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   2011| July-September  | Volume 7 | Issue 3  
    Online since August 5, 2011

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Who did the first laparoscopic cholecystectomy?
Craig A Blum, David B Adams
July-September 2011, 7(3):165-168
DOI:10.4103/0972-9941.83506  PMID:22022097
Laparoscopic cholecystectomy (LC) has served as the igniting spark in the laparoscopic surgery explosion; however, it is unclear who created the spark. The question remains: Who did the first LC?
  6,030 234 4
Intraincisional vs intraperitoneal infiltration of local anaesthetic for controlling early post-laparoscopic cholecystectomy pain
Gouda M El-labban, Emad N Hokkam, Mohamed A El-labban, Khaled Morsy, Sameh Saadl, Khaled S Heissam
July-September 2011, 7(3):173-177
DOI:10.4103/0972-9941.83508  PMID:22022099
Background: The study was designed to compare the effect of intraincisional vs intraperitoneal infiltration of levobupivacaine 0.25% on post-operative pain in laparoscopic cholecystectomy. Materials and Methods: This randomised controlled study was carried out on 189 patients who underwent laparoscopic cholecystectomy. Group 1 was the control group and did not receive either intraperitoneal or intraincisional levobupivacaine. Group 2 was assigned to receive local infiltration (intraincisional) of 20 ml solution of levobupivacaine 0.25%, while Group 3 received 20 ml solution of levobupivacaine 0.25% intraperitoneally. Post-operative pain was recorded for 24 hours post-operatively. Results: Post-operative abdominal pain was significantly lower with intraincisional infiltration of levobupivacaine 0.25% in group 2. This difference was reported from 30 minutes till 24 hours post-operatively. Right shoulder pain showed significantly lower incidence in group 2 and group 3 compared to control group. Although statistically insignificant, shoulder pain was less in group 3 than group 2. Conclusion: Intraincisional infiltration of levobupivacaine is more effective than intraperitoneal route in controlling post-operative abdominal pain. It decreases the need for rescue analgesia.
  5,109 302 4
Transanal division of the anorectal junction followed by laparoscopic low anterior resection and coloanal pouch anastomosis: A technique facilitated by a balloon port
Avanish P Saklani, Parin Shah, Nader Naguib, Nicola Tanner, Peter Mekhail, Ashraf G Masoud
July-September 2011, 7(3):195-199
DOI:10.4103/0972-9941.83515  PMID:22022106
We performed a laparoscopic ultra low anterior resection in two patients with low rectal cancers (3 cm from dentate line). A transanal division and continuous suture closure of anorectal junction was performed first followed by laparoscopic low anterior resection. A handsewn anastomosis between colonic pouch/transverse coloplasty and anal canal was facilitated by use of a transanal balloon port.
  5,152 120 -
To study the incidence of organ damage and post-operative care in patients of blunt abdominal trauma with haemoperitoneum managed by laparoscopy
Samir M Shah, Komal S Shah, Parthesh K Joshi, Rajan B Somani, Vikram B Gohil, Shivendra M Dakhda
July-September 2011, 7(3):169-172
DOI:10.4103/0972-9941.83507  PMID:22022098
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.
  4,073 185 -
An unusual case in surgical emergency: Abdominal cocoon and its laparoscopic management
Metin Ertem, Volkan Ozben, Hakan Gok, Ersin Aksu
July-September 2011, 7(3):184-186
DOI:10.4103/0972-9941.83511  PMID:22022102
Small bowel obstruction associated with abdominal cocoon (AC) is a rarely encountered surgical emergency. This condition is characterised by a thick fibrous membrane which encases the small bowel partially or completely. It is usually difficult to be able to make a definitive diagnosis in the presence of obscure clinical and radiological findings. Diagnosis is usually made at laparotomy when the encasement of the small bowel within a cocoon-like sac is visualised. Here, we report on a 29-year-old male patient who presented with acute small bowel obstruction and was eventually diagnosed with AC at laparoscopy. In this case, laparoscopic excision of the fibrous sac and extensive adhesiolysis resulted in complete recovery. Although rare, the diagnosis of AC should be kept in cases of patients with intestinal obstruction combined with relevant imaging findings. Laparoscopy should also be considered for the management of this condition in suitable patients.
  3,747 127 6
Laparoscopic preperitoneal mesh repair using a novel self-adhesive mesh
Nik Kosai, Paul Anthony Sutton, Jonathan Evans, Joseph Varghese
July-September 2011, 7(3):192-194
DOI:10.4103/0972-9941.83514  PMID:22022105
Prosthetic mesh is now used routinely in inguinal hernia repairs, although its fixation is thought to be a potential cause of chronic groin pain. The Parietene ProGrip™ (TYCO Healthcare) mesh, which is semi-resorbable and incorporates self-fixing properties, has been shown to provide satisfactory repair in open surgery. We describe the use of this mesh in TAPP hernia repair, which has not previously been reported in the literature. A prospective study of 29 patients showed a mean operative time to be 47.6 min, with 96% of patients discharged home on the day of surgery or the day after. Visual analog pain scales (out of 10) reduced from 4 preoperatively to 0 at 6 months, and only 1 patient suffered a minor wound complication. The use of this mesh in transabdominal preperitoneal hernia repair is therefore feasible, safe, and may reduce postoperative pain.
  3,712 152 4
Route to neo-inguinal canal: Our experience
J Jacob Swaroop Anand, V Kumaran, G Rajamani, S Kannan, N Venkatesa Mohan, R Rengarajan, V Muthulingam
July-September 2011, 7(3):178-180
DOI:10.4103/0972-9941.83509  PMID:22022100
Aim: The objective of this study was to stress the importance and value of this route to neo-inguinal canal creation for undescended testis management laparoscopically. Materials and Methods: Data from the Department of Paediatric Surgery, Coimbatore Medical College, was taken. Retrospective study was undertaken for the period 2004 to 2008. Here the surgical technique and outcome of the treatment are recorded for children aged 1 year to 12 years. Results: A total of 126 children underwent laparoscopic stage II surgery by this route (medial to the medial umbilical ligament). Right-sided undescended testis (UDT) was present in 76 (60%) patients. Left-sided UDT was present in 45 (35%) patients. Bilateral UDT was present in 5 (5%) patients. There were 90 (71%) patients aged less than 2 years and 36 (29%) patients aged more than 2 years. The eldest patient was 12 years of age. The overall hospital stay was 1 day. There were no complications seen in the follow-up. In all cases, the testis could not be brought down in a single stage. Conclusion: Creation of neo-inguinal canal medial to the medial umbilical ligament and just lateral to the bladder has the advantage of gaining more length on the vessels and vas to bring the testis to scrotum. The laparoscopic management of undescended testis in stage II by this innovative new route is simple, less complicated and well tolerated.
  3,229 129 -
A case report of incisional hernia through a 5 mm lateral port site following laparoscopic cholecystectomy
Audrius Dulskas, Raimundas Lunevicius, Juozas Stanaitis
July-September 2011, 7(3):187-189
DOI:10.4103/0972-9941.83512  PMID:22022103
Introduction: Less than 10 mm port-site herniation is a rare complication after laparoscopic surgery. We report a case of complicated herniation through the 5-mm lateral trocar port site. Case Report: A 63-year old obese female was admitted due to intestinal obstruction. She has undergone the laparoscopic cholecystectomy 1 year ago. On examination, abdomen was bloated and roughly 10 cm size mass was palpable on the right subcostal area. Plane radiogram of the abdomen showed signs of intestinal obstruction. Since conservative treatment was ineffective, the patient was operated on. The laparotomy revealed a protrusion of a part of right large intestine and greater omentum into the subcutaneous space through the abdominal wall defect below right subcostal margin. There was a dilatation of intestines proximally incarcerated colon. It was released and a part of omentum was resected. The peritoneum and fascia-muscular defect was closed by interrupted vicryl sutures. Conclusion: Acute herniation through a 5 mm size most lateral trocar port site is a rare complication of laparoscopic surgery requiring prompt differential diagnosis.
  3,139 125 3
The vermiform appendix presenting in a laparoscopic port site hernia
Rafiq Latyf, Richard Slater, Jeffrey P Garner
July-September 2011, 7(3):181-183
DOI:10.4103/0972-9941.83510  PMID:22022101
Laparoscopic port site hernias (PSHs) are uncommon but present a potential source of morbidity due to incarceration of the hernial contents which is usually omental fat or small bowel. We report only the third case of the vermiform appendix presenting in a symptomatic PSH; we discuss the appropriate management of this condition as well as ways in which the incidence of PSHs may be reduced.
  3,068 109 4
Laparoscopic dissection of the pararectal space
Sami M Walid, Richard L Heaton
July-September 2011, 7(3):190-191
DOI:10.4103/0972-9941.83513  PMID:22022104
Pelvic adhesions affecting the uterine adnexa or cul-de-sacs are a common finding in gynaecological surgery. We present a referred patient with a history of laparoscopic hysterectomy and right salpingo-oophorectomy and an unresected left ovarian mass causing ovarian retention syndrome. The left ovarian complex was hidden in the left pararectal space. The laparoscopic technique for dealing with such a rare case is explained.
  2,493 112 -
Bleeding complications in laparoscopic cholecystectomy: Incidence, mechanisms, prevention and management
Sudhir Kumar Thakur
July-September 2011, 7(3):200-200
DOI:10.4103/0972-9941.83516  PMID:22022107
  2,394 128 -
2004 Journal of Minimal Access Surgery
Published by Wolters Kluwer - Medknow
Online since 15th August '04