ABSTRACT
Background: Laparoscopy involves insufflation of the abdomen by gas so that the endoscope can view the intra-abdominal contents without being in direct contact with the viscera or tissue. Access to the abdomen is the one challenge of laparoscopy that is particular to the insertion of surgical instruments through small incisions. Materials and Methods: The study was a prospective, randomized, double-blind, and comparative study conducted on 100 consenting patients who underwent laparoscopic surgeries at Father Muller Medical College Hospital, for a period of 3 years from December 2014 to 2017 for various conditions needing laparoscopy who fulfilled a pre-determined the inclusion and exclusion criteria. Results: In our study, the least age was 20 years, and maximum age was 61 years. Age ranged from 18 to 65 years with mean age of 40 years. Most cases were males 86%. There was no difference in the two groups in terms of demography and perioperative factors such as type of surgery and body mass index; hence, the data were statistically comparable. The mean time needed to create pneumoperitoneum was 2.31 ± 1 min in Veress needle technique and 3.99 ± 1 in open method (P = 0.000) gas leak was observed in 11 patients in open group whereas no patient had a gas leak in Group B (P = 0.000). Pneumoperitoneum was achieved in all 100 cases. There were 7 cases of abdominal wall hemorrhage 4 acute that was managed laparoscopically by harmonic cauterization. No vascular injury, bowel, omental was noted in both groups. Neither open nor closed needed with conversion to open due to inadequate access into the peritoneal cavity. One closed as access could not be gained was converted to open method. 3 (6%) patients had post-operative hematoma at the umbilical port site in open Group A whereas no one developed this complication in a closed group 9 (9%) patients presented with surgical site infection at the umbilical trocar site and 4 in the closed group
ABSTRACT
Background: The occurrence of groin hernias is so common that the overall lifetime risk of developing one is 15% in male and about 5% in female. The most significant advances to impact inguinal hernia repair have been the addition of prosthetic materials to conventional repair and the introduction of laparoscopy to general surgical procedures. Materials and Methods: A total of 100 consecutive consenting cases who presented with a primary diagnosis of uncomplicated inguinal hernia to the Department of General Surgery at Father Muller Medical College Hospital from the period December 2013 to January 2016. Following a detailed history and clinical diagnosis a provisional diagnosis was made and the investigations. The following details regarding the patient were collected age of the patient, symptoms, and their duration, treatment given, complications if any, duration of hospital stay, and duration of return to work. Results: In our study, the mean age was 47.43 years and the most common age group when hernia occurred was 35-54 years with 54% of the cases. 97% were males and 3% females. Swelling was the most common presenting. Most hernias 43% occurred on the right side, followed by 18% on the left and 39% had bilateral involvement. The duration of surgery in the totally extraperitoneal (TEP) group the mean duration was 47.60 min the transabdominal preperitoneal (TAPP) group the mean duration was 48.90 min. The only post-operative complication occurred in our study was urinary retention. Conclusion: There is statistically significant difference between the two groups, namely, TEP and TAPP with respect to the duration of surgery and resuming routine activity postoperatively. The only finding of significance is the post-operative complication was urinary retention; this is not a major one, and this contributed an increase in the post-operative hospital stay being increased in the TEP group than the TAPP group with a two-tailed P = 0.
ABSTRACT
Introduction: Gastroesophageal reflux is the backward flow of gastric contents into the esophagus. Gastroesophageal reflux is a normal physiological process that occurs several times a day without symptoms or damage of the esophageal mucosa in most otherwise healthy individuals. Materials and Methods: This study was a cross-sectional prospective observational study, in which the patients are chosen by purposive sampling technique; the first consecutive 350 cases were taken to evaluate the patterns of demographic and lifestyle profile among patients aged between 30 and 60 years of age attending a tertiary care center, South India. This study was focused to evaluate the clinical scenarios of various patients diagnosed with gastroesophageal reflux disease (GERD) based on diagnostic criteria in South Indian population attending Department of General Surgery and Gastroenterology, Father Muller Medical College, Mangalore, from August to July 2016. Results: The mean age was 33.6 ± 10.0 years. Females (62%) were the predominant when compared to males. Heartburn was present in 50%, regurgitation in 40% and the presence of both symptoms was observed in 48.3%. Majority of the study subjects have mild GERD (77%) followed by moderate and severe grades. The body mass index range of ≥30.0 kg/m2 was highest (48%). 58% belong to lower socioeconomic group. The patients who are consuming non-vegetarian diet, smokers, stress, hypertension, and diabetes mellitus have a significant association and more succumbed to the development of GERD (P < 0.05). Conclusion: Socioeconomic factors have a significant impact on the GERD manifestations. A number of studies have been performed to evaluate the influence of socioeconomic status and GERD and concluded that lower socioeconomic status has a significant negative impact on the quality of life and implied to GERD.