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  Citation statistics : Table of Contents
   2010| January-March  | Volume 6 | Issue 1  
    Online since April 15, 2010

 
 
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ORIGINAL ARTICLES
Anastomotic leak rate and outcome for laparoscopic intra-corporeal stapled anastomosis
Vitali Goriainov, Andrew J Miles
January-March 2010, 6(1):6-10
DOI:10.4103/0972-9941.62527  PMID:20585487
Aims :A prospective clinical audit of all patients undergoing laparoscopic surgery with the intention of primary colonic left-sided intracorporeal stapled anastomosis to identify the rate of anastomotic leaks on an intention to treat basis with or without defunctioning stoma. Materials and Methods : All patients undergoing laparoscopic colorectal surgery resulting in left-sided stapled anastomosis were included with no selection criteria applied. All operations were conducted by the same surgical team and the same preparation and intraoperative methods were used. The factors analyzed for this audit were patient demographics (age and sex), indication for operation, procedure performed, height of anastomosis, leak rate and the outcome, inpatient stay, mortality, rate of defunctioning stomas, and rate of conversion to open procedure. Results for anastomotic leakage were compared with known results from the Wessex Colorectal Audit for open colorectal surgery. Results : A total of 69 patients (43 females, 26 males; median age 69 years, range 19 - 86 years) underwent colonic procedures with left-sided intracorporeal stapled anastomoses. Of these, 14 patients underwent reversal of Hartmann's, 42 - Anterior Resection, 11 - Sigmoid Colectomy, 2 - Left Hemicolectomy. Excluding reversals of Hartmann's, 29 operations were performed for malignant and 26 for benign disease. Five patients were defunctioned, and 3 were subsequently reversed. The median height of anastomosis was 12 cm, range 4 - 18 cm from anal verge as measured either intra-operatively, or by rigid sigmoidoscopy post-operatively. Four cases were converted to open surgery. There was 1 post-operative death within 30 days. There was 1 anastomotic leak (the patient that died), and 1 patient developed a colo-vesical fistula. Median post-operative stay was 7 days, range 2-19. Conclusion : This clinical audit confirms that the anastomotic leak rate for left-sided colorectal stapled anastomosis is no worse than that for open surgery. Therefore the decision making process for defunctioning stoma should be guided by the same principles as open surgery.
  7 4,704 267
INSTRUMENTS AND EQUIPMENTS
The basket trainer: A homemade laparoscopic trainer attainable to every resident
Nidal Jaber
January-March 2010, 6(1):3-5
DOI:10.4103/0972-9941.62525  PMID:20585486
Laparoscopic trainers have been proved to be effective to improve skills of laparoscopic surgery; they are usually installed at hospital in the surgical department with limited access hours, usually inconvenient to the schedule of the resident. Simple trainer boxes are necessary for residents who desire developing their skills at home independently to the venue and hours of surgical departments. Our goal is to bring the laparoscopic trainer to the desktop of the surgical resident by making it very cheap, small, light, secure and easy to construct. We describe a model of laparoscopic trainer using steel basket which, we believe, meets all of the above-mentioned requirements. It is accessible to any personal budget and can be constructed with a minimum of hand skill. It is small and light enough to permit its daily use on the desktop of the resident for a couple of hours, then after it can be stocked in any locker.
  4 5,515 310
HOW I DO IT DIFFERENTLY?
Port site closure after laparoscopic surgery
PR Shah, N Naguib, K Thippeswammy, AG Masoud
January-March 2010, 6(1):22-23
DOI:10.4103/0972-9941.62534  PMID:20585491
We have reported a novel technique for the closure of the ports after laparoscopic surgery. Using this technique all the ports are closed under vision, thus preventing port herniation.
  2 2,633 235
ORIGINAL ARTICLES
One stage bilateral endoscopic sympathectomy under local anesthesia: Is a valid, and safe procedure for treatment of palmer hyperhidrosis?
Mohamed Salah Awad, Awny Elzeftawy, Salah Mansour, Wael Elshelfa
January-March 2010, 6(1):11-15
DOI:10.4103/0972-9941.62529  PMID:20585488
Objective : Thoracoscopic sympathetic surgery is currently the best treatment for hyperhidrosis, and the success rate is quite high, but poor emphasis has been given to the type of anaesthesia and its application through either one or two stages of surgery. This study has evaluated the operative and postoperative results of one-stage bilateral thoracoscopic sympathectomy under local anaesthesia. Materials and Methods : From 2003 to 2007, n=14 patients with hyperhidrosis of the upper limbs [4 females and 10 males] with a mean age of 28±2.11 year [range 26-44] were included. They were operated on by means of bilateral ETS under local anaesthesia. The mean follow-up was 1.5 years (range 13-24 months). Results : No operative mortality was recorded. The mean operating room time for the whole bilateral procedure under was 73. 5±14.5 range [60 -120] min most of the patients were discharged the same day after a chest roentgenogram except, only two patients with gustatory sweating one recurrent sweating in the patient who had previously axillary hyperhidrosis. Also among them two patients (20%) experienced a minimal pneumothorax that required no treatment. Postoperative quality of life and satisfaction were excellent and cost was significantly reduced. Conclusions : Bilateral thoracoscopic sympathectomy for palmar hyperhidrosis could be safely and effectively performed in patients refusing GA regarding cost and satisfaction.
  2 3,620 168
UNUSUAL CASES
Systemic inflammatory response syndrome following laparoscopic repair of diaphragmatic injury: A case report
Philip Umman
January-March 2010, 6(1):16-18
DOI:10.4103/0972-9941.62530  PMID:20585489
Trauma is a major cause of morbidity and mortality in the younger age group. Though diagnostic laparoscopy has been attempted in trauma earlier, with the advance in minimal access techniques, there is an increasing attempt at advancing the indications for laparoscopy in the setting of trauma. Though there are reports and studies on the successful use of laparoscopy in the setting of abdominal trauma, it is essential to remember that laparoscopy in trauma is associated with risks inherent in the procedure itself and also with higher incidence of missed injuries if used as a diagnostic tool.
  1 2,451 175
EDITORIAL
Looking back...looking ahead
Tehemton E Udwadia
January-March 2010, 6(1):1-2
DOI:10.4103/0972-9941.62524  PMID:20585485
  - 1,772 162
LETTERS TO EDITOR
Laparoscopic feeding jejunostomy
Sourabh Aggarwal, Sahil Batra, Jesna S Mathew
January-March 2010, 6(1):24-24
DOI:10.4103/0972-9941.62531  PMID:20585492
  - 1,752 133
Laparoscopic removal of worm in biliary canal
Viroj Wiwanitkit
January-March 2010, 6(1):24-25
DOI:10.4103/0972-9941.62533  PMID:20585493
  - 1,142 113
UNUSUAL CASES
Laparoscopic appendicectomy for suspected mesh-induced appendicitis after laparoscopic transabdominal preperitoneal polypropylene mesh inguinal herniorraphy
Jason M Jennings, Philip C.H Ng
January-March 2010, 6(1):19-21
DOI:10.4103/0972-9941.62532  PMID:20585490
Laparoscopic inguinal herniorraphy via a transabdominal preperitoneal (TAPP) approach using Polypropylene Mesh (Mesh) and staples is an accepted technique. Mesh induces a localised inflammatory response that may extend to, and involve, adjacent abdominal and pelvic viscera such as the appendix. We present an interesting case of suspected Mesh-induced appendicitis treated successfully with laparoscopic appendicectomy, without Mesh removal, in an elderly gentleman who presented with symptoms and signs of acute appendicitis 18 months after laparoscopic inguinal hernia repair. Possible mechanisms for Mesh-induced appendicitis are briefly discussed.
  - 2,489 150
2004 Journal of Minimal Access Surgery
Published by Wolters Kluwer - Medknow
Online since 15th August '04