Persistent urachus is a rare congenital anomaly. Various types of remnants have been described including cyst, alternating sinus, patent urachus, diverticulum, and sinus. The most common presenting symptom of urachal sinus is umbilical discharge. Radical excision of the remnant, with or without a bladder cuff, is essential to prevent future malignant degeneration or recurrence of the remnant. Although open surgical excision has been the treatment of choice for many years, the laparoscopic approach has become an attractive alternative because of its association with less postoperative pain, better cosmesis, and rapid convalescence. Laparoscopic radical excision of a urachal sinus was performed in a 16-year-old female patient who presented with umbilical discharge.

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.

Background: Thyroid lobectomy is a common operative technique of management of benign solitary thyroid nodules in which drains are used routinely. Objective of this study to compare the outcome of thyroid lobectomies undergone with and without drains in patients of benign solitary thyroid nodules.Methods: A comparative cross-sectional research was completed on 98 patients of benign solitary thyroid nodules at surgery department of Liaquat University Hospital Jamshoro. Patients having age of 18-60 years underwent thyroid lobectomies were included and distributed in two groups A and B. Group A includes thyroid lobectomies with drain and Group B without drain. Postoperative outcomes including pain score assessed via visual analog score (VAS), hospital stay and complications including wound infection, seroma and hematoma.Results: Out of 98 cases, 49 underwent thyroid lobectomy with drain and 49 without a drain. Females patients were in majority in group A 42 (85.7%) and also in group B 47 (95.9%). No significant difference (p-value=0.674) was in mean age of group A 30.8±10.2 years and group B 31.8±12.2 years. Higher mean with significant difference (p-value=0.001) was in pain score of group A 5.61±1.25 as compared to group B 3.55±0.70. No significant difference was in complications; seroma 1 (2.04%) vs 5 (10.20%), hematoma 1 (2.04%) vs 1 (2.04%) and infection 3 (6.12%) vs 0 (0.0%) in group A and B respectively. Higher mean with significant difference (p-value=0.001) was in hospital stay of group A 2.40±1.57 days as compared to group B 1.42±0.54 days. No significant difference (p-value=0.748) was in overall rate of complications in group A 5 (10.20%) and B 6 (12.24%).Conclusions: Thyroid lobectomy with drain is not effective in lowering the postoperative complications whereas enhanced the risk of postoperative pain, wound infection and duration of hospital stay as compared to thyroid lobectomy without a drain.

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.