Background: Access into the abdomen is the one challenge of laparoscopy that is particular to the insertion of surgical instruments through small incisions. In the last three decades, rapid advances in laparoscopic surgery have made it an invaluable part of general surgery, but there remains no clear consensus as an on optimal method of entry into the peritoneal cavity. The objective of this study was to study the comparison and efficacy between closed (veress needle)and open method (Hasson's) of intraperitoneal access to create pneumoperitoneum in laparoscopic surgeries. Methods: All patients >18 year undergoing laparoscopic procedure at Sir Sayajirao Gaekwad Hospital attached to Medical College Baroda from November 2015 to November 2016, and include 160 patients. This was Prospective study and total 160 cases of Laparoscopic surgery was taken in 1-year period. Methods used to create pneumoperitoneum were of surgeon's choice in each case. Cases were performed by one method more than other method (63 patients by veress needle and 97 by open method). Student t test (two tailed, independent) had been used to find the significance of study parameters on continuous scale between two groups. All data were entered in Microsoft Excel sheet. Data calculation was done in software -Microsoft Excel and Medcalc statistical software 16.8.4.0. Results: The Mean operative time for access in veress needle group was 5.12 mins as compare to open method where it was 3.94 mins. Port site Gas leakage was slightly more in open method. There were no any major complications occurred in any group. There were minor complications occur in both methods at access like; omental injury, port site gas leakage, extra-peritoneal insufflations, loss of space and entry in wrong plane.

Background: Diabetic foot ulcer is estimated to affect 15% of all diabetic individuals during their lifetime. Management requires a multisystem approach. Various techniques have been tried to treat chronic ulcers, but none was proved to be ideal.Methods: This is a prospective randomised comparative study, where 56 patients with diabetic foot ulcers admitted in dept of surgery SSG hospital, Baroda, india were divided into two comparable groups. Of which 28 underwent topical phenytoin dressings, remaining 28 underwent Betadine dressing (5% w/v povidone – iodine solution). The variables were compared after 14 days based on rate of granulation tissue formation as percentage of ulcer surface area, wound culture-sensitivity and duration of hospital stay. Chi square test was used to compare the data at each of the assessment point in both groups. Results: In Phenytoin group, the mean rate of healthy granulation tissue formation was 60.71%, and mean hospital stay was 23.96 days with negative culture sensitivity was 54%. The Betadine group showed, the mean rate of granulation tissue formation was 11%, and mean hospital stay was 35 days with negative culture sensitivity was 18%.Conclusions: Topical phenytoin dressing considered as superior and cost effective in management of diabetic ulcers.

Background: Laparoscopic inguinal hernia repair has been shown to be slightly superior to open approaches. The aim of study is to compare advantages and disadvantages between two methods of extra peritoneal access for TEP repair of inguinal hernia using conventional balloon device method and using Dulucq method.Methods: This is a prospective study. It was conducted from June 2014 to November 2016 at SSG Hospital Vadodara. Total 50 patients of inguinal hernia taken for laparoscopic TEP repair among them patients were divided in two groups by envelop method of randomization, in 25 patients extra peritoneal space was created by balloon method and in 25 patients extra peritoneal space was created by veress needle or Dulucq method.Results: The mean time taken for extra peritoneal space creation by balloon method was 13.12 minutes and the mean time taken for extra peritoneal space creation by veress needle method was 9.32 minutes. The mean total operative time required for TEP by balloon method was 66.7 minutes and that for, TEP with veress needle method was 53 minutes.Conclusions: Total time for extraperitoneal space creation by Dulucq method is less as compared to balloon method of extraperitoneal space creation in laparoscopic TEP repair of inguinal hernia.