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Introduction: Since the inception of laparoscopy, it has been explored in many fields of surgery, like in the abdomen, hernia, thorax, etc., Laparoscopic hernioplasty in adults is being practiced by many surgeons nowadays. However, the role of laparoscopic inguinal hernia repair in pediatric patients is not well-established, even though it is being explored as an alternative to open herniotomy procedure. In the present study, laparoscopic needlescopic hernia repair was compared with the conventional open herniotomy procedure. Material and Methods: The study was a case-control study conducted in a tertiary care hospital in northeast India during 2018-2021. A total of 25 patients underwent needlescopic hernia repair, the outcome of which was compared by collecting data of 25 more patients who earlier underwent open herniotomy repairs. Results: The laparoscopic needlescopic repair took a longer operative time as compared to the open technique with a smaller-sized incision. Conclusion: Laparoscopic needlescopic hernia repair is a safe and feasible procedure with a similar outcome to open herniotomy but with a smaller scar.
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Background: Cholecystectomy is one of the most common general surgical operations performed worldwide. Limited data is available about the histopathological diagnoses of various gallbladder diseases in North Eastern part of India even though a higher incidence of gallbladder cancer has been reported from this part of the Country. Hence, a retrospective review of the histopathological findings of routine cholecystectomy specimens was done to assess the incidence of gallbladder cancer and other gallbladder pathologies. Aims and Objective: To study the incidence of gallbladder cancer and other pathologic findings in routine cholecystectomy specimens. Methodology: A retrospective study of the histopathological findings of cholecystectomy specimens with presumed benign gallbladder diseases who had undergone cholecystectomy from June 2013 till October 2021. Results: A total of 1683 patients had undergone cholecystectomy during the study period. In total, 1354 patients underwent laparoscopic cholecystectomy and 339 patients underwent open cholecystectomy. Gallstones were present in 1631 patients. Chronic cholecystitis and cholesterosis were the most common histopathologic findings, followed by pyloric metaplasia. Unsuspected gallbladder cancer was detected in eight patients (0.48%). Conclusion: Chronic cholecystitis was the most common histopathologic finding followed by pyloric metaplasia. Gallstones were found in most patients. Incidental gallbladder cancer was detected in 0.48% of patients.
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INTRODUCTION: Hematuria is a clinical sign and symptom that every individual would have a worst nightmare and invokes a physician to carefully evaluate possible causes of hematuria. It may be medical or surgical causes. A thorough examination is required to exact the primary pathology. As such, a study on hematuria in North east India is not sufficiently researched or published. MATERIAL & METHODS: Here we present an observational study in our institution on that very topic. A study was done purely on surgical causes of hematuria on symptomatic patients. It was done on the inpatient and outpatient basis in Assam Medical College, Dibrugarh during the period of 2016-2019. Total 43 patients were evaluated, who came with symptomatic hematuria. RESULTS: Out of 43 cases of symptomatic hematuria, 34 were male and 9 were females patients. Carcinoma urinary bladder was the commonest cause of hematuria, followed by BPH, urolithiasis, carcinoma prostrate, carcinoma upper urinary tract, etc. CONCLUSION: Benign prostatic hyperplasia was found to be the most common benign cause and carcinoma bladder was the commonest malignant cause of hematuria.
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Primary inflammatory myofibroblastic tumor (IMT) is a very rare tumor arising from stomach and it closely mimics gastric GIST. It usually affects the lung and found in children and young patients. The diagnosis of gastric IMT is usually done post-operatively by immunohistochemistry examination where it is seen that IMT is positive to SMA and vimentin. Complete surgical excision is the treatment of choice and local recurrence is usually seen in incompletely resected cases.
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Endometriosis is generally common benign disease manifested by the presence of uterine tissue outside the uterus. Umbilical endometriosis as such is rare entity but many a time it may go unnoticed to general physician if no symptoms arises from it. The documented case of umbilical endometriosis case is below 100 as per the case reports research. Here, in the case report we present an umbilical endometriosis arises after a laparoscopic and umbilical hernia repair procedure.
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BACKGROUND: Surgical site infection (SSI) after cholecystectomy unduly delays patients' early return to normal activities and also leaves behind relatively disfigured cosmetic scars at the port sites. This prospective study was undertaken to assess the various risk factors leading to SSI in patients undergoing cholecystectomy, both by laparoscopic and open techniques in this part of India for which no data is available at present. MATERIAL AND METHODS: A total of 1507 cholecystectomies (1184 by laparoscopy and 323 by open technique) during a 6 year period. The various risk factors studied were gender, age, BMI, DM, chronic anaemia, COPD, timing of surgery (elective or emergent), influence of surgeon (operated by resident surgeon or faculty), intraoperative bile spillage, etc., Odd's ratio was calculated to see the influence of the factors on SSI and statistical significance was tested by Chi-square test. RESULTS: The overall rate of infection was 3.12% (1.94% in laparoscopy and 7.43% in the open technique). Intraoperative bile spillage, increasing age, increased duration of surgery, laparoscopic cholecystectomy done by resident surgeons, increased intraoperative blood loss, emergent operations done for acute cholecystitis, etc., were associated with higher rates of SSI. CONCLUSION: Meticulous operative techniques avoiding bile spillage and blood loss during cholecystectomy may reduce the chances of developing SSI.
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INTRODUCTION: Infections after surgeries considerably increase patients' hospital stay, thereby prolonging patients' early return to productive life. At the same time, the cost of hospitalization also increases. Therefore, if objective tests can predict infections before it actually happens, then more preventive measures in the form of upgrading antibiotics can be taken which might prevent patients from developing serious infections and thereby reduce morbidity and mortality of surgery. MATERIAL AND METHODS: It was a prospective cross sectional study to assess the efficacy of acute phase reactants C-reactive protein (CRP) and interleukin 6 (IL 6) in predicting infections in patients undergoing routine general surgical operations. A total of 74 patients were included in the study. Laparoscopic surgical procedures were not included in the study to maintain uniformity in the procedures. Data so collected were analyzed by using SPSS version 22. RESULTS: A total of 27 patients developed wound infections postoperatively. The mean rise in the levels of CRP and IL 6 was higher in those patients who developed postoperative wound infections. The positive predictive value and negative predictive value was found to be better with IL 6 than with CRP. CONCLUSION: It may be concluded that a serial estimation of CRP and IL 6 postoperatively can predict infections and may be utilized routinely in general surgical practice.
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Reporting herewith 2 cases of Meckel's diverticulum presenting with acute intestinal obstruction. The patients were managed surgically. The cases were presented in emergency department and management were based on clinical and imaging after a initial resuscitation. The intra-operative findings are discussed in herewith.
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INTRODUCTION: Gall bladder (GB) retrieval is an important cause for postoperative pain after laparoscopic cholecystectomy (LC). GB is usually extracted either from the epigastric or the umbilical port and there are limited data to decide the superiority of one over other in terms of postoperative pain. This study was designed to determine whether GB retrieval from the umbilical port was associated with less pain as compared to epigastric port in adult patients undergoing four ports elective LC. MATERIAL AND METHODS: A total of 100 patients took part in the study and were randomly allocated into 2 groups. Postoperatively, port-site pain score was assessed at 1, 6, 12, and 24 h by visual analog scale (VAS) score both for the epigastric and umbilical ports in all the patients and the collected data were analyzed by using SPSS version 22. RESULT: VAS score for postoperative pain at epigastric port at 1, 6, 12, and 24 h found to be higher as compared to umbilical port (6.640 ± 1.494 vs. 5.500 ± 1.176, 6.620 ± 1.549 vs. 5.320 ± 1.188, 6.100 ± 1.549 vs. 4.660 ± 1.232, 5.250 ± 1.459 vs. 3.970 ± 1.274, respectively) which was statistically significant (P value 0.001). But the time taken for retrieval of GB was significantly longer in the umbilical group (4.94 ± 1.56 vs. 3.24 ± 1.29). CONCLUSION: Umbilical port is better as compared to epigastric port for GB retrieval in patient undergoing elective four port LC in terms of postoperative port-site pain but it takes relatively longer time for the extraction.