Objectives: To report the outcomes in a series using modified tubularized incised plate (TIP) urethroplasty (Snodgrass) technique. The use of the TIP urethroplasty (Snodgrass) technique has gained wide acceptance among pediatric urologists for the correction of hypospadias repair because of its good cosmesis, low complication rate, and reliability in creating a vertically oriented meatus. Methods: A total of 54 boys aged 2 -13 years admitted in paediatric surgery ward Glanular(5.5%),Coronal(18.5%),Subcoronal(35.18%), Distal RMCH and IBH,Rajshahi with penile(11.1%),midpenile(9.6%) hypospadias underwent one-stage repair using a modified TIP repair during January,2010 to December,2010 were included in the study. Outcome was reviewed for each patient to determine the complications, reoperations, cosmesis, and functional results after surgery. Results: With at least 6 months of follow-up, all patients had achieved excellent functional and cosmetic results, with the meatus at the tip of the penis on follow-up. Three repairs for meatal stenosis and two for fistula were needed. Conclusions: The modified TIP procedure is a safe and reliable technique. It provides excellent cosmesis with a low reoperation rate.DOI: http://dx.doi.org/10.3329/kyamcj.v1i2.13317KYAMC Journal Vol.1(2) January 2011,64-69

A 20 year old housewife presented with multiple needles in her abdominal wall as revealed by radiological examination. She had unrelated symptoms but the needles were more or less silent for months except one group caused foreign body granuloma formation. Exploration and removal of four of these needles were done under general anaesthesia. Deliberately inserted needles in the abdominal wall are very unusual, which is not yet reported to our knowledge.

Background: Laparoscopic appendectomy is considered as a superior alternative to open appendectomy. Usual laparoscopic appendectomy is performed with the three port system. In this study, we performed a unique single transumblical incision two-port laparoscopic assisted appendectomy with the aim to reduce postoperative complications as well as improving cosmesis and patients' satisfaction. Methods: From January 2010 to December 2011, 136 patients were admitted with clinically diagnosed acute appendicitis and were randomly assigned to single transumblical incision two-port laparoscopic assisted appendectomy. Result: Transumblical single incision two-port laparoscopic assisted appendectomy was attempted in all patients (52 males and 84 females) with an average age of 8.5 years. Transumblical single incision two-port laparoscopic-assisted appendectomy was successfully completed in 134 patients. In two patients, another additional port was required due to sever adhesion of the appendix. Mean operation time was 25.2 min (range, 17-38), and mean postoperative hospital stay was 2 days (range 1-3). Postoperative complications were negligible. Conclusion: Transumblical single incision two-port laparoscopic-assisted appendectomy appears to be a feasible and safe technique for the treatment of acute appendicitis in the paediatric setting. It allows nearly scar less abdominal surgery.

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Background: Traditionally in herniotomy, indirect hernial sac is dealt by high ligation and removal of the redundant part, to avoid recurrence. However, some authorities are of the opinion that excision of the hernial sac without ligation is not associated with recurrence of the hernia. Some have even shown adverse events related to hernial sac ligation like increased post-operative pain and discomfort. There is no consensus on how the hernial sac should be managed during laparoscopic herniotomy. Objectives: Present study aimed to determine the feasibility of laparoscopic sac excision without ligation in pediatric age group, by a randomized comparison. Materials and methods: This interventional study was performed in the department of Paediatric Surgery, Rajshahi Medical College Hospital, Rajshahi, Bangladesh, over a period of one year. A total of 189 patients were included in the study as per inclusion and exclusion criteria and randomized in the three groups. Comparisons were made among three procedures of laparoscopic herniotomy, namely; Percutaneous extraperitoneal closure, Intraperitoneal purse-string closure and laparoscopic sac excision without ligation. The main outcome measures were recurrence rate, operative time, hospital stay, postoperative hematoma and hydrocele formation.  Results: Recurrence rate, operative time and hospital stay were not amplified in laparoscopic sac excision procedure than others. Postoperative hydrocele formation was significantly less. Conclusion: Laparoscopic sac excision in indirect pediatric inguinal hernia is safe. The procedure is not associate TAJ 2020; 33(2): 20-26