Introduction Laparoscopic pyloromyotomy (LP) is becoming increasingly adopted in the management of patients with infantile hypertrophic pyloric stenosis (IHPS). We encountered few difficulties during the performance of laparoscopic pyloromyotomy initially so few modifications were done in the technique. We retrospectively analyzed and compared our patients who had undergone LP before the implementation of the modification with the patients operated after implementing the modifications. Materials and methods Retrospective analysis of the data of patients with IHPS operated in the Department of Pediatric Surgery; AIIMS Jodhpur from May 2016 to February 2019 was done. Medical records were reviewed for demographic data, physical findings, operative details, time to achieve full feeds, post-operative emesis, postoperative length of stay, complications, and follow-up. We compared our initial seven cases before the implementation of modification (cohort A) with the 11 cases after the implementation of these modifications (cohort B). Results The mean age and weight of the patients at the time of presentation was 44.2 days (range 30-120 days) and 3.25 kg (range 2-4.1 kg), respectively. The mean follow-up duration was 8 months. Both the cohorts were comparable in terms of mean age and weight at the time of presentation. The difference in duration of surgery, time to full feed and time to discharge was significant with a p value of < 0.0001, 0.0144 and 0.006, respectively. Conclusion LP is a safe, simple and easy to learn procedure that can reproduce the results of open Ramstedt pyloromyotomy.

Context: Laparoscopic repair of pediatric inguinal hernia is gaining popularity, however there is no consensus about the technique of operation. Aims: The aim of the study was to compare the results and complications of two techniques of laparoscopic pediatric hernia repair. Settings and Design: This retrospective study was conducted at the Department of Pediatric Surgery in All India Institute of Medical Sciences (AIIMS), Jodhpur. Subjects and Methods: All children who underwent laparoscopic inguinal hernia repair at AIIMS, Jodhpur, during the period of September 2016–March 2019 were retrospectively studied. Parameters studied included age, gender, side of hernia, technique used, operating time, complications, and hospital stay. Patients were divided into two groups depending on whether the hernial sac was divided or not divided before taking a purse-string suture. Statistical Analysis Used: Student's t-test and Fischer exact test were used to analyze data. Results: A total of 114 patients were included in the study. The median age was 36.4 months. Hernial sac was divided before suturing in 53 patients, while sac was left intact in 61 patients. The mean follow-up was 11.4 months (range: 4–16). Age, gender, side of hernia, complications, and hospital stay were comparable in both groups. There was a significant difference between the mean operating duration in patients who underwent division of hernia sac compared to patients in whom the sac was not divided before putting purse-string suture (92.5 min [45–150] vs. 65.7 [30–90], respectively, P = 0.0101). Hernia recurrence (3.8% in Group A vs. 1.6% in Group B) was comparable in the two groups. Conclusions: Laparoscopic pediatric hernia repair done with or without dividing the peritoneal sac gives comparable results, however operative duration is less if sac is not divided.

Introduction: Using checklists has been common in high-risk industries such as aviation, space, and maritime sectors. It is routinely being used in health care also. Daily ward rounds play an essential role in patient care. Missing key details in rounds are common. Sometimes, these medical errors can lead to adverse events or mismanagement of patients. A checklist was introduced for daily ward rounds in our newly established institution. This study aims to assess the improvement in the documentation. Materials and Methods: A checklist for ward rounds was introduced in September 2018. During the study period, between July 2017 and January 2020, 30 random case records for each of the two groups were taken. Group A (without checklist) and Group B (checklist) were compared to see the documentation of patient identification, diagnosis, operative status, fresh complaints, vitals, examination findings, charting treatment, catheters/drains/intravenous access, and urinary status/bowel movements. Results: Sixty case records were included in the study. Comparison of documentation between Group A and Group B showed a significant difference in patient identification (50% vs. 100%), diagnosis (47% vs. 100%), operative status (33% vs. 100%), fresh complaints (76% vs. 100%), vitals (63% vs. 100%), examination findings (43% vs. 100%), charting treatment (73% vs. 100%), catheters/drains/intravenous access (10% vs. 86%), and urinary status/bowel movements (30% vs. 100%). Conclusion: Using checklists for daily ward rounds improves documentation. It reduces the gap in communication and potential errors in patient management.