Port site complications in patient after laproscopic cholecystectomy

To assess the frequency of port site complications in patient after laproscopic cholecystectomy. Observational study. This study was carried out in the Department of Minimal Invasive Surgical Centre [MISC] at Liaquat University of Medical and Health Sciences Jamshoro Pakistan, from Oct 2009 to 31[st] May 2011. This study consisted of Four hundred and fifty patients, admitted for laparoscopic cholecystectomy. Base line and specific investigations were done in all patients, especially ultrasound of abdomen for assessment of gallstone disease. Inclusion criteria were that all patients diagnosed as case of gallstone disease on the basis of history, clinical examination and investigations specially ultrasound of abdomen. Exclusion criteria included complicated gallstone disease, unfit patients for general anesthesia, pregnant ladies due to risk of foetal loss, patients with carcinoma of gall bladder, patient with acute pancreatitis and patients with obstructive jaundice. Postoperatively the patients were followed for up to 6 months and observed port site complications. Results were prepared with help of tables and graphs. Data was analyzed through SPSS software. 315[70%] were female and 135[30%] male. Ratio male: female ratio of 1:2.3. Age ranging from a minimum of 20 year to 65 year with mean age was 38 + 3.4 years. Complications were port site infection in 4 [0.88%] cases, followed by port site bleeding in one [0.22%] case and epigastric port site diathermy burn in one [0.22%] case. In conclusion, we recommend all 10 mm trocar sites be closed care fully. Over stretching of infra / supra umbilical port should be avoided. Gallbladder should be removed in endo-beg

outcome of well's operation in the surgical management of rectal prolapse

To see the outcome of Well's operation in the surgical management of rectal prolapse. Quasi Experimental study. This study was carried out in Department of surgery, Liaquat University of Medical and Health Sciences, Jamshoro from 11-5-2006 to 10-05-2009. This study consisted of 30 cases of rectal prolapse admitted through the outpatient department, as well as from casualty department of Liaquat University Hospital Jamshoro. Detailed History was taken from all the patients with special regard to the rectal prolapse. Inclusion criteria were that all the adults patients [Male and female] of rectal prolapse on the basis of history and fit for anesthesia and surgery were included in the study. Exclusion criteria included unfit patients for general anesthesia, another local pathology like haemorrhoids or rectal tumor. Data was analyzed through SPSS software. Out of 30 cases, 14[46.7%] were males and 16[53.3%] were females. There was wide variation of age with mean age + SD was 40.67 + 12.4 years. Most of the patients had constipation 23[76.7%] cases, 20[66.6%] cases were presented with Mucus discharge, 11[36.6%] cases had urinary incontinence, 09[30.0%] cases had Diarrhoea and 07[23.3%] cases had bleeding. Co-morbidity factors were diabetes mellitus in 07[23.3%] cases, hypertension was present in 09[30.0%] and IHD was found only in 02[6.7%]. Ten [33.3%] cases were anemic, 05[16.66%] cases with HBsAg, 07[23.3%] had Hepatitis C and only 1[3.3%] case had duel viral infection. Complications were seen in all the cases, 28[93.3%] cases were found in majority who had pain after the procedure, 08[26.7%] cases developed the wound infection associated with retention of urine, 05[16.7%] had urinary incontinence associated with reactionary haemorrhage, 07[13.3%] had anal stenosis associated with incisional hernia, 01[3.3%] were found with ureteric damage, 03[10.0%] cases had sexual dysfunction and only 1[3.3%] case had Rectal stricture. Recurrence of rectal prolapse occurred in only 1[3.3%] patient. In conclusion, this study suggests that Wells operation may be a good choice for treatment of complete rectal prolapse, in view of its low complication and recurrence rates

Haemorrhoids

The objectives of the study are to compare the outcome of the Doppler Guided Haemorrhoidal Artery Ligation and open Haemorrhoidectomy in 2nd and 3rd Degree Haemorrhoids. Comparative study. Study was carried out at the General Surgical Department at Liaquat University Hospital, Jamshoro and private hospital Hyderabad from 2008-2009. Study consisted of 50 patients of diagnosed cases of heamorrhoid. Patients were divided in two groups. In Group A Standard open Haemorrhoidectomy and Group B we used Doppler Guided Haemorrhoidal artery ligation. Detailed history was taken from all the patients with special regard to the bleeding per rectum or some thing coming out during defecation and Clinical examination of anal canal DRE and Proctoscopy was done. In both groups male were 37 [74%] and female 13 [26%] with male: Female Ratio of 2: 8:1. Age ranging from 20 to 60 years in both group, mean ages of patients were 38.28 + 10.355 years. 3rd degree haemorrhoid 31[62%] while 2nd degree 19[38%]. Complications were mild to moderate pain 24[96%] patients in DG -HAL group while moderate to severe pain 23[92%] in excisional heamorrhoidectomy group. Anal stenosis in 2[8%], patients, anal fissure 1 [4%] patients and feacal incontinence 1[4%] patients were observed only in excisional heamorrhoidectomy. Recurrence occurred in one case [4%] in each group. DG-HAL procedure has a low rate of complications, earlier mobilization, implies a shorter hospital stay and offers the patient a more comfortable postoperative period than Excisional heamorrhoidectomy procedure

Compare the outcome of open versus laparoscopic varicocelectomy

To compare the outcome of the laparoscopic surgery with open varicocelectomy. It is also assess the operative time, postoperative pain, postoperative recovery of patients and postoperative complications of both procedures such as, bleeding, haematoma, wound infection, hyderocele, laparoscopic related complications and recurrence. Observational Study. This study was carried out in Surgical Unit-IV, Liaquat University Hospital Jamshoro, from January 2009 to December 2010. This study consisted of 80 patients of varicocele grade III were admitted and divided in two groups. Group A for open varicocelectomy and group B for laparoscopic varicocelectomy in which each group consist of 40 patients. The ages of patients ranged between 11 years to 50 years. The mean age of LV group was 25.72 +/- 6.026 years and for OV group was 27.58 +/- 6.694 years. In OV group 92.5% of patients were having left varicocele, 5% right varicocele and 2.5 bilateral disease where as in LV group 90% of cases were having left, 7.5% right and 2.5% bilateral varicocele. The mean time in OV group was 29.70 +/- 8.498 minutes and 25.08 +/- 5.558 minutes in LV group [p 0.005]. the mild pain was observed in 7 [17.5%] patients of OV group and 16 [40%] patients of LV group. Whereas, severe pain was described by 10[25%] patients in OV group and 4 [10%] patients in LV group [p0.032]. The wound infection was found in 6 [15%] patients of OV group and 2 [5%] patients of LV group. The hydrocele was seen in 5[12.5%] cases of OV as compared 2 [5%] cases of LV group. Residual varicocele and recurrence of varicocele was observed in two cases [2.5%] of OV group and 3 cases of LV group with value p<0.359. It was longer about 2-3 days in 34[855] of OV patients as compared to LV cases where majority 36[90%] were discharged within 1 to 2 days. The results shows that LV is superior than OV in terms of better cosmesis, less operative time, less complications, short hospital stay and early return to work