Background: Laparoscopic inguinal hernia repair offers variety of advantages than the conventional repair. Therefore, laparoscopic transabdominal preperitoneal (TAPP) and totally extraperitoneal (TEP) techniques are frequently preferred. Single-incision laparoscopic surgery (SILS) was developed with the aim of reducing the invasiveness of conventional laparoscopy and has been successfully performed by many surgeons.Methods: This study was conducted on 25 patients over a period of one year from November 2011 to October 2012 in Department of General Surgery, Acharya Sri Chander College of Medical Sciences and Hospital, Sidhra, Jammu (ASCOMS), India with uncomplicated inguinal hernia which underwent single port laparoscopic TAPP (SPL-TAPP).Results: In this study, all the patients (100%) had unilateral inguinal hernia, among them 16 (64%) had direct and 9 (36%) had indirect inguinal hernia. Pediatric patients were excluded from study. The mean age, weight and height were 44.4, 59.46 and 157.2 cm respectively. Intraoperative data for SPL-TAPP had complications in 1 case (seroma formation) and need for conversion to conventional surgery was also seen in 1 case.Conclusions: Single port TAPP offers to be safe and efficacious with minimum re-occurrences and shorter hospital stay.
Rapunzel syndrome is a rare form of trichobezoar with accumulation of large amounts of hair extending from stomach to variable portion of small intestine. An 18 year old girl was brought to surgery opd with complaints of vomiting on and off since 3 months. Contrast enhanced computed tomography abdomen showed a bezoar extending from stomach into the duodenum and proximal jejunum suggestive of Rapunzel syndrome with 3rd and 4th part of duodenum along with duodenojejunal junction. On laparotomy, a trichobezoar occupying the entire stomach measured 100 cm in length and 700 grams in weight. Since the mass formed in Rapunzel syndrome is generally too large to be removed endoscopically or laparoscopically, it requires removal by open gastrostomy.
Introduction: Inguinal hernia repair is the most frequently performed surgical procedure worldwide. Advances in laparoscopic techniques have ushered an opportunity to improve and improvise many surgical procedures. Singleincision laparoscopic surgery (SILS) was developed with the aim of reducing the invasiveness of conventional laparoscopy, and has been successfully performed by many surgeons. Aim of the study was to asses the safety and feasibility of single por laparoscopic approach for inguinal hernia repair. Material and methods: This study was conducted on 50 patients presenting to Acharya sri chander college of Medical Sciences and Hospital, Sidhra, Jammu ASCOMS over a period of one year from November 2011 to October 2012 with uncomplicated inguinal hernia in whom 25 patients underwent single port laparoscopic TAPP(SPL-TAPP) hernia repair and 25 underwent conventional three port transabdominal preperitoneal hernia repair. Results: No significant differences were noted among patient demographics. The age group ranged from 20-60 years. The mean Age, weight and height in SPL-TAPP were 44.4, 59.46 and 157.2 cm respectively. Mean operative time, hospital stay in single port TAPP was significantly lower as compared to conventional surgery. Moreover postoperative complications were also lesser in SPL-TAPP with almost no reoccurances. Conclusion: Single port TAPP offers to be safe and efficacious with minimum reoccurances and shorter hospital stay
Background: Inguinal hernia repair is the most frequently performed operation in general surgery. The standard method for inguinal hernia repair had changed little over a hundred years.Methods: Present study was conducted on 60 patients having inguinal hernia and were operated by two different methods i.e. Lichtenstein tension free inguinal hernia repair (Group A) and laparoscopic hernia repair (Group B). Aim of the study conducted was to compare the various observations and complications in post-operative period.Results: There was no statistically significant difference in the age group, side and type of hernia in the two groups. Laparoscopic repair was a longer procedure than Lichtenstein inguinal hernia repair and it was statistically significant (p<0.05). Postoperatively urinary retention was the most common complication in Group A. Other complications were genital oedema (13.33%), haematoma (13.33%), seroma (13.33%) and wound infection (6.67%) which led to increased post-operative hospital stay. In Group B, pneumoscrotum was the most common complication. Other complications included subcutaneous emphysema (6.67%) and seroma (6.67%).Conclusions: Lichtenstein tension free inguinal hernia repair is safe, efficient and cheaper procedure with no extra equipment being required while Laparoscopic repair takes more time, laparoscopic equipment and training in minimal access surgery.
BACKGROUND Intestinal obstruction accounts for 15% of all patients presenting to emergency department with complaints of acute abdominal pain. Recognising obstruction early, aggressive preoperative treatment, skilled surgical techniques and intensive postoperative management improves outcome. We wanted to correlate the clinical findings with radiological and intra-operative findings in cases of intestinal obstruction. METHODS 50 cases of intestinal obstruction chosen by simple random technique, were studied in the department of general surgery at MMIMSR, Mullana, Ambala. Intraoperative findings were compared with x-ray, USG abdomen and CT abdomen findings. RESULTS Adhesions and bands (26%) were found to be the most common cause of intestinal obstruction. Most common finding on plain x-ray abdomen was the presence of dilated gut loops (82%). USG abdomen has limited diagnostic value in cases of intestinal obstruction with most common finding reported in USG abdomen being that of small bowel obstruction (62%). Out of 49 patients who underwent CT scan abdomen and surgery, CT findings matched with intraoperative in 45 patients (91.84%) and the most common finding was adhesions and bands (22.4%). CONCLUSIONS X-ray abdomen and USG abdomen have limitations and are diagnostic only in a handful of cases. CT abdomen provides much more elaborate information and helps the surgeon to understand the pathology. Preoperative CT also helps prevent laparotomies in scenarios where surgeon with preoperative knowledge can opt for laparoscopic approach, thereby reducing postoperative stay in the hospital and complication. So, understanding of the imaging modalities and knowing when to use them and what to look for can save precious time of the patient and also that of the surgeon allowing for early diagnosis and better plan of treatment.
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