Aim:Aim of this study is to evaluate the results of Subfascial Endoscopic Perforator Surgery(SEPS) in treating varicose veins in 2nd trimester of pregnancy for below knee perforator incompetence.Materials and Methods:A case series was undertaken at our institute from the period January 2010 to January 2014 on 45 pregnant women. Pregnant women with failed conservative management for varicose veins were subjected to SEPS in 2nd trimester Perioperative parameters like operative time, intraoperative complications, post-operative complications, hospital stay, pain relief, ulcer healing duration and recurrence rate were studied. All the patients were reviewed and followed up for a minimum period of 3 years.Results:During the study period.total of 45 pregnant women were enrolled in the study. The median age of the patients was 26 years (range 22 years - 30 years). The mean operative time was 90±10 minutes. The post-operative hospital stay was 1-2days. There were no intraoperative complications like bleeding or gas embolism. There were no post-operative complications like seroma or abscess, port site infection, deep vein thrombosis and gas embolism. Mean healing duration of ulcers following surgery was 7-8 weeks. No patient complained of temporary or permanent paraesthesia. Every patient was subjected to follow up for a minimum period of 3 years. 5(11.1%) patients with recurrence were documented in the study.Conclusion:SEPS is a safe, cost effective and novel minimal invasive procedure in treatment of varicose veins in 2nd trimester of pregnancy for below knee perforator incompetence.

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Background: Laparoscopic right hemicolectomy for the right-side colon cancer is well-established and proven to be better than the open approach in terms of post-operative and overall hospital stay. Laparoscopic right hemicolectomy can be done by lateral to medial approach (LA), medial to lateral approach (MA), or tunnel/IRETA approach (TA). No previous study has been conducted to compare the clinical outcomes of all three approaches and the superiority of one approach over the other is still debatable. Aims and Objectives: This retrospective study was conducted to compare all three approaches and to find the ideal one to practice. Materials and Methods: This is a retrospective cohort study carried out to analyze 86 patients who were admitted to the department of General Surgery from March 2015 to December 2021 with a diagnosis of the right-side colon cancer and underwent laparoscopic right hemicolectomy with either of these three approaches. A total of 29 patients had operated with lateral to medial approach (LA), 29 patients with medial approach (MA), and 28 with tunnel (TA) approach. The patient’s baseline demographics, perioperative parameters, and post-operative outcomes were compared. Results: Intraoperative blood loss was significantly lower in the medial to lateral approach and tunnel approach. Duration of surgery was less in the medial to lateral approach as compared to the other two approaches and was statistically significant. R0 resection, lymph node dissection, intraoperative and post-operative complications, morbidity, mortality, and conversion to open were similar in all three groups. Conclusion: Laparoscopic medial to lateral to medial to lateral approach is feasible and safe and should be preferred approaches in laparoscopic right hemicolectomy.

BACKGROUND: Primary Lumbar hernias are rare posterolateral abdominal wall defect. Rarity of disease and by virtue of its location there is no standard consensus for surgical options and traditionally it is approached through open repair. Therefore, we report a series of 10 patients from two institutions who underwent successful Laparoscopic mesh repair of Lumbar hernias with technical description of surgery. AllSTUDY DESIGN: patients with primary lumbar hernias total number of 10 who presented to two institute over a period of 12 years (Feb 2010 to April 2022) and underwent Laparoscopic mesh repair were included in the study. Data collected regarding intraoperative and postoperative course with 2-24 months postoperative follow up were reviewed retrospectively. All of the 10 patients underwent Laparoscopic repair withRESULTS: polypropylene mesh placement over the defect in retroperitoneal space without the primary closure of defect. All patients had uneventful intraoperative and postoperative course with average length of hospital stay of 1.3 days. No complications were reported and there was no recurrence during follow up for 2-24 months. Lumbar hernia being a rare entity, there is lack of sufcient data precludes aCONCLUSION: standardized approach. On the basis of data from our case series of 10 patients we believe Laparoscopic mesh repair for primary lumbar hernia is the best available treatment option considering it safe, effective, gives intraoperatively better visualization of anatomy even at difcult retroperitoneal space and uneventful postoperative course with decreased hospital stay and no recurrences in follow-up.

An ectopic pregnancy is one in which the fertilised ovum is implanted and develop outside normal endometrial cavity. The most common localisation is tubal. We present the case of a patient found to have a cornual pregnancy diagnosed at 27 weeks of gestation.