A study of skin closure of surgical wound by subcuticular sutures with polyglactin 910 fast (rapide vicryl) in planned surgery

Background: The skin is the largest and among the most complex organs of the body. Although the skin functions simply as a protective barrier to interface with our environment, its structure and physiology are complex. Suturing is commonly used today as a mean by which wounds are closed to prevent infection and fasten healing with minimal scarring. Cosmetic results of healed wound are also important and as awareness is increasing among general population, they are more concerned with cosmetic scar. Various techniques are developed to give cosmetically better scar, like subcuticular suture, adhesive tapes, staplers, etc.Methods: Study was randomized, prospective, observational and longitudinal including 100 patients, selected according to inclusion criteria.Results: Cosmetic result of the study were good; 87% patients were having good to excellent cosmetic results. And 13% patients were having scar which was cosmetically not good (scar was either hypertrophied or thickened). complication was not significant (only 3% having on post-operative day 5).Conclusions: Surgical wound closure with subcuticular suture with absorbable suture material gives excellent cosmetic results, cheaper and cost-effective compare to other technique of wound closure having similar cosmetic result. As the removal of suture is not required, no follow up visit needed, and it saves the extra time and expenditure of patient

Role of triple assessment modalities in diagnosis of palpable breast lump

Background: One fourth of women suffer from breast disease in their lifetime. Carcinoma of breast is the second most common cancer in the world. Timely and accurate diagnosis of breast lump with early intervention can be life saving. There are various modalities for the diagnosis of breast lump such as USG, FNAC and Mammography, MRI etc. but none of them is perfect. There are numerous reports suggesting that if the results of clinical assessment, mammography and FNAC are all combined, the diagnostic accuracy is nearly 100%. Furthermore, these techniques also provide information about tumor size, number, extent and grade preoperatively.Methods: Study was randomized, prospective, observational and longitudinal including 100 patients, selected according to inclusion criteria.Results: The sensitivity, specificity and accuracy of triple test in present study were 98.68%, 87.5%, and 96% respectively. Out of 100, 76 patients were confirmed as having benign lesion and 24 patients having malignant lesion by histopathology examination.Conclusions: Results of triple assessment are same as the results by histopathology examination in majority of cases. It is highly accurate, can be used as a confirmatory diagnostic tool for breast lump, thus there is no need to perform diagnostic open biopsy for breast lump

Spontaneous intravesical knotting of infant feeding tube: a rare case report

Infant Feeding tube is universally used in Paediatric Patients for many diagnostic as well as therapeutic purposes. Intravesical knotting of IFT is rare but having significant morbidity. We here present such a rare case report in 6 month old patient treated endoscopically. Sometimes it is very difficult to remove knotting with various techniques discussed later, but it may cause more trauma to urethra. There are only few reported cases worldwide about it in few journals. But Endoscopic removal being safe among all. In such Urological Emergency, always early Identification is most important to prevent further complications. As neonate and infant’s urethra is small compared to the available smallest Foley catheter (8Fr), a 5 Fr and 8 Fr feeding tubes are practical alternatives to drain urine from the bladder. Intravesical catheter knotting of small feeding tubes placed as urinary diversion from the bladder is rare. The first case of catheter knotting in a pediatric patient was reported in 1976

Giant prostatic hyperplasia: surgical treatment a rare case

We report a rare case of giant prostatic hyperplasia in an 80-year-old male patient. MRI revealed a markedly enlarged prostate measuring 814gm.We have performed suprapubic open prostatectomy (Transvesical). The adenoma was completely enucleated in one piece which was 11cm×16cm in size and weighed 504gm

Comparative study of modified open technique and closed technique for primary trocar insertion in laparoscopic surgery

Background: The objective of this study was to compare the safety and efficacy of modified open technique and closed technique for gaining entry [primary trocar insertion] and establishing pneumoperitoneum in laparoscopic surgery.   Methods: The present study was prospective, observational and longitudinal.  Protocol of the procedure was formed along with Performa, Patient Information Sheet and Informed Consent Form. The present study was carried out in surgery department of C.U Shah medical college, Surendranagar, Gujarat state. The study was carried out from 1st October 2012 till 31st May 2014. A total of two hundred patients undergoing emergency and elective laparoscopic surgery were included in our study.  Case records of  patients was recorded in the Performa containing demographic details, size and site of trocar insertion, technique of trocar insertion, intraoperative, early postoperative and late post operative complications were noted.Results: Total of 200 cases was included in our study. The age of patients ranges from 10-70 years. Out of 200 cases 90% were females suffering from different ailments and 105 were males in group A while in Group b 80% were females and 20%were males.  In terms of on table complications; gastrointestinal injury is more in close method of trocar insertion.Conclusions: We would advocate the modified open technique of trocar insertion as a technique of choice in primary trocar insertion as it is more efficacious and counts more on patient safety as compared to the close technique.

A comparative study of laparoscopic cholecystectomy with and without abdominal drain

Background: Laparoscopic surgery has several advantages when compared to open surgery, including faster post-operative recovery and lower pain scores. Laparoscopic cholecystectomy is the main method of treatment of symptomatic gallstones. Routine drainage after laparoscopic cholecystectomy is an issue of considerable debate.Methods: Study was randomized, prospective, observational and longitudinal including 100 patients, selected according to inclusion criteria.Results: The sub hepatic fluid collection on first ultrasound at 24hrs was higher in drained group than in non-drained groups. Further, the difference became insignificant on subsequent ultrasound at 72hrs. Incidence of post-operative drain site pain was present in 25% of patients with drain (more at drain site). Incidence drain site infection was present in 16.6% of patients in drain group. Majority of the patients with drain group (n=24) required hospital stay for ≥3 days, while for majority of patients without drain group (n=20), required hospital stay was 1 day.Conclusions: An uncomplicated gall stone disease can be treated by laparoscopic cholecystectomy without need for drain with reasonable safety by an experienced surgeon. With no usage of drain, it is significantly advantageous in terms of post-operative pain, use of analgesics and hospital stay

Comparative study of modified open technique and closed technique for primary trocar insertion in laparoscopic surgery

Background: The objective of this study was to compare the safety and efficacy of modified open technique and closed technique for gaining entry [primary trocar insertion] and establishing pneumoperitoneum in laparoscopic surgery.   Methods: The present study was prospective, observational and longitudinal.  Protocol of the procedure was formed along with Performa, Patient Information Sheet and Informed Consent Form. The present study was carried out in surgery department of C.U Shah medical college, Surendranagar, Gujarat state. The study was carried out from 1st October 2012 till 31st May 2014. A total of two hundred patients undergoing emergency and elective laparoscopic surgery were included in our study.  Case records of  patients was recorded in the Performa containing demographic details, size and site of trocar insertion, technique of trocar insertion, intraoperative, early postoperative and late post operative complications were noted.Results: Total of 200 cases was included in our study. The age of patients ranges from 10-70 years. Out of 200 cases 90% were females suffering from different ailments and 105 were males in group A while in Group b 80% were females and 20%were males.  In terms of on table complications; gastrointestinal injury is more in close method of trocar insertion.Conclusions: We would advocate the modified open technique of trocar insertion as a technique of choice in primary trocar insertion as it is more efficacious and counts more on patient safety as compared to the close technique.