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, RMCH, with Glanular (5.5%), Coronal (18.5%), Subcoronal (35.18%), Distal 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. TAJ 2010; 23(1): 26-32

Sacrococcygeal teratoma is a common congenital neoplasm. This tumor contains derivatives ofmore than one of the three embryonic germ cell layers e.g. ectoderm, mesoderm & endodermand usually arises as a mass in the sacrococcygeal region. Here we are reporting a case of hugesacrococcygeal teratoma presenting as a lower abdominal and perineal mass in a thirteen-yearoldschoolgirl, which is very rare.doi: 10.3329/taj.v16i2.3888TAJ December 2003; Vol.16(2): 76-78

Congenital Diaphragmatic Hernia is one of the most challenging diagnosis faced by pediatric surgeons. From the time of its first anatomic description more than 300 years ago, CDH has carried a high mortality rate. We aimed to review patients who presented with hernia of diaphragm during the last six months. In this retrospective study, the medical records of three patients treated for diaphragmatic hernias who were admitted to Rajshahi Medical College Hospital between July 2012 and December 2012 were analyzed. Three patients with age of 45 days to 7 years were included in the study. Male to female ratio was 1:2. All patients had left-sided diaphragmatic hernia. Chest X-ray was obtained from all patients which was diagnostic. One patient needed thoracotomy incision. No patient required mesh repair. The mean hospitalization time was 14 days. There was no postoperative death. Diaphragmatic hernia is an uncommon and challenging situation for the surgeon. Prompt diagnosis and treatment prevent serious morbidity and mortality associated with complications such as gangrene and perforation of herniated organ.

Laparoscopic appendectomy considered as 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 port site complication as well as improving cosmesis and patients satisfaction. From January 2010, 32 patients were admitted with clinically diagnosed acute appendicitis and were randomly assigned to single transumblical incision two-port laparoscopic assisted appendectomy. Transumblical single incision two-port laparoscopic assisted appendectomy was attempted in all patients (9 males and 23 females) with an average age of 9.2 years. Transumblical single incision two-port laparoscopic assisted appendectomy was successfully completed in 31 patients. In one patient, another additional port required due to severe adhesion of the appendix. Mean operation time was 25.2 minutes (range, 17-38), and mean postoperative hospital stay was 1.Sdays (range 1-2). Postoperative complications (local pericaecal abscess) occurred in one case that was treated conservatively. 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. The true benefit of the technique should be assessed by randomized controlled trials.TAJ 2009; 22(1): 289-294

We evaluated the safety and efficacy of laparoscopic orchiopexy to manage a nonpalpable intra-abdominal testis and studied the outcomes. We report our 3 years experience.Patients and methods Laparoscopic Orchiopexy was performed on 28 children (32 testicular units) for non-palpable intra-abdominal testis between 2010 and 2012. We retrospectively reviewed the medical records. The mean age was 3.4 years (range, 2.5 -11 years). Of the 28 patients, 18 (64.28 %) were on the right, 6 (21.44%) were on the left and 4 (14.28%) of bilateral. The mean follow-up period was 14.8 months (range, 3-36 months). Testicular viability and orchiopexed positioning were evaluated within 1 month and beyond 3 months.Results  Thirty one testes were descended successfully by laparoscopy. The average operative time was 41.5 ± 3.8 min. Primary laparoscopic orchiopexy done in 26 testes.Three of unilateral and 2 of bilateral testicular units underwent one -stage Fowler-Stephens Orchiopexy. One patient needs laparoscopic orchiectomy. At follow-up (mean 14.8 months), one testis atrophied and need orchiectomy. Testicular survival rate was 96.77% (30/31) and all of the testes maintained an adequate size. Twenty six (86.66%) are in an acceptable scrotal position and 4 testes (13.33%) are mid to high in the scrotum without atrophy. There was no recurrent inguinal hernia.Conclusions  Laparoscopic orchiopexy is successful for a nonpalpable intra-abdominal testis with a high testicular survival rate. The low incidence of complications and high success rate underscore the feasibility of this procedure. It is our procedure of choice for the treatment of nonpalpable testis.TAJ 2011; 24(2): 70-75