BACKGROUND:Laparoscopy is safe and effective in the management of blunt trauma abdomen (BTA) with haemoperitoneum, with all benefits of minimal access surgery.AIMS:To study the incidence of organ damage and post-operative care in patients of blunt abdominal trauma with haemoperitoneum, managed by a new modality of treatment — laparoscopy.MATERIALS AND METHODS:Prospectively collected data on laparoscopy performed in patients with blunt abdominal injury, between the years 2004 to 2006, were analysed. Under general anaesthesia pneumoperitoneum was created. A 10 mm umbilical port, right-sided port in the anterior axillary line (5 mm / 10 mm), left-sided port in the anterior axillary line (5 mm / 10 mm) and an extra port were made according to the organ injury, and laparoscopy was performed and managed according to the organ injury.RESULT:Twenty-five patients had laparoscopy for blunt trauma abdomen with haemoperitoneum. Liver followed by the spleen were the most common sites of injuries. The overall failure rate was 4%. Post-operative stay and complications were much less. Laparoscopy reduced the number of negative laparotomies, with a limitation that it could not be performed in haemodynamically unstable patients.CONCLUSION:The liver and spleen are the most common organs involved in patients with blunt abdominal trauma with haemoperitoneum. Laparoscopy is safe and efficient in patients with blunt trauma abdomen with haemoperitoneum, with fast recovery and low hospital stay.
International Journal of Case Reports and Images (IJCRI) is an international, peer reviewed, monthly, open access, online journal, publishing high-quality, articles in all areas of basic medical sciences and clinical specialties.Aim of IJCRI is to encourage the publication of new information by providing a platform for reporting of unique, unusual and rare cases which enhance understanding of disease process, its diagnosis, management and clinico-pathologic correlations. IJCRI publishes Review Conclusion:Occurrence of port site hydatid cyst is rare complication after laparoscopic hydatid cystostomy, but can occur due to lodgment of scolices at port site during laparoscopy.
Background: Diverting temporary stoma is created to protect the primary bowel pathology and distal anastomosis. Once that primary pathology has been overcome or distal anastomosis gets healed, closure of temporary stomas can be carried out. Invention of stapling devices for intestinal anastomosis provided another dimension than hand sewn method to the stoma closure techniques. In this study, we have compared two methods of loop stoma closure-hand sewn method versus stapler method.Methods: This is prospective comparative study in which 50 cases of loop ileostomy/colostomy were taken. 25 patients underwent ileostomy/colostomy closure by hand sewn anastomosis (group A). Another 25 patients underwent ileostomy/colostomy closure by stapler anastomosis (group B). Time taken for operation, initiation of oral intake, anastomotic leak, post-operative wound infection and total hospital stay duration were compared between these two groups to conclude about which method is superior and in the best interest of patient and surgeon.Results: Mean operation time 105.96 minutes (group A) and 72.84 minutes (group B). Mean time to start oral intake 5.36 days (group A), 3.6 days (group B). 16% patients (4/25) group A and 4% patients (1/25) group B developed anastomotic leak. 28% patients (7/25) group A and 8% patients (2/25) group B had post-operative wound infection. Mean hospital stay 10.4 days in group A and 7.84 days in group B.Conclusions: Stapler method provides significant benefits in terms of less operative time, early oral intake and less hospital stay. Overall stapler method for stoma closure is more efficient and cost effective.
Background: Uroflowmetry is diagnostic procedure of various urinary tract diseases like urethral stricture, benign prostatic hyperplasia, neurogenic bladder, detrusor muscle overactivity by calculating the rate of urine expulsion against the time unit in second. Uroflowmetry is simple and non-invasive diagnostic method.Methods: This is a prospective study of 100 cases which fulfil inclusion and exclusion criteria. After taking informed written consent of the patients, they have gone under uroflowmetry study by Urocap 3 uroflowmeter, and graphs were obtained and result analysed.Results: Maximum number of patients has prolonged curve graph were diagnosed as benign prostate hypertrophy (BPH) (53%), dysfunctional voiding curve for detrusor overactivity (20%) intermittent flow curve for neurogenic bladder (7%), Box variety for urethral stricture (7%).Conclusions: In present study we found that uroflowmetry is helpful in diagnosis of certain urological pathologies. Common lower urinary symptoms were burning micturition, frequency and difficulty in micturition. Age group from 50-70 years was often presented with bladder outflow obstruction. Uroflowmetry overall useful in diagnosis of BPH and urethral stricture which can be supported by ultrasonography of prostate with PVRV and RGU respectively to avoid other invasive and more difficult pressure or flow urodynamic study.
Background: Intestinal anastomosis is a commonly performed procedure in surgery. Various evolvements have occurred in the field of intestinal anastomosis and recent advancement is the use of stapler in laparoscopic surgeries as a device for Gastrointestinal (GI) anastomosis. Few previous studies evaluating the clinical safety of the 2 laparoscopic linear stapling devices are available.Methods: A prospective comparative study of 50 cases which met the inclusion and exclusion criteria were included in this hospital-based study. They were randomly allocated to two groups, Group A which underwent laparoscopic intestinal anastomosis by Endo GIA tri-staple (purple) stapler and Group B which underwent Endo GIA universal loading unit (blue/green) stapler. Primary outcome was assessed in terms of intra-operative staple line bleeding, operative time and post-operative anastomotic leak.Results: Patients with laparoscopic intestinal anastomosis by Endo GIA tri-staple stapler (purple) have required less operation time as compared to Endo GIA universal loading unit. In Endo GIA universal loading unit (blue/green) 04% patients developed anastomotic leak and 40% patients had intra-operative staple line bleed while with Endo GIA tri-staple no postoperative anastomotic leak was found and 02% patients developed intra-operative staple line bleeding.Conclusions: The result of our study has shown that the Endo GIA reload tri- staple (purple) is superior in terms of having no anastomosis leak, negligent staple line bleeding and less operation time as compared with Endo GIA universal loading unit (blue/green). Thus, laparoscopic intestinal anastomosis by Endo GIA reload tri-staple stapler (purple) technology is more effective and overall more efficient.
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