Background: Although sleeve gastrectomy provides a technically simple procedure with minimal effect on digestive tract it deprives the stomach of its ligaments of fixation which results in impairment of gastric functions, vomiting, axial gastric rotation in addition to bleeding or leakage from the stable line. Objective of present study is the effect of stable line fixation during sleeve gastrectomy.Methods: This is a prospective randomized study using closed envelop method carried on 100 patients with morbid obesity who underwent laparoscopic sleeve gastrectomy (LSG) they were divided into two groups each is 50 patient group A underwent classic (LSG) with no fixation and group (B) with staple line fixation.Results: Patients were 68 females and 32 males with a mean age of 32.2±5.7 years, mean (BMI) 48.9±8.6kg/m2. postoperative vomiting, gastric axial rotation, impaired gastric emptying all were significantly higher in group A. Although both staple line bleeding and leakage were higher in the group A, but it was not statistically significant. Also, the operative time was shorter in the group A, but it was not significant.Conclusions: staple line fixation should be a step during sleeve gastrectomy as it regains the stomach its ligaments of fixation anatomically and so functions better less vomiting, less gastric axial rotation, better gastric emptying in addition to decreasing staple line bleeding and leakage with minimal effect on operative time.

Background: Para-umbilical hernioplasty is mostly safe but there are possible complications like seroma, wound infection and recurrence. Tranexamic acid is a synthetic derivative of the amino acid lysine that exerts an anti-fibrinolytic action through the reversible blockade of lysine binding sites on plasminogen molecules, used in the prevention and treatment of excessive bleeding both in primary and secondary care. Our study aimed to evaluate the effect of intravenous tranexamic acid injection on reduction of seroma after para-umbilical hernioplasty.Methods: We conduct a prospective controlled trial to compare the effect of intra-operative, intravenous single dose of tranexamic acid by a dose of 10 mg/kg body weight with induction of anaesthesia on the occurrence of local wound complications as seroma, wound infection in addition to time of drain removal and the amounts of drain output, by comparison between two groups.Results: Single intravenous dose of tranexamic acid with induction of anathesia reduced drain duration (P-value was 0.001), drain output in 1st day (P-value was 0.008), and drain output in 5th  day (P-value was 0.036). Adverse effects were not observed.There were no significant difference in occurence of seroma (P-value was 0.429), and wound infection (P-value was 1.00).Conclusions: Our study revealed that tranexamic acid showed significant correlation with decrease duration of drains and fewer amounts of drain volumes in first day post-operative.

Introduction: Seroma is the commonest complication of breast cancer surgery, and although its consequences most often cause no more than discomfort and anxiety, more important sequelae include flap necrosis and wound dehiscence. Seroma management can be difficult and frustrating for both the patient and surgeon. Numerous methods to reduce post-mastectomy seroma formation have been tried with no consistent success. Methods: Sixty patients were prepared for modified radical mastectomy. Of those, the study group contains 30 patients and the control group contains 30 patients. Study group had axillary space obliteration while the other had the conventional procedure; total drain outputs were recorded daily for all patients prior to drain removal. The drains were removed when the daily drainage was less than 30 ml. Results: This study contains 60 patients, and the study group contains 30 patients, and the control group contains 30 patients. Age, tumor size, No. of positive lymph nodes were of no significant differences to be more concise on the effect of axillary space obliteration. The mean of day of drain removal in the control group was 13.2 ± 1.0 days (9 -18 days) with a mean of total drain output of (4700 ± 90.3 ml) (3722 -4930) while the mean in the study group of day of drain removal was 7.1 ± 1.3 days (6 -12) with a mean of total drain output of 1530 ± 422 ml (range 600 -2100 ml) p < 0.001. Conclusion: Obliteration of axillary space is a valuable procedure that significantly decreases seroma after mastectomy and axillary dissection.

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Background: Intracapsular total thyroidectomy is a rising new technique in management of benign thyroid disease seeking for safety. Our aim in this study is to evaluate safety and effectiveness of intracapsular technique in treatment of benign thyroid disease.Methods: this prospective study was carried out in department of general surgery, Menoufia University hospital and department of general surgery, Tala central hospital; from June 2018 to April 2019 on 58 patients with benign thyroid disease all had undergone intracapsular total thyroidectomy.Results: 58 patients underwent intracapsular total thyroidectomy. There was no recurrent laryngeal nerve injury either transient or permanent and no external laryngeal nerve injury. There was no parathyroid injury or hypoparathyriod complications.Conclusions: Intracapsular total thyroidectomy is a safe method in treatment of benign thyroid disease and can be done easily in central hospitals and non-highly specialized centres.