Sigmoid volvulus is the most common type of colonic volvulus and occurs when a portion or whole of the sigmoid colon twists around its blood supply. In sigmoid volvulus, this occurs at the base of the mesentery. Sigmoid volvulus often recurs and it is controversial whether preventive surgery should be performed in recurrent cases, especially in elderly and high-risk cases. Herein, we report the case of an 83 year old man with Parkinson’s disease who presented with acute sigmoid volvulus and was successfully treated with laparoscopic sigmoidopexy i.e. fixation of the untwisted colon to the abdominal wall. Laparoscopic sigmoidopexy may be an acceptable treatment for acute sigmoid volvulus in patients unwilling to undergo definitive resection with colostomy.
Femoral hernia is one of the rare types of groin hernia. Though classical clinical examination findings for its accurate diagnosis are well documented, it very often gets mistaken for the much commoner inguinal hernia. Traditionally, it has been surgically repaired by open approach. However, the advent of laparoscopy has brought femoral hernia repair under its purview. The purpose of this study is to evaluate the incidence of femoral hernia in our series and outcomes of its laparoscopic repair. We retrospectively evaluated the prospectively collected data of all the 796 patients who had undergone laparoscopic repair for groin hernias, performed by a single surgeon at our institution, over 15 years (from 2007 to 2022). There were 7 patients of femoral hernia in our series. All were diagnosed ‘on table’, while operating purportedly for inguinal hernia. Three out of these seven patients had occult femoral hernia. Femoral hernia is a rare entity and is often not accurately diagnosed pre-operatively. Its laparoscopic management is feasible, effective, and safe.
Pelvi-ureteric junction obstruction is not a rare clinical entity. It is indeed one of the common urological conditions presenting most commonly as hydronephrosis and pain. The most common etiology for patients suffering from acquired pelvi-ureteric junction obstruction is the presence of calculus/calculi. An aberrant renal vessel (now termed as Vascular bar) is one of the causes in adults which is often missed on pre-operative investigations and is detected intra-operatively. We present herein, a case report of a 28 years old female who came with complaints of loin pain since 2 to 3 months. The workup investigations revealed only hydronephrosis without any calculi. Thus a diagnosis of primary pelvi-ureteric junction obstruction was made. The patient was successfully managed by a laparoscopic pyeloplasty.
Keywords : PUJ obstruction, Vascular bar, aberrant renal vessel, laparoscopic pyeloplasty
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