Extraperitoneal approach for laparoscopic varicocelectomy [preliminary study]

In this study, 20 patients with primary varicocele were clinically diagnosed. Duplex was done for all cases to assess the presence of reflux and size of spermatic veins as preoperative baseline. Laparoscopic varicocelectomy was done using extraperitoneal approach with blunt dissection. Spermatic veins were identified, isolated from artery and individually clipped and divided. Three months postoperatively, duplex was done to check the reflux and size of spermatic veins. There was no recurrence. The technique adopted in this study differed from previously reported techniques in several aspects: patient positioning, method of creating and maintaining working space and operative field

Diagnostic peritoneal lavage [DPL]: accuracy in predicting necessary laparotomy following both blunt and penetrating trauma

Management of abdominal trauma requires more than the detection of injury. Accurate assessment of the need for operative repair is important for successful outcome. Diagnostic peritoneal lavage [DPL] is now established as investigation of choice in patients with blunt and penetrating abdominal trauma in whom clinical findings are equivocal. This study included 80 cases of abdominal injuries. DPL was done for them, the open technique was used which is more safe. Various criteria for evaluation of DPL fluid were studied

Typhoid ileal perforation

25 cases of perforated typhoid ulcers of the ileum are reported. 12 cases were diagnosed preoperatively as perforated typhoid ulcers, either being referred by physicians or from hospitals. The remaining cases were diagnosed as peritonitis with perforated typhoid as differential diagnosis in 5 cases. A case of peritonitis after mild closed abdominal trauma proved to have 2 perforated typhoid ulcers. A technique of serosal patch using a loop of jejunum to reinforce the suture line and to protect incipient ulcers was practiced in 10 cases with favorable results

Neck injuries: one years experience in one trauma center

Neck injuries comprise a minor but important part of trauma surgical practice. Debate still exists about the best methods to handle some cases. Thirty-three cases of neck injuries admitted to the Trauma and Surgical Emergency Unit during the period from January 1993 to January 1994 were studied. Patients were classified according to type and site of injury, stability of the patient and seriousness of presenting symptoms and signs. After examination of the data and results, the authors recommended an early exploration for patients with penetrating injuries in zone II, or I and III with signs of major trauma. A watchful 72 hours surveillance should be considered for those with blunt trauma and for those with zone I and III penetrating injuries with signs of minor trauma