Laparoscopic assisted right hemicolectomy. An experience of laparoscopic assisted right hemicolectomy in benign disease -- tuberculosis

To assess the outcome of laparoscopic assisted right hemicolectomy in benign diseases like tuberculosis. Prospective observational study. Surgical unit-I of Jinnah Hospital Lahore. Jan 2009 and June 2010. This study included a series of twenty patients with preoperative clinical diagnosis of ileocecal tuberculosis. A three trocar technique was used to perform laparoscopic right hemi colectomy and anastomosis was performed outside the abdomen by extending the supraumbilical incision. Data of 20 patients who underwent laparoscopic assisted right hemicolectomy was analyzed. Mean age of the patients was 27.5 years with male to female ratio 4:1 [Table-I]. There was zero conversion [0%] to open surgery and no intra-operative complications [0%] were observed. Average hospital stay was 5.8 days. No patients had to be re operated. On histopathology of specimen final diagnosis was 95% ileo cecal tuberculosis and one patients [5%] turned out to be having lymphoma [Table-III]. The laparoscopic colon surgery can produce excellent results in selected patients of abdominal tuberculosis. Advantages of laparoscopic over open surgery include less postoperative pain, short-term postoperative ileus, earlier return to daily activity

Inguinal hernia repair; experience of laparoscopic total extaperitoneal approach

To evaluate early results of laparoscopic repair of inguinal hernia by totally extraperitoneal approach [TEP] performed. At Surgical unit III, Jinnah hospital Lahore. From August 2005 to July 2008. 97 patients over the age of 30 years underwent TEP repair of their inguinal hernia. Post operative assessment of the patients included pain score assessment and analgesia requirement, along with ability to walk upright comfortably, time taken to return to normal activity and early complications like seroma, haematoma, infection etc. Post-operative pain assessment at 8 hours after surgery showed 43[44.3%] patients required extra analgesia while 24 hours after surgery only 13[13.4%] patients required extra analgesia. Mean operative time was 95 min [range 55-130min] for unilateral hernia. However, as experience increased with TEP repair, mean operating time decreased to 75mins in the second half of the cases. 21[20.6%] patients at 24hrs and 51[52.6%] patients at 48hrs could walk upright without any help. Median period for return to normal activity at domestic level was 5days [range 3-23].Incidence of early complications is shown in table-Ill. Our results of TEP laparoscopic hernia repair are comparable to European experience in terms of postoperative pain, mobility of patient and rehabilitation, as well as early complications