background: It is important to examine every step in any surgery to identify and evaluate its imortance, necessity and purpose with a view to find its better alternatives if they can be found at all. The most appropriate surgical procedure is the one which takes minimum time to be complete, simplest to perform, causing least damage and least complication for the patient. Present study was undertaken to assess the benefits of the Misgav Ladach cesarean section technique in comparison to the conventional Pfannenstiel technique in the tertiary care hospital and evaluate the operative parameters like efficacy, safety, duration of surgery, blood loss, need for suture material, post-operative pain and post-operative stay in hospital.Methods: All the women posted for emergency cesarean section in the Obstetrics OT at Sir T Hospital, Bhavnagar, Gujarat were included in this study. Some of the common indications at our hospital for cesarean section were fetal distress, cephalopelvic disproportion, failure of progress of labour, breech presentation, previous cesarean section and failed induction. Informed consent was taken. All the patients were randomly allocated to two groups with 50 women in each group. Group 1 Pfannenstiel incision and Group 2 Misgav Ladach.Results: The duration of surgery, blood loss and post-operative pain were significantly less in the Misgav Ladach group (P<0.001).Conclusions: Misgav Ladach technique of cesarean section has many advantages and should be used routinely.


2008 ◽  
Vol 122 (4) ◽  
pp. 369-373 ◽  
Author(s):  
H M Hegazy ◽  
O A Albirmawy ◽  
A H Kaka ◽  
A S Behiry

AbstractObjectives:To compare the advantages and disadvantages of potassium titanyl phosphate laser with those of bipolar radiofrequency techniques, in paediatric tonsillectomy.Study design:Prospective, randomised, clinical study.Patients and methods:From July 2004 to April 2006, 80 patients aged between 10 and 15 years, with tonsillectomy planned for chronic tonsillitis, were included in the study. Children were prospectively randomised into two equal groups: potassium titanyl phosphate laser tonsillectomy and bipolar radiofrequency tonsillectomy. Operative time and intra-operative blood loss were recorded. Patients were scheduled for follow up during the first, second and fourth post-operative weeks. They were asked to record their pain and discomfort on a standardised visual analogue scale, from zero (no pain) to 10 (severe pain). Post-operative complications were also recorded and managed.Results:The potassium titanyl phosphate laser group showed a slightly longer operative time (mean 12 minutes) than the bipolar radiofrequency group (mean 10 minutes). Intra-operative blood loss was significantly less in the potassium titanyl phosphate laser group (mean 21 cm3) than in the bipolar radiofrequency group (mean 30 cm3). In the first week, post-operative pain scores were less in the potassium titanyl phosphate laser group than in the bipolar radiofrequency group (means 7.5 and 8.5, respectively). However, in the second week pain scores increased more in the potassium titanyl phosphate laser group than in the bipolar radiofrequency group (means 8.5 and 6, respectively). In the fourth week, both groups showed equal and nearly normal pain scores. No case of reactionary post-tonsillectomy haemorrhage was recorded in either group. Only one case of secondary post-tonsillectomy haemorrhage was recorded, in the potassium titanyl phosphate laser group (2.5 per cent), managed conservatively.Conclusion:Both the potassium titanyl phosphate and the bipolar radiofrequency techniques were safe and easy to use for tonsillectomy, with reduced operative time, blood loss and complication rates and better post-operative general patient condition. Potassium titanyl phosphate laser resulted in reduced operative bleeding and immediate post-operative pain, compared with the bipolar radiofrequency technique. However, potassium titanyl phosphate laser required slightly more operative time and caused more late post-operative pain than the bipolar radiofrequency technique. The low rate of recorded complications showed that both techniques cause little damage to the tonsillar bed during dissection, thus minimising complications.


2006 ◽  
Vol 121 (1) ◽  
pp. 19-24 ◽  
Author(s):  
M Z Naja ◽  
M El-Rajab ◽  
W Kabalan ◽  
M T Itani ◽  
K Kharma ◽  
...  

Background: Submucosal resection is accompanied by significant post-operative pain and discomfort. The aim of this randomized, double-blinded clinical trial was to study the efficacy of a local block anaesthetic, delivered after induction of general anaesthesia, in reducing post-operative pain.Methods: Patients aged 16 years and over who were scheduled for elective submucosal resection were randomly assigned to receive either standardized general anaesthesia, general anaesthesia with local anaesthetic infiltration or general anaesthesia with placebo infiltration. Haemodynamic stability, intra-operative blood loss, post-operative pain (over a seven day follow-up period), analgesics consumption, hospital stay, and the patient's and surgeon's levels of satisfaction were assessed.Results: We found significantly lower results for pack removal pain score, volume of intra-operative blood loss, number of patients suffering from headache, altered dental sensation or nasal pain, number of patients who consumed analgesics, and length of hospital stay, comparing the infiltration group with the general anaesthesia and placebo groups (p<0.05).Conclusion: This clinical trial showed that infiltration with the local anaesthetics fentanyl and clonidine substantially reduced post-operative pain and shortened patients' hospital stay.


2012 ◽  
Vol 126 (11) ◽  
pp. 1142-1149 ◽  
Author(s):  
S J Frampton ◽  
M J A Ward ◽  
V S Sunkaraneni ◽  
H Ismail-Koch ◽  
Z A Sheppard ◽  
...  

AbstractObjective:This trial aimed to compare the guillotine technique of tonsillectomy with ‘cold steel’ dissection, the current ‘gold standard’.Design:A single centre, randomised, controlled trial.Methods:One hundred children aged 3 to 11 years who were listed for bilateral tonsillectomy were recruited. Patients had one tonsil removed by each technique, and were blinded to the side. The operative time, intra-operative blood loss, haemostasis requirement and post-operative pain scores were recorded and compared.Results:Operative time and intra-operative blood loss were both significantly less for the guillotine technique (p < 0.001) and there was a significantly reduced haemostasis requirement (p < 0.001). Pain was also less on the guillotine side (p < 0.001). There were no tonsillar remnants or palatal trauma for either technique. There was no significant difference between techniques in the frequency of secondary haemorrhage.Conclusion:This study provides level Ib evidence that guillotine tonsillectomy in children with mobile tonsils is an effective and time-efficient procedure which produces less intra-operative blood loss and post-operative pain than cold steel dissection.


2014 ◽  
Vol 2 (4) ◽  
pp. 175-180
Author(s):  
Deepak Regmi ◽  
Toran KC ◽  
Meera Bista ◽  
Sangita Shrestha

Background: The option for dissection and haemostasis during thyroid surgery include either the modern ultrasonic technology (Harmonic Focus™) or the conventional technique using knot and ties, monopolar or bipolar electrocautery. Comparison between the surgical outcomes of open hemithyroidectomy using these two modalities was done.Objective: To compare the surgical outcomes of ultrasonic technique using Harmonic Focus™ (HS) with Conventional technique (CT) in open hemithyoidectomy.Method: Twenty consecutive patients undergoing open hemithyroidectomy for benign solitary thyroid nodule of ≤ 3 cm were randomly assigned into two groups; group HS (n=10) and group CT (n=10). Analysis of surgical outcomes performed by these two techniques, particularly: operative time, intra-operative blood loss, post operative pain, incision size, complications and hospital stay were done.Results: The age, sex and pathologies were comparable in both the groups. For the group HS, mean operative time was (mean ± SD=55 ± 5 min) 15 minutes shorter than group CT (mean ± SD= 70 ± 10 min) (P<0.01). Mean operative blood loss was (mean ± SD=20 ±10 ml) 16 ml less in group HS than CT (mean ± SD= 36 ±12 ml) (P<0.01). The group HS experienced less post operative pain (mean ± SD=4 ± 0.94 VAS) than CT (mean ± SD= 7 ± 0.81 VAS) (P<0.001). The incision size at the time of skin closure was 1.6 cm shorter in group HS ((mean ± SD= 3.95 ±0.61 vs. 5.5 ± 0.78cm) (P<0.01). Hospital stay (mean ± SD= 2.30 ± 0.48 vs. 4.20 ±0.42 days) was statistically significant (P<0.01) in group HS than CT. There were no major complications.Conclusion: In patients undergoing open hemithyroidectomy, HS is a faster, better cosmetic, safe and less morbid tool than CT. Its use reduces operative time, blood loss, post operative pain, scar size, along with hospital stay.DOI: http://dx.doi.org/10.3126/jkmc.v2i4.11774  Journal of Kathmandu Medical CollegeVol. 2, No. 4, Issue 6, Oct.-Dec., 2013Page: 175-180


2020 ◽  
Vol 8 (5_suppl5) ◽  
pp. 2325967120S0008
Author(s):  
Sanjeev Patnaik

Background: Minimally invasive surgery has become a trend in the last decade in all aspects of Orthopaedic surgery, including Total Hip Replacement. The debates and the interest generated in MIS THR is considerable and several approaches have been advocated. The potential benefits include lower surgical morbidity, less pain and peri-operative blood loss, quicker rehabilitation, shorter in-patient stay and improved cosmesis. On the other hand, deficient peer-reviewed literature, a steep learning curve, increased rate of complications due to inadequate visualization, component mal-position, neurovascular injuries, dislocation and intra-operative fractures have drawn criticism. Objectives: To present the various surgical tips and tricks and early functional and radiological results of MIS THR by anterolateral approach. Study designs & Methods: The retrospective analysis of the records of patients undergoing Anterolateral MIS THR between January 2013 and January 2019 was the basis of this study. 72 hips of 70 patients were included in the study. The length of incision , duration of surgery, peri-operative blood loss, were studied. Functional assessment by Harris Hip Score, pain assessment by VAS score and radiological assessment for acetabular component and femoral stem positions were measured on plane X-rays. Data on preoperative and postoperative hemoglobin and hematocrit values, number of blood transfusions,time to ambulate as well as duration of hospital stay was studied. Results: We had no major complications in the form of mortality, fatal Pulmonary embolism , temporary femoral nerve neuropraxia was seen in 1 case, component mal-position in 3 cases , superficial infection 1 case and a non displaced proximal femoral fracture line was evident on the early postoperative X-ray of 1 case. Functional assessment by Harris Hip Score (HHS )improved from pre-operative 42 (range:26-46) to postoperative 95 (range:72-98) at 1 yr. Radiologic analysis was carried out at post-operative 6weeks, 3months,6months and 1year. Femoral stem varus alignment was seen in 3 cases, Average Acetabular cup abduction angle was 43degrees (range: 40-55 degrees). Average acetabular cup ante-version angle was 17 degrees (range: 12-25 degrees). Of the 72hips, 64 were within the Lewinnek safe zone. The average postoperative hemoglobin value was 9.7 g/dl ( range: 8.5-12.3g/dl) and the average postoperative hematocrit value was 29.8% (range: 28.1-30.6%). Conclusions: The MIS anterolateral approach allows adequate exposure for component placement, less perioperative blood loss and pain in immediate post-op period , earlier discharge from hospital along with early return to function , good cosmesis with better patient satisfaction.


Author(s):  
Harjinder Singh ◽  
Monika Jindal ◽  
Monika Gupta ◽  
S. P. S. Goraya ◽  
Manisha Behal ◽  
...  

Background: Hysterectomy is the 2nd most common surgical procedure performed in women and is associated with various complications like any other major surgical procedure. The objectives and aims of this study was to compare the effects of ligasure and conventional clamping and suturing in abdominal hysterectomy.Methods: A randomized controlled trial was performed by randomizing the patients in 2 groups - ligasure (A) and conventional hysterectomy (B). Operative time, no. of sutures, blood loss, hospital stay and cost factor to patient were studied as its main outcomes. A total of 100 patients were studied.Results: 66% of patients in group A had duration of surgery that was less than an hour in spite of associated co-morbidities. More no (76%) of patients in Group A had significantly less blood loss (<50 ml) as compared to 60% of patients in Group B. Only one suture was used in 80% of patients in Group A while in group B all of the patients required more than one suture from stumps to vault. There by reducing the cost of surgery.Conclusion: Apparently ligasure group seems to have less time for surgery and less blood loss and more intraoperative and postoperative complications, but to prove one ligasure group superior or inferior over conventional method we need to have more studies. But yes, Ligasure group reduces the cost of surgery to patient by reducing suture consumption as compared to conventional group. 


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