RESUMO
Surgery for ulcerative colitis is a major and complex colorectal surgery. Laparoscopy benefits these patients with better outcomes in context of cosmesis, pain and early recovery, especially in young patients. For surgeons, it is a better tool for improving vision and magnification in deep cavities. This is not the simple extension of the laparoscopy training. Starting from preoperative preparation to post operative care there are wide variations as compared to open surgery. There are also many variations in steps of laparoscopic surgery. It involves left colon, right colon and rectal mobilisation, low division of rectum, pouch creation and anastomosis of pouch to rectum. Over many years after standardisation of this technique, it takes same operative time as open surgery at our centre. So we present our standardized technique of laparoscopic assisted restorative proctocolectomy and ileal pouch anal anastomosis (IPAA).
RESUMO
The most common congenital anomaly of the pancreas is pancreatic divisum (Tadokoro et al. in Anat Res Int 2011:1-7, 2011). Agenesis of the dorsal pancreas is extremely rare (Schnedl et al. in World J Gastroenterol 15(3):376-377, 2009). We are reporting a case of agenesis of dorsal pancreas presented with ampullary carcinoma.
RESUMO
There are more than 50 different techniques of laparoscopic cholecystectomy (LC) available in literature mainly due to modifications by surgeons in aim to improve postoperative outcome and cosmesis. These modifications include reduction in port size and/or number than what is used in standard LC. There is no uniform nomenclature to describe these different techniques so that it is not possible to compare the outcomes of different techniques. We brief the advantages and disadvantages of each of these techniques and suggest the situation where particular technique would be useful. We also propose a nomenclature which is easy to remember and apply, so that any future comparison will be possible between the techniques.
RESUMO
Surgeons always look for ways to reduce the size and number of ports in laparoscopy, where in today's era, we have single-incision laparoscopic surgery (SILS). While doing so, principal 'adequate exposure' should not be compromised. For upper gastrointestinal laparoscopic surgeries, we have adopted a novel technique for retraction of the left lobe of liver, which is described here. Device can be made both single sling and double sling, with help of an infant feeding tube and any routinely used suture material. Placement of device does not require any incision, special energy source, or instrument. It can help in SILS. Detailed technique is described in the text. Operative times did not change significantly. Exposure was excellent. No special instruments or energy devices are required; thus, it is cost-effective. Reducing one port for liver retraction gives better cosmetic results. No liver injury due to the device was noticed in any of the cases. This technique is simpler and cheaper and also gives reasonable cosmetic results compared to other techniques described in the literature.
Assuntos
Colecistectomia/efeitos adversos , Colestase/etiologia , Doenças da Vesícula Biliar/cirurgia , Fígado/patologia , Atrofia/diagnóstico , Atrofia/etiologia , Atrofia/terapia , Colestase/patologia , Colestase/terapia , Doenças da Vesícula Biliar/complicações , Doenças da Vesícula Biliar/patologia , Humanos , Hipertrofia/diagnóstico , Hipertrofia/etiologia , Hipertrofia/terapia , Masculino , Pessoa de Meia-IdadeRESUMO
Pulmonary blastoma is a rare primary lung neoplasm, in that monophasic variety is far too rare. There are no specific clinical features seen for pulmonary blastoma; computed tomography and histopathology are diagnostic. Surgical excision is the treatment of choice; however, adjuvant chemotherapy and radiotherapy may be required in large and aggressive tumors.
Assuntos
Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/cirurgia , Blastoma Pulmonar/diagnóstico , Blastoma Pulmonar/cirurgia , Adolescente , Biópsia , Quimioterapia Adjuvante , Diagnóstico Diferencial , Diagnóstico por Imagem , Feminino , Humanos , Neoplasias Pulmonares/tratamento farmacológico , Neoplasias Pulmonares/patologia , Blastoma Pulmonar/tratamento farmacológico , Blastoma Pulmonar/patologia , ToracotomiaRESUMO
Inadvertent insertion of the intercostal tube into abdomen is not rare. It can present by different ways. In the present case an Ascaris worm crept into the intercostal drainage bag to reveal the false passage of the tube.
Assuntos
Ascaríase/diagnóstico , Ascaris , Tubos Torácicos , Drenagem , Jejuno/lesões , Erros Médicos/efeitos adversos , Animais , Humanos , Masculino , Pessoa de Meia-Idade , Pneumotórax/diagnóstico , Pneumotórax/etiologia , Pneumotórax/terapiaRESUMO
A wide variety of anomalies may occur as a result of the vitellointestinal duct (VID) failing to obliterate completely. Most reports on symptomatic VID focus on Meckel's diverticulum, while other anomalies are given little attention. We report a case of a baby of five months who had an intestinal loop inverted through a patent VID. The inverted loop was reduced and ileostomy was done which was closed after 6 weeks.