to study the outcome of Limberg flap reconstruction in pilonidal sinus disease. STUDY DESIGN: Prospective study. MATERIALS AND METHODS: 32 patients with pilonidal sinus disease underwent rhomboid excision with Limberg flap. Duration of operation, postoperative pain, duration of hospital stay and postoperative complications were noted. Follow up of all patients was performed on an outpatient basis. RESULTS: There were 30 males (93.75%) and 2 females (6.25%), with a mean age of 28 years. The mean duration of symptoms was 6 months. Mean operative time was about 45 minutes. Mean pain score (VAS scale), was 3.65. The mean length of hospital stay was 4 days and most patients returned to work within 3 weeks. Three patients presented with post-operative complications of which one patient had recurrence (3%). CONCLUSION: Limberg flap technique is an effective procedure for pilonidal sinus disease associated with fewer complications and an easily mastered technique.
BACKGROUND:Inguinal hernia still remains a significant clinical problem despite the availability of variety of surgical techniques. This study was designed to evaluate the outcome and benefit of open preperitoneal mesh repair. OBJECTIVE: To evaluate the open preperitoneal mesh repair technique regarding complications, recurrences, safety and benefit. PATIENTS AND METHODS: Between July 2013 and June 2014, a prospective study of 25 consecutive patients operated for groin hernia using an open preperitoneal mesh technique was performed. The outcome variables being analyzed included operative time, time to return to normal activity, pain level, complications and recurrence rate. RESULTS: Wound infection occurred in only 1 patient. No seroma or recurrence was observed. Moreover, pain and hospital stay were not different from those obtained by other repair techniques. CONCLUSIONS: Open preperitoneal mesh repair is a safe procedure and gives a good result similar to those of the commonly used anterior approaches. It is easier to learn than laparoscopic repair and should be the procedure of choice for difficult inguinal hernias.
BACKGROUND AND OBJECTIVES: Choledocholithiasis complicates the working and management of cholelithiasis necessitating additional diagnostic procedures, increasing morbidity and mortality. CBD stone generally remain asymptomatic but when symptoms start appearing, cause a lot of suffering. There are various treatment modalities available presently. The objective of our study was to study the incidence, various modes of clinical presentations and different modalities of treatment in common bile duct stones. MATERIALS AND METHODS: 35 Patients were prospectively studied from July 2012 to June 2014 as in-patients in Victoria Hospital. RESULTS: CBD stones occurred predominantly in elderly females and presented from subclinical jaundice to complications in the form of biliary pancreatitis and cholangitis. USG abdomen with LFT was able to diagnose majority of the CBD stones preoperatively. Per operative cholangiogram was used selectively in case USG was inconclusive, ERCP was used in patients presenting with severe obstructive jaundice, pancreatitis, cholangitis, minimal CBD ductal dilation. Open exploration was the main focus with a wide variety of procedures performed according to specific indications. CONCLUSION: CBD was more common in elderly female patients probably due to neglected gall bladder stones. CBD stones can occur from occult asymptomatic stones only with altered LFT to symptomatic presentation in the form of cholangitis, pancreatitis. USG abdomen was inexpensive and easily available imaging modality to diagnose CBD stones with per operative cholangiogram being needed in minority of the cases. While ERCP was good in treating complications of CBD stones and early stages of the disease; the more advanced stage of the disease with gross CBD ductal dilation and multiple stones open CBD exploration were more productive.
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