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Port Placement 1. 10mm Right hand working port 2. 10 mm Camera port 3. 5 mm Left hand working port
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Objective: To evaluate the results of Laparoscopic Appendicectomy using midline suprapubic port for camera. Methodology: This prospective descriptive study was done from January 2007 to 30 April 2008. All patients undergoing Laparoscopic Appendicectomy during the study period were included. Operative time, conversion, complications & hospital stay...
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Purpose:
Single port laparoscopic surgery (SPLS) is a technique which is increasing in popularity. The benefit of SPLS in complex Crohn's disease (CD), which includes a significant cohort of young patients sometimes needing multiple operations, has not been comprehensively assessed. This study analyses our early experience with this technique.
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Citations
... [7] Similarly, in study by Zubair et al., the incidence of PSI in laparoscopic appendectomy was 5.88% in adult population. [18] The rate is low because of enhanced expertise, short duration of procedure, and greater number of laparoscopic procedures as compared to pediatric population. In the study of Khiari et al., the reported PSI was 6% in patients undergoing laparoscopic appendectomy. ...
Background: Laparoscopic appendectomy is being practiced throughout the world for the treatment of acute appendicitis in children and adults. The objective of this study was to determine the frequency of port sites infection in children undergoing laparoscopic appendectomy at our institution. Methods: The study was conducted at the Pediatric Surgery Unit of Lady Reading Hospital Peshawar from January 2014 to Jan 2015. All the patients with the diagnosis of acute appendicitis underwent a three-port laparoscopic appendectomy. Port-site infection was noted postoperatively. Results: Total number of patients in this study was 207 including 138 males (66.70%) and 69 (33.3%) females (M:F 2:1). The age ranged from 6 to 14 years, with mean age of 11 years ±2.096. The overall complications occurred in 39 (18.84%) patients. The port-site infection occurred in 33 (16%) patients. Port-site infection involved only the umbilical port sites and was superficial. Port-site infection was managed conservatively without any sequelae. Conclusion: Laparoscopic appendectomy is a safe technique in children with port-site infection rate of 16%. There is no morbidity as all the port-site infections occurred at umbilical port-site were superficial thus managed conservatively.
... Various authors within Pakistan have looked at various aspects of minimal access surgery like management of difficult cases 7 , as a diagnostic modality 8,9 , use in evaluation of chronic pain 10 , newer techniques like laparoscopic appendicectomies 11 and hernia repair. 12 Recently Asghar and co-workers 13 looked at the stress endured by patients during open and laparoscopic cholecystectomies. ...
Objective: To evaluate post graduate surgical residents' training in minimal access surgery. Methodology: This cross sectional survey was based on a 16-item self reporting questionnaire that was provided to 48 third, fourth and fifth year postgraduate general surgical trainees doing residency in seven Karachi institutions accredited by College of Physicians and Surgeons Pakistan for Fellowship training. All 48 trainees completed and returned the given questionnaire. Results: Eleven were 3rd year, 33 were 4th year and four trainees were 5th year residents. Mean age of the trainees was 30.31(SD 2.8) years (range 27 to 43), Males were 35 (72.92%), females were 13 (27.08%). Forty six (95.83%) answered that laparoscopic surgery was performed in their department, while two (4.17%) replied in negative. Nine (18.75%) said that they had performed Laparoscopic Cholecystectomy under supervision, while 39 (81.25%) responded "no". Regarding "Dry Lab" access 18(37.5%) responded "yes" while 30 (62.5%) said no. Similarly regarding "Wet Lab" none said "yes", all (100%) responded by saying "No" as was the case of Virtual Reality Simulator where 45 (93.75%) said "No" while three (6.25 %) did not answer this question and none responded "Yes". Out of the 48 trainees questioned only nine (18.75%) had ever attended a Basic Laparoscopy workshop while 39 (81.25%) had not. Trainees own perception regarding their skills and status in laparoscopic surgery training was such that none said Excellent, 7(14.58%) said Good, eight (16.67%) labelled themselves as Average while nine (18.75%) thought they were below average, 23 (47.92%) said they were Poor in this Skill and one(2.08%) did not respond. Most 41 (85.42%) would prefer to do a One Year Fellowship in Minimal Access Training following FCPS, while one(2.08%) said "No" and six (12.5%) were not sure. Conclusion: Education and training in Minimal Access Surgery within Institutions of Karachi is not standardized and access to training facilities is limited.
Objective: To compare the outcome of laparoscopic and open appendecectomies in terms of operative time and post-operative morbidity. Methodology: This prospective study was done from March, 2008 to March, 2009, at Surgical "C" Unit of Khyber Teaching Hospital, Peshawar. All consecutive appendectomies (open and laparoscopic) performed over this time were included. Demographic details, operative time, conversion, infective post-operative complications and delay in discharge were recorded. The patients were divided into two groups, laparoscopic appendectomies (LA) and open appendectomies (OA). Results: A total of 165 appendectomies were performed, 72 in the LA group and 93 in OA group. Eighteen appendectomies were perforated at the time of operation. The patients' ages ranged from 12-65 years (median 24 years). Eighty were males and eighty five were females. Operative time in LA group was longer with mean duration of 45 minutes (range 35-75 minutes) compared with 35 minutes (range 30-55 minutes) in OA group. A glove finger was used as extraction bag in 59 (83%) in LA group. LA patients' wound infection was recorded in12 patients, two out of 72 in LA and 10 out of 93 in OA group. The site of infection was the port of specimen extraction in LA group. Intra-abdominal abscesses complication was observed in one case in the OA group. LA group had shorter hospital stay (mean 1.5 days) than (OA) (mean 3.5 days), and early return to normal activity, 8-15(mean 10.5) days in LA and15-25(mean18.5) days in OA. Conclusion: Laparoscopic Appendectomy (LA) is safe and has major benefits like less post-operative pain, decreased wound infection, early hospital discharge and earlier return to work than Open Appendectomy (OA). LA is recommended in all patients with acute appendicitis if laparoscopy is not contraindicated.
