ABSTRACT
Background:Laparoscopic surgery is a pioneering technique that has metamorphosed the field of surgery in the past and is now considered the recommended surgical approach for many procedures.1The last published data showed an average of eight cases per month.5The purpose of this study was to assess an increase or decrease in the number of Laparoscopic surgeries at GPHC and if there were more advanced cases as compared to the last published data.Methods:Data of the laparoscopic surgeries done at GPHC for the year 2018 was obtained from the records in the Main Operating theatre. Data collected will focus on the number and type of Laparoscopic surgeries.Results:An audit of GPHC operating register shows a total of 180 cases for 2018 representing an average of 15 cases per month. There was a significant difference in the first six months of 2018 (5 cases per month) versus the last six months of 2018 (25 cases per month). A total of 19 cases were converted. Most of the advanced cases were done in latter half of 2018 and included 27 diagnostic laparoscopy, 9 inguinal hernias, 2 AP resections, 2 Graham’s patch, 2 ventral hernias, 2 rectopexy and 1 Heller’s myotomy.Conclusion:The number of laparoscopic surgeries at GPHC has increased significantly especially in the latter half of 2018. This number has risen to three times the number in the last published data. While the majority of cases continued to be cholecystectomy and appendectomies, a greater variety of advanced cases were done in 2018 as compared to the last published data.
ABSTRACT
Introduction:Rectal prolapse is a debilitating and unpleasant condition adversely affecting the quality of life. It is a distal displacement of the rectum through the pelvic diaphragm that produces pressure symptoms on other pelvic organs causing fecal incontinence, obstructive defecation, or even strangulation. Different perineal and abdominal approaches have been described for surgical correction of rectal prolapse. Laparoscopic Rectopexy has been proven to be an effective treatment for rectal prolapse. Objective:LPR has recently been practiced as a method of treatment for rectal prolapse at GPHC. This study aims to assess the clinical and functional outcomes of the patients who underwent Laparoscopic Rectopexy in the effort to highlight this practice in Guyana and the Caribbean. Design /Method:The study design includes a retrospective review and prospective follow-up of a series of 4 patients who underwent LPR at GPHC for rectal prolapse. Pre-operative, intra-operative and post-operative factors surrounding the procedure were recorded and analyzed.Results:All patients were males of 29-52 years of age. One (1) Patient was a smoker and One (1) used alcohol. Two (2) patients had a previous perineal approach for rectal prolapse that recurred. No comorbidities were recorded. All patients had complete rectal procidentia. Laparoscopic Ventral Mesh Rectopexy was done for each patient. None of the cases were converted. All patients were fully ambulant by postoperative day one and all were discharged by postoperative day three. No short-term recurrence was recorded for three patients; the fourth patient did not complete the six months postoperative period. Conclusion: Laparoscopic Rectopexy was successfully pioneered at GPHC as a method of management for rectal prolapse with good outcomes