Laparoscopic Port Entry methods - A Critical Review

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

Liver Enzyme Changes in Lap Appendectomy a Reason for Concern

Introduction: Abdominal pain remains the foe runner of complaints’ presenting to the general surgeon in the present world. Acute appendicitis is the most common of the acute abdominal conditions presenting which requires immediate surgical intervention. Materials and Methods: The study was a prospective experimental study conducted on 100 cases evaluated and diagnosed as acute appendicitis and was admitted to Father Muller Hospital who underwent laparoscopic appendectomy from the time period September 2014 to August 2016. Results: In present study, the enrolled patients above the age of 16 years, in our study most patients who were treated with laparoscopic appendectomy were in the age group 21–30 years with 39%, females accounted for 51% of the study. In our study, we found that the serum glutamic pyruvic transaminase levels serum glutamic oxaloacetic transaminase levels, unconjugated bilirubin levels increased postoperatively statistically significantly with a P < 0.001 and returned to the baseline levels 7th day postoperatively.

Menstrual Irregularities and Thyroid: A Second Thought

Background and Objective: Thyroid disorders are implicated in a broad spectrum of reproductive disorders ranging from abnormal sexual development to menstrual irregularities, infertility, and premature menopause. Thyroid disorders are 10 times more common in women than men. Materials and Methods: This study was a cross-sectional study conducted in the Department of Obstetrics and Gynaecology endocrinology and surgery, at Father Muller Medical College Hospital, Mangalore, Karnataka. On 100 women in the age group of 15–45 years attending or admitted in the hospital during the period from September 2016 to August 2015, with suspected thyroid disorders with menstrual disturbances for a period of 18 months. Results and Observations: The most common age group was 35–45 years with 49% of the study population. 42% were unmarried. Most of the patients presented to us <3 months of onset of symptoms 37%, 46% from 3 months to 6 months, and 3% patients had symptoms more than 2 years. In our study, population in menstrual irregularities had 32% subclinical hypothyroid, 48% hypothyroid, 20% hyperthyroid, respectively, there was significant association with thyroid hormone levels with Fisher’s exact test P = 0.020. Conclusion: Menstrual disturbances are one of the most common complaints of women for which biochemical estimation of thyroid hormones should be done subclinical hypothyroidism and hypothyroid cases account for a large treatable percentage of menstrual disturbance

Rectal botryomycosis mimicking carcinoma.

Botryomycosis is a granulomatous disease that was first recognized in horses. The lesion is infective with fungus-like grains similar to the sulfur granules in actinomycosis. We report 54-year-old woman with a strong suspicion of rectal carcinoma that turned out to be rectal botryomycosis. She responded to erythromycin.