The objective of this study is to determine the frequency of umbilicus port site hernia after laparoscopic procedure. Study Design: Prospective study. Setting: Minimal Invasive Surgical Centre and General Surgery Department LUMHS Jamshoro. Period: March 2015 to February 2017. Materials and Methods: During these two years all the patients visiting surgery department for laparoscopic Procedure. All patients regardless of age and both were undergo base line investigation and preoperative anesthetics fitness done were included. We identified 539 cases that matched our inclusion criteria. 10mm trocar was used for umbilical side and closed with J shaped vicryl #1. After surgery, these patients were followed-up for two years and assessed regularly for complications. Results: In our setup, laparoscopic procedures were performed in 539 patients. There were 83.48% (n=450) females and 16.51% (n=89) males who had laparoscopic procedures done. Among these, there were 442 cholecystectomies, 43 appendicectomies and 54 diagnostic laparoscopies. The highest number of patients visiting for laparoscopic cholecystectomies belong to the age range of 31-40 years. In 82% of the cases laparoscopic cholecystectomy was performed while in other cases laparoscopic appendicectomy and diagnostic laparoscopy was performed. After long term follow-up of these patients for a time period of two years, port site hernia was reported in 1.48% (n=8) patients. Conclusion: Port site hernia is a troublesome complication of laparoscopic procedures, although has much lesser rate than conventional procedures. Factors predisposing to development of port site hernia needs to be identified in all patients and steps should be taken to avoid complications. Large size and bladed trocars should not be used, and fascia closure is recommended at umbilical insertion site.

Objectives: The objective of this study is to determine the frequency of post-operative complications of thyroidectomy. Study Design: Observational study. Setting: LUMHS Jamshoro at the Surgery Department. Period: January 2016 to December 2017. Material and Method: During these two years all the patients visiting surgery department with thyroid swelling were assessed. Assessment of thyroid swelling was done by detailed history and clinical examination. For further assessment of the swelling thyroid function tests (serum T3, T4, TSH level), ultrasound, isotope scanning and FNAC was performed.  Assessed post-operative complications of thyroidectomy. Results: After assessment thyroidectomy was performed in 143 patients. Among them there were 37 males and 106 females. The ages of patients were in the range of 15-55 years and mean age was found to be 38 years. All of these patients have visited us due to complain of thyroid swelling. After complete assessment it was found that most commonly diagnosed thyroid swelling was multinodular goitre (51.04%). On ultrasound findings 60% of patients showed solid consistency whereas cystic and mixed were found in less patients. Post-operative complications were found in 61 patients (42.6%). Hypocalcaemia was the most frequent complication found in 14.68% of patients. Conclusion: Thyroidectomy is a commonly performed procedure in endocrine surgery with low morbidity and mortality. Despite improvements in surgical techniques and anaesthetic equipment, the rate of complications in thyroidectomy is constant. Post-operative measurement of calcium levels in susceptible patients can prevent tetany and emergency room admissions.

Objective: To determine the outcome of endoscopic pilonidal sinus treatment (EPSIT): Is a new minimally invasive treatment in pilonidal sinus. Study Design: This is a observational study. Setting: Study carried out at General Surgery department, Liaquat University of Medical and Health Sciences Jamshoro, form March 2020 to Feb 2021. Materials and Methods:  Patients aged between 20-40 years, both gender having sinus in the cleft of the buttocks on clinical examination with associated symptoms like pain when sitting or standing, reddened, sore skin around the area, pus or blood draining from sinus, hair protruding from the lesion and formation of more than one sinus tract, or holes in the skin were included in this study. Patients with abscess and recurrent pilonidal sinus were excluded. Outcome measurements were postoperative pain, return to normal daily activities and complication rates including infection, recurrence. Results: 44 patients with Pilonidal Sinus were included in this study.  15 to 40 years with mean age ± SD (range) was 26.56±4.1 years. 40(90.90%) were male where as 4(9.09%) were females. Mostly patients have single external openings in 37(84.09%) patients with midline opening location in 26(59.09%) patients. The mean operative time±SD (range) was 21.09±3.62 minutes (15 to 45 min). According to the visual analog scale (VAS) score for postoperative pain assessment after 48 hours of surgery, 36 patients (81.81%) reported a VAS between 1 to 3, and 8(18.18%) reported a score between 4 to 6. Postoperative wound infection was seen in one case 2.27% while recurrence was observed in two cases 4.54%. The overall healing rate was 93.18%. The mean time to return to normal daily activities was 6.1±11 (range, 2–15) days.  Conclusion: To conclude that the EPSiT is safe, effective, simple, repeatable and very welcomed by the patients if explained correctly. We can say that EPSiT can be labeled as a day surgery, with fast post-operative recovery and early return to work.

Objective: To determine the outcome of video-assisted anal fistula treatment (VAAFT): A new minimally invasive treatment option for fistula in ano. Study Design: This is an observational study. Setting: Study carried out at General Surgery department, Liaquat University of Medical and Health Sciences Jamshoro, form January 2020 to June 2020. Material & Method: Inclusion criteria for this study were patients aged 18-60 years visiting the outpatient department with primary/recurrent fistula having symptoms. Among these individuals having anal fistula due to secondary causes like IBD, tuberculosis or any malignancy were not included in the study. VAAFT was performed by experience general surgeon and post-operative follow up was done till 1 years. Results: A total of 68 patients with fistula in ano were selected for video assisted anal fistula treatment (VAAFT) in our setup. It included 67.6% (n=46) males and 32.3% (n=22) females who agreed for the procedure. The mean age of patients were found to be 43+13 years. Post-operatively complete healing was observed in 75% (n=51) patients and 14.7% patients had persistent fistula after the procedure.  Conclusion: VAAFT is a minimally invasive surgical intervention implied to treat primary and recurrent anal fistulas, having lesser rates of recurrence and few post-operative complications. It should be implied over large scales for treatment of primary and recurrent anal fistula as it  carries the lowest rate of anal incontinence.