Objectives To report the outcomes in a series using modified tubularized incised plate (TIP) urethroplasty (Snodgrass) technique. The use of the TIP urethroplasty (Snodgrass) technique has gained wide acceptance among pediatric urologists for the correction of hypospadias repair because of its good cosmesis, low complication rate, and reliability in creating a vertically oriented meatus. Methods A total of 54 boys aged 2 -13 years admitted in paediatric surgery ward, RMCH, with Glanular (5.5%), Coronal (18.5%), Subcoronal (35.18%), Distal penile (11.1%), midpenile (9.6%) hypospadias underwent one-stage repair using a modified TIP repair during January,2010 to December,2010 were included in the study. Outcome was reviewed for each patient to determine the complications, reoperations, cosmesis, and functional results after surgery.   Results With at least 6 months of follow-up, all patients had achieved excellent functional and cosmetic results, with the meatus at the tip of the penis on follow-up. Three repairs for meatal stenosis and two for fistula were needed. Conclusions The modified TIP procedure is a safe and reliable technique. It provides excellent cosmesis with a low reoperation rate. TAJ 2010; 23(1): 26-32

Background: Neonatal surgery (NS) is an extremely challenging leading edge of pediatric surgery. In our country NS death were 8% due to treatable congenital anomalies. The objectives of study were to observe yearly admission of NS patients, age of presentation, anthropometric records, prenatal record and types of congenital anomalies, and mortality of treated neonates. Materials and Methods: This cross-sectional study was conducted on 337 admitted neonates to assess the state of 70 consecutive NS patients admitted in the Pediatric Surgery ward. Birth weight was compared with randomly selected and sex matched 154 were neonatology neonates (NN), and 113 delivered un-admitted healthy neonates of the labor-ward (LN). The variables observed were number of neonatal surgical patients admitted, age of presentation, birth and admission weight, prenatal ultrasonogram for fetal anomalies and the types of anomalies, outcome (mortality) of neonatal surgery. Results: The mean age of surgical neonates at the time of admission was 5.7 ± 6.39 (1-25) days. Mean birth weight of surgical and neonatology neonates was 2.66 ± 0.76 (1.5-4.5) kg and 2.24 ± 0.71 (0.9-4) kg respectively. The difference was significant (p < 0.01). The mean admission weight of the surgical and neonatology neonates were 2.57 ± 0.66 (1.4-4.1) kg and 2.25 ± 0.62 (0.8-4.1) kg respectively showing significant difference (p < 0.01). Ten percent of NS patients and 38.3% of NN patients had records of prenatal ultrasonogram, and their reports were normal fetus. The difference was significant (Z = 4.36). Eighty seven percent NS patients and 49% NNs were delivered at home and the difference was significant (Z = 4.49). Major surgical problem were anorectal malformation (48.6%) and neonatal intestinal obstruction (20%). The treatments given to the patient admitted in the pediatric surgery ward were emergency laparotomy with resection-anastomosis, ileostomy, and transverse loop colostomy in 29 (41.3%), anoplasty 21 (30%), incision and drainage of abscess 5 (7.1%), and conservative treatment 15 (21.43%). The mortality rate of neonatal surgical and neonatology patients was 12.9% and 13% respectively. Conclusion: The number of NS patients (work load) indicated the necessity of establishment of a NS unit which could be viable. The mortality of NS patients were due to low birth weight, and delivery at home causing transport delay from birth place to the pediatric surgery ward because of lack of prenatal awareness of presence of congenital anomalies. Anorectal malformation is the commonest congenital anomaly, followed by neonatal intestinal obstruction. Emergency laparotomy was the major surgical intervention offered. To improve the survival of the NS patients, prenatal diagnosis of the congenital anomaly, mandatory delivery at defined hospital, rapid transport of the surgical neonates born away from hospital, and establishment of a NS unit in tertiary level hospitals were indicated. Journal of Surgical Sciences (2020) Vol. 24 (1) : 26-31

Laparoscopic appendectomy considered as superior alternative to open appendectomy. Usual laparoscopic appendectomy is performed with the three port system. In this study, we performed a unique single transumblical incision two-port laparoscopic assisted appendectomy with the aim to reduce postoperative port site complication as well as improving cosmesis and patients satisfaction. From January 2010, 32 patients were admitted with clinically diagnosed acute appendicitis and were randomly assigned to single transumblical incision two-port laparoscopic assisted appendectomy. Transumblical single incision two-port laparoscopic assisted appendectomy was attempted in all patients (9 males and 23 females) with an average age of 9.2 years. Transumblical single incision two-port laparoscopic assisted appendectomy was successfully completed in 31 patients. In one patient, another additional port required due to severe adhesion of the appendix. Mean operation time was 25.2 minutes (range, 17-38), and mean postoperative hospital stay was 1.Sdays (range 1-2). Postoperative complications (local pericaecal abscess) occurred in one case that was treated conservatively. Transumblical single incision two-port laparoscopic assisted appendectomy appears to be a feasible and safe technique for the treatment of acute appendicitis in the paediatric setting. It allows nearly scar less abdominal surgery. The true benefit of the technique should be assessed by randomized controlled trials.TAJ 2009; 22(1): 289-294

Intussusception in the pediatric age group is usually idiopathic in origin, and in a small number of patients ranging from 2% to 12%, a pathological lesion as a leading point is identifiable. Of the variety of pathologcial lesions identified as leading points for intussusception, Meckel’s diverticulum is the most common but very rarely, isolated heterotopic pancreas is found within it.This is a case report of intussusception in an infant caused by an isolated heterotopic pancreas of the Meckel’s diverticulum. The literature on the subject is also reviewed. TAJ 2011; 24(1): 16-20

A 4 years old female and 1.5 months old male with classical exstrophy and a 2 days old male child with cloacal exstrophy were admitted in Paediatric Surgery Department of Sher-e-Bangla Medical College Hospital (SBMCH), Barisal. The mothers of all children had complaints of protrusion of fleshy mass in lower abdomen from birth. They always remain wet producing smell of urine.The cloacal exstrophy case had a prolapsed ileum that was discharging stool. He had no anus too.All of the cases underwent one stage closure of urinary bladder and urethra and lower abdomen without osteotomy and patient was discharged. After 8 months of first operation the female patient underwent repair of the wound dehiscence. At the time of discharge her urinary bladder capacity was 10 ml and remained dry for 5 minute after manual evacuation. The male patient with classical exstrophy developed urethrocutaneous fistula on 15 th post-operative day. The cloacal exstrophy case was discharged with end ileostomy on 10th post-operative day.