Advances in the Surgical Management of Achalasia Cardia: A Review | Chapter 9 | Medical Science: Updates and Prospects Vol. 2

 

Achalasia cardia, an oesophageal dynamic disorder, is a relatively rare primary motor oesophageal disease characterised by the functional loss of plexus ganglion cells in the distal oesophagus and lower oesophageal sphincter. The management of Achalasia Cardia can be divided into medical and surgical management. This chapter synthesises the literature findings to examine the various surgical procedures available for achalasia cardia, focusing on their respective advantages and potential complications. The surgical management of achalasia cardia has undergone significant advancements over the past decade, particularly following the introduction of Heller's myotomy. Currently, laparoscopic Heller's myotomy, often accompanied by partial fundoplication, is regarded as the gold standard for the surgical treatment of achalasia cardia. Additionally, robotic Heller's myotomy is gradually gaining prominence with the advent of robotic surgical techniques. In contrast, thoracoscopic myotomy is now infrequently performed, and esophagectomy is reserved for patients with end-stage achalasia cardia. The choice of surgical approach is typically individualised, taking into account the patient’s condition and risk profile.

 

Author(s) Details
Kumar H.R.
Taylor’s University School of Medicine Clinical Campus,4700 Sg Buloh, Selangor, Malaysia.

 

Please see the book here :- https://doi.org/10.9734/bpi/msup/v2/6625

Laparoscopic Management of Anaphylactic Shock Following Abdominal Trauma Revealing Intravascular Rupture of Cystic Echinococcosis (A Case Report and Brief Literature Review) | Chapter 04 | Issues and Developments in Medicine and Medical Research Vol. 5

 Anaphylactic shock produced by an accidental traumatic intraperitoneal rupture is a well-known consequence, as opposed to anaphylactic shock caused by the intravascular dissemination of cyst contents, which is uncommon. Cyst rupture after trauma or spontaneous rupture is a common consequence of hydatid illness. This article describes an uncommon instance of a 13-year-old child who was admitted to a public hospital with little indicators after suffering a trauma. Ultrasonography revealed a hydatid cyst in the liver, with the cyst contents draining into the right hepatic vein and no free peritoneal fluid. Anaphylactic shock ensued shortly after, and the patient was brought to our emergency room. After stabilising the patient, an abdominal laparoscopic examination revealed a ruptured cyst, which was treated laparoscopically. Albendazole was also given to the patient. The purpose of this study is to determine the feasibility and safety of laparoscopy in the treatment of complex Hepatic Echinococcosis, as well as the length of operation and hospital stay. In this type of Echinococcosis clinical presentation, we believe laparoscopic surgery is a good option.

Author(S) Details

Haif Assia
Department of Pediatric Surgery, University Hospital Center of SETIF, Algeria and Laboratory of Applied Pediatric Surgery, Ferhat Abbas Setif University 1, Algeria.

View Book:- https://stm.bookpi.org/IDMMR-V5/article/view/5579

A Systemic Review on Robotic Versus Laparoscopic Adrenalectomy | New Visions in Science and Technology Vol. 5

 Background: For most surgical procedures, minimally invasive surgery has become the norm. Many research have been conducted to compare robotic and laparoscopic adrenalectomy.   The goal of this study is to look at the majority of the papers that compare robotic and laparoscopic adrenalectomy to see whether treatment has better clinical outcomes. Methods: A comprehensive search of the ScienceDirect and PubMed databases. Two independent reviewers gathered the perioperative clinical results. The pooled effect estimates were calculated using random-effects (DerSimonian-Laird) models.   In our investigation, 18 studies were found to be eligible. Ten of them were prospective, while the other eight were retrospective. A total of 1376 patients underwent adrenalectomy, with 592 (43.02%) receiving RA treatment and 784 (56.9%) receiving LA treatment. The conversion rate (OR: 0.70, 95 percent CI 0.31-1.57, P= 0.65), intraoperative complications (OR: 2.18, 95 percent CI 0.49- 9.71, P= 0.28), post-operative complications (OR: 0.83, 95 percent CI 0.55-1.24, P= 0.49), and mortality (OR: 0.42, 95 percent CI 0.07-2.72, P= 0.98) were all similar in both groups. Robotic adrenalectomy, on the other hand, was related with longer operational times (MD: 9.89 min, 95 percent CI: -2.79 to 22.58), a shorter hospital stay (MD: -0.33, 95 percent CI: -0.46 to -0.21), and less blood loss (MD: -0.33, 95 percent CI: -0.46 to -0.21). (MD: -25.34, 95 percent CI: -36.77 to -13.91). Conclusions: When compared to laparoscopic adrenalectomy, we found that robotic adrenalectomy is equally safe and feasible, with similar clinical outcomes. To assess the role and cost-effectiveness of robotic adrenal surgery, however, further well-designed research are needed.

Author (S) Details

Emad Rezkallah

General Surgery Department, James Cook University Hospital, South Tees NHS Foundation Trust, England.

Andrew Elsaify

Medical School, Misr University for Science and Technology, Egypt.

Grace Lim

General Surgery Department, James Cook University Hospital, South Tees NHS Foundation Trust, England.

Wael Elsaify

General Surgery Department, James Cook University Hospital, South Tees NHS Foundation Trust, England.

View Book :- https://stm.bookpi.org/NVST-V5/article/view/4101

Management of Symptomatic Gall Stones in a Tertiary Care Health Facility in Southern Nigeria: A Recent Study | Chapter 9 | Highlights on Medicine and Medical Research Vol. 7

 Background: Gallstone disease is one of the most frequent digestive system diseases. The illness spans from silent to symptomatic stones, each with its own set of problems. The disease is exceedingly uncommon among black people, and it is unknown among Africa's Bantu and Masai tribes. Surgery is still the most effective treatment for symptomatic gallstone disease, as other options are usually ineffective. Previously, open surgery was the only choice for cholecystectomy, but with the development of minimally invasive procedures, laparoscopic cholecystectomy has become the gold standard of surgical care.

Although not widespread in this environment, there is a need to assess the age and sex prevalence, the types of stones that are common, the various modes of clinical presentation and disease spectrum, as well as the treatment modalities used in this institution.

Methods: This is a sixteen-year retrospective review of all cases handled in this institution. Using a proforma, the case files of these patients were downloaded and essential information collected. SPSS VERSION 22 was used to analyse the data.

Results: Gall stone illness is more common in women, with a male-to-female ratio of 1:5.6. The most prevalent age group was 41-50 years, and the most common manner of presentation was recurring right hypochondrial/epigastric discomfort. In contrast to what happens in Europe and North America, the most common stone type was mixed.

Conclusion: This study found that gall stone disease is mainly prevalent among females in this area, and that open surgery is still used to treat it.

Author(s) Details

Promise N. Wichendu
Department of Surgery, University of Port Harcourt Teaching Hospital, Choba, Port Harcourt, Nigeria.

A. Dodiyi-Manuel
Department of Surgery, University of Port Harcourt Teaching Hospital, Choba, Port Harcourt, Nigeria.

Kelechi Ikonwa
Department of Surgery, University of Port Harcourt Teaching Hospital, Choba, Port Harcourt, Nigeria.

View Book :- https://stm.bookpi.org/HMMR-V7/article/view/1064

An Audit of Laparoscopic Surgery in a Developing Country in East Africa at the Beginning of a Surgeon's Learning Curve | Chapter 16 | Highlights on Medicine and Medical Research Vol. 5

 Background: Laparoscopic surgery has been used for surgical access in a variety of situations. The gold standard treatment for cholecystitis in the West is laparoscopic cholecystectomy. Laparoscopic appendicectomy, on the other hand, has sparked debate due to its high cost and time-consuming existence, as well as the numerous trocar sites, which all add up to the duration of an open appendicectomy incision.Laparoscopic surgery has many benefits, including a faster return to daily life, a shorter hospital stay, and less postoperative analgesia. The aim of this study is to evaluate the initial experience of laparoscopic units in a developing country in East Africa.

The thesis was performed retrospectively in the Department of Surgery. This research included all patients who agreed to laparoscopic cholecystectomy and laparoscopic appendicectomy within the first 13 months.

Ten (10) patients consented to laparoscopic cholecystectomies with a male:female ratio of 1:2.33, and twenty (20) patients consented to laparoscopic appendicectomies with a male:female ratio of 1:1.2. The average operating time for laparoscopic cholecystectomy was 58.5 minutes and for laparoscopic appendicectomy was 40.45 minutes. For laparoscopic cholecystectomy, post-operative admission lasted 3 to 5 days, with a mean of 4.2 days, and for laparoscopic appendicectomy, it lasted 2 to 5 days, with a mean of 2.65 days. Aside from a spinal headache in two patients (2.6 percent) out of the total laparoscopic procedures, no other complications were identified. During the one-month follow-up period, there were no readmissions.

Conclusions: Laparoscopic cholecystectomy and appendicectomy are safe and allow for early discharge. The low incidence of cholecystitis in Uganda, relative to the higher incidence of appendicitis, supports the use of laparoscopic appendicectomy for hand and eye coordination training rather than cholecystectomy. The surgeons' initial cases of laparoscopic procedures have shown an acceptable degree of protection, indicating that laparoscopic appendicectomy is a viable option for learning the fundamentals of laparoscopic surgery.

Author (s) Details

Richard Wismayer
Department of Surgery, Masaka Regional Referral Hospital, Masaka, Uganda and Department of Surgery, Habib Medical School, IUIU University, Kampala, Uganda.

View Book :- https://stm.bookpi.org/HMMR-V5/article/view/703

Emphasizing Novel Technique Combining Tissue and Mesh Repair for Umbilical Hernia in Adults | Chapter 9 | Research Trends and Challenges in Medical Science Vol. 7

Introduction: To the surgeon, umbilical hernia in adults poses a problem. In creating a successful repair, recognising the anatomical and pathological intricacies of the hernia is central. A number of repairs have been attempted in order to repair umbilical hernias. None of them have, however, defied the test of time. Objective: The objective of the study is to establish a technique that offers mesh-reinforced anatomical reconstruction of the defect. Materials and Methods: 20 patients underwent an umbilical hernia hybrid repair operation. Tabulated and analysed the observations. Results: None of the twenty patients had a recurrence. Conclusion: for umbilical hernias in adults, a combined mesh strengthening of tissue repair is advocated. This novel tissue repair mesh reinforcement technique is best suited for adult umbilical hernia repair due to its excellent results and low cost.

Author(s) Details

Dr. Ketan Vagholkar
Department of Surgery, Dr. D. Y. Patil Medical College, Navi Mumbai, India.

Dr. Suvarna Vagholkar
Department of Surgery, Dr. D. Y. Patil Medical College, Navi Mumbai, India.

View Book :- https://bp.bookpi.org/index.php/bpi/catalog/book/361