Background: Laparoscopic surgery is dominating in the field of hernia. The search for the ideal prosthetic biomaterial has been a longstanding issue with debate over simple versus composite biomaterial and lightweight versus heavyweight meshes. This study was done to evaluate the early outcome of lightweight mesh in laparoscopic totally extraperitoneal (TEP) repair.Methods: This prospective observational study was done for a period of 16 months. On the basis of selection criteria patient underwent laparoscopic TEP repair using light weight mesh, early outcomes were evaluated in terms of immediate postoperative pain (analysed via visual analog scale) and chronic groin pain (analysed by visual analogue scale and graded according to Cunningham), patients were also evaluated for operation time, intraoperative bleeding, seroma, stiffness or numbness around groin, or any other complications.Results: There was no intraoperative bleeding among any of the patients. Immediate post-operative pain assessed by visual analogue scale 20% scored one in the visual analogue scale in post-operative day 1. None of the patients were having any complications (like stiffness or numbness in groin or thigh and any other complication) during post-surgery follow up. Only one patient reported mild chronic groin pain at the end of 3 months after surgery.Conclusions: The short term results of laparoscopic TEP repair for inguinal hernia using light weight mesh are quite encouraging. We can conclude that light weigh mesh is fulfilling important role in successful hernia repair as it is associated with very less morbidity.

Objective: To determine the prevalence of Intestinal Tuberculosis in cases of Acute abdomen. Design & Duration: A randomized prospective study from August 2019 to July 2020. Setting: Department of Surgery, VMMC & Safdarjung Hospital, New Delhi. Patients: A total number of 200 patients with Acute Abdomen, who presented as intestinal obstruction or peritonitis. Methodology: Detailed data of each patient including presentation, operative findings, procedure performed, post operative outcome and histopathology was entered on a specially designed proforma, compiled and analyzed. Results: Among the 200 patients with acute abdomen, 32 (16%) had Intestinal Tuberculosis on the basis of operative findings and histopatholoigcal reports. Age of the patients ranged between 15 to 65 years; majority (75%) were in the age group of 20 to 40 years. Male to female ratio was 1:0.45. Twelve (37.5%) patients had evidence of Pulmonary Tuberculosis as well on X-ray chest. The commonest operative findings were hyperplastic ileocaecal tuberculosis (34.3%), followed by strictures (25%), and perforations (25%). The overall mortality in cases of acute abdomen was 6% and among tubercular patients 9.3%. Conclusion: Intestinal Tuberculosis is a common problem presenting to general surgical units in the developing countries, often in an acute form. A high index of suspicion, proper evaluation and therapeutic trial in suspected patients is essential for an early diagnosis, in order to minimize complications.

Background: Ileal perforations are a common occurrence in our hospital setup with a majority of cases having an etiology of typhoid. The presentation and management of ileal perforation with special reference to typhoid, nonspecific and traumatic perforations and the outcomes in these patients and the factors affecting prognosis are important. Aims and objectives of the study were to study the management of Ileal perforation. To compare the outcome of two different types of treatment for Ileal perforation i.e. Primary Closure (vs) Resection and Ileostomy. Methods: This is a randomized comparative observational study conducted in Surgery Department of VMMC & Safdarjung Hospital, New Delhi between October 2019 to July 2020. A Minimum of 28 patients was included in the study. Diagnosis was made on the basis of the X-ray erect abdomen, ultrasound abdomen, Widal test and intra-operative findings. Results: The common age groups affected was 41-50 years age group (5 patients) and 61-70 years age groups (5 patients). The least affected were 1-10years age group (one patient). The incidence in males was slightly greater than females. Male to female ratio was 2.5:1. Typhoid perforation is the most common case of ileal perforation followed by non-specific perforation. Post-operative complications are more in the primary closure group with 32.14% (9 patients) which is lower when compared to ileostomy group 17.85% (5 patients). Complications of primary closure were wound infection (2 patients), burst abdomen (3 patients), faecal fistula (1 patient), respiratory complications (3 patients). Complications in ileostomy group were wound infection (4 patients) and respiratory complications (one patient). Conclusions: Mortality was more in primary closure group with 21.42% (6 patients) and mortality was less in ileostomy group with 7.14% (2 patients). This study proposes that ileostomy may be given priority over other surgical options in moribund patients.