Frequency of Port Site Wound Infection with and Without End Gloves Techniques of Retrieval of Gallbladder in Pouch

Background: The gallbladder is a hollow organ that sits just beneath the right lobe of the liver. Chief functioning of gallbladder is to store gall, also known as bile that is required for digestion of food. Removing gallbladder through small incision in the abdomen is called laparoscopic cholecystectomy. Among benefits of cholecystectomy are decreased need for postoperative analgesia, decreased postoperative pain and shortened hospital stay from 1 week to less than 24 hours. Objective: To compare the frequency of port site wound infection with and without endogloves techniques of retrieval of gallbladder in pouch after laparoscopic cholecystectomy for chronic calculus cholecystitis. Design: It was a randomized controlled trial. Study Settings: This study was conducted at Department of General Surgery, Midland Doctors Medical Institute Tandali Muzaffarabad from July 2019 to July 2021 Material and Methods: A total of 260 cases who fulfilled inclusion criteria were enrolled in the study through wards of Department of General Surgery. Written informed consent was obtained from all the patients. Two groups were made by random division of patients. Conventional laparoscopic cholecystectomy was performed in patients of group I. Through umbilical port gall-bladder was retrieved in these patients, exactly spot on by a sterile surgical hand glove endobag. Vicryl “O” with J-shaped needle was used to close 10mm umbilical port (fascial defect) and 5mm ports were conventionally closed. In patients of group II, conventional laparoscopic cholecystectomy was performed and gall-bladder was retrieved as in patients of group I but without using surgical sterile hand glove endobag. Results: The mean age of the patients in study group was 48.09±15.402 years and in control group it was 47.51±16.48 years. Male to female ratio was 1.06:1. The post-op wound infection was found in 11 (4.23%) patients. Statistically significant difference was found in groups (P<0.05). Conclusion: The use of endoglove technique of retrieval of gallbladder in pouch after laparoscopic cholecystectomy for chronic calculus cholecystitis is safe, cheap, simple and potentially reduces significant port site wound infection compared to without endogloves. Keywords: Laparoscopic Cholecystectomy, Endoglove, Gallbladder (GB).

Comparing Urinary and Sexual Complications of Robot-Assisted Radical Prostatectomy and Laparoscopic Radical Prostatectomy in Prostate Cancer: a Systematic Review and Meta-Analysis Protocol

Review question / Objective: The aims of this study are: 1. To compare urinary complications of robot-assisted radical prostatectomy(RARP) and laparoscopic radical prostatectomy(LRP) in patients with prostate cancer; 2. To compare sexual complications of RARP and LRP in patients with prostate cancer. Condition being studied: Prostate cancer is one of the most prevalent types of cancer; according to 2018 statistics, prostate cancer was responsible for 7.1% of all cancer in men. The primary intervention in such patients is radical prostatectomy surgery (RP), which could be performed in different methods in patients that cancer has not spread beyond the prostate gland or has not spread much. One of the most common types of RP is laparoscopic radical prostatectomy. There are several techniques for performing RP; two are Conventional Laparoscopic Radical Prostatectomy (LRP) and Robot-Assisted Radical Prostatectomy (RARP). Sexual and urinary difficulties can occur in prostate cancer patients due to cancer itself or the treatment. Like any treatment option and surgery, radical prostatectomy can carry risks, like urinary(e.g., incontinency) and sexual complications(e.g., Impotence). In this review, we compared urinary and sexual complications of LRP and RARP.

Laparoendoscopic single-site compared with conventional laparoscopic surgery for gynaecological acute abdomen in pregnant women

Objective To estimate the safety and feasibility of laparoendoscopic single-site surgery (LESS) in pregnant patients with acute abdomen. Methods Baseline characteristics, surgical results, and obstetric and neonatal outcomes were retrospectively compared between single and multiport procedures in patients who underwent laparoscopic surgery during pregnancy between 2017 and 2021. Results Fifty-four pregnant patients were included: 26 who underwent LESS (salpingectomy, 11 cases/cystectomy, 15 cases) and 28 who underwent conventional laparoscopic surgeries (salpingectomy, 12 cases/cystectomy, 16 cases) during pregnancy. One patient in the single-port group required additional ports. No patients converted to laparotomy. In patients undergoing salpingectomy, the single-port group showed lower 8- and 24-h postoperative pain scores, shorter hospital stays, and lower Self-rating Anxiety Scale scores prior to discharge versus conventional laparoscopy. One patient experienced postoperative vaginal bleeding and a missed abortion during follow-up. In patients receiving cystectomy, 8- and 24-h pain scores, postoperative hospital stay, and anxiety scores were lower in the single-port versus multiport group. Other outcomes were comparable between the groups. Conclusion The feasibility and efficacy of laparoscopic surgery during pregnancy is similar between single- or multiport routes, however, the single-port route may be associated with less postoperative pain, shorter hospital stay, and lower anxiety.