DocumentsDate added
Original article
Swarupjit Ghata1,*, Dharmendra Dugar2, Ranjit Kumar Mishra3, Ramji Khetri2,Tim Houghton T1
Affiliation:
1Third Year P.G Student, 2Associate professor, 3Professor and Head , Department of General Surgery, Hi-Tech Medical College and Hospital, Bhubaneswar, Odisha, India
The name of the department(s) and institution(s) to which the work should be attributed:
Department of General Surgery, Hi-Tech Medical College and Hospital, Bhubaneswar, Odisha, India
Address reprint requests to
Dr.Swarupjit Ghata,
Third Year P.G Student,
Department of General Surgery, Hi-Tech Medical College and Hospital, Bhubaneswar, Odisha, India
Article citation: Ghata S, Dugar D, Mishra R K, Khetri R, Tim HT. Study of port site complications in laparoscopic surgeries. J Pharm Biomed Sci. 2015; 05(02):134-138. Available at www.jpbms.info
ABSTRACT: Background: The approach to surgical treatment underwent a paradigm shift in 1987. Mouret performed the first human laparoscopic cholecystectomy in France in 1987 and now has become the gold standard treatment for patients suffering from cholelithiasis. Laparoscopic surgery became the standard care for many gynecological and surgical conditions with documented benefits and excellent outcome. In addition to the general complications of surgery and anesthesia, laparoscopy has unique complications relating to abdominal entry and surgical instrumentation. The early innovators and early adopters have identified such risks and complications associated with such procedures and analyzed them.
Material & method: It is a prospective study on complications of the port site in laparoscopic surgeries. The data collection for our study included patients from Hi-Tech medical college and hospital, Bhubaneswar, Odisha during the period June 2012- December 2014. All the complications encountered while creating ports in laparoscopic surgeries were studied. Complications related to faulty techniques and due to human error were taken into account and studied.
Results: In our study 100 different patients posted for laparoscopic surgeries in Hi-Tech medical college and hospital were studied to evaluate the port site complications in laparoscopic surgeries. In our study, out of 100 patients, 55 were male and 45 were female. Out of the 100 patients, there were 9 patients who had complications. Highest number of complications was seen in patients of 60 to 79 years of age. Thus, it was inferred that old patients who already had less immunity and who were suffering from other co-morbid conditions were at increased risk of complications from laparoscopic surgeries. Out of the 9 complications, 7 were post-operative, 1 occurred while maintaining the port during surgery and 1 occurred while creating port.
Conclusion: Laparoscopic surgery introduces to the new set of risks such as trocar injury, cardiovascular problems and damage to the bowel and major vessels that are rarely if ever encountered in open surgeries. Laparoscopic surgeries by inexperienced surgeons should be discouraged. All the training institutes should have a protocol to train, access, accredit the trained. All the surgeries should be recorded and analyzed to identify the cause of the complications noted and ways to avoid them. Working with a team makes a good sense.
KEYWORDS: Laparoscopy [Lap]; Port site complications; Trocar injury; bowel injury; vessel injury.
REFERENCES
1.Hasson HM. A modified instrument and method for laparoscopy. Am J Obstet Gynecol. 1971;110:886-887
2.Tonouchi H, Ohmori Y, Kobayashi M, Kusunoki M. Trocar site hernia. Arch Surg. 2004;139:1248-1256
3.Molloy D, Kaloo PD, Cooper M, Nguyen TV. Laparoscopic entry: A literature review and analysis of techniques and complications of primary port entry. Aust N Z J Obstet Gynaecol. 2002;42:246-54
4.Jansen,F. W., Kapiteyn, K., Trimbos-Kemper, T., Hermans, J. and Trimbos, J. B. (1997), Complications of laparoscopy: a prospective multicentre observational study. BJOG,104:595-600
5.Bonjer HJ, Hazebroek EJ, Kazemier G, et al. Open versus closed establishment of pneumoperitoneum in laparoscopic surgery. Br J Surg. 1997;84(5):599-602
6.El-Banna M, Abdel-Atty M, El-Meteini M, Aly S. Management of laparoscopic-related bowel injuries. Surg Endosc. 2000;14(9):779-82
7.Boni L, Benevento A, Rovera F, et al. Infective complications in laparoscopic surgery. Surg Infect (Larchmt) 2006;7:109-11
8.Berger D, Bientzle M, Muller A. Postoperative complications after laparoscopic incisional hernia repair. Incidence and treatment. Surg Endosc 2002;16(12):1720-1723.
Source of funding: None
Competing interest / Conflict of interest: The author(s) have no competing interests for financial support, publication of this research, patents and royalties through this collaborative research. All authors were equally involved in discussed research work. There is no financial conflict with the subject matter discussed in the manuscript.
Statement of Originality of work: The manuscript has been read and approved by all the authors, the requirements for authorship have been met, and that each author believes that the manuscript represents honest and original work.
Disclaimer: Any views expressed in this paper are those of the authors and do not reflect the official policy or position of the Department of Defense.
Copyright © 2015 Ghata S, Dugar D, Mishra R K, Khetri R, Tim HT. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Case report
Lakshmi Kant Pathak.1,*, MD, MRCP, FACP, Chirag Chavda2.,MD, Mohamed Mohamed,1,±, MD, Vimala Vijayaraghavan3, MD
Affiliation:
1,*,±Sanford Medical Center, University of North Dakota, Fargo, USA
2Methodist Health system, Dallas, USA
3Caribbean Medical University, Chicago, USA
The name of the department(s) and institution(s) to which the work should be attributed:
1.Sanford Medical Center, University Of North Dakota, Fargo, USA
2.Methodist Health system, Dallas, USA
3.Caribbean Medical University, Chicago, USA
Address reprint requests to
Dr Lakshmi Kant Pathak, MD, MRCP, FACP
Sanford Medical Center, University of North Dakota, Fargo, USA
Article citation:
Pathak LK,Chavda C,Mohamed M,Vijayaraghavan V. The idiom, laughter is the best medicine is not always true. Takotsubo Cardiomyopathy precipitated by positive emotion, recurrence in the patient. Understanding the facts and review of literature. J Pharm Biomed Sci. 2015; 05(02):131-133. Available at www.jpbms.info
ABSTRACT:
Takotsubo Cardiomyopathy is a rare but well described entity. The disease is also known as stress induced cardiomyopathy or apical ballooning syndrome. As the name implies, it is usually but not always associated with an antecedent stressful event. Almost all cases of Takotsubo cardiomyopathy are triggered by negative stressors such as anger, grief, and anxiety. Some cases are triggered by physical exertion. Complete recovery is the most common outcome and recurrence is very rare. It is also called broken heart syndrome.
It mimics acute coronary syndrome and the correct diagnosis is based on angiographic finding of apical ballooning in the absence of significant coronary obstruction.
This article reports a unique case of recurrence of Takotsubo cardiomyopathy not described before triggered by a positive emotion in the same patient. To our knowledge, this is the only case report of recurrence twice following positive emotion as the trigger in the same patient. This patient condition on the contrary can be called "happy heart syndrome" or may be “laughter disaster”.
The patient had an uneventful course following both episodes.
The article also reviews briefly the literature available on etiology, pathogenesis andprognosis..
KEYWORDS: Takotsubo cardiomyopathy; recurrence; positive emotions; LV dysfunction.
Statement of Originality of work: The manuscript has been read and approved by all the authors, the requirements for authorship have been met, and that each author believes that the manuscript represents honest and original work.
REFERENCES
1."Happiness" and stress cardiomyopathy (apical ballooning syndrome/Takotsubo syndrome) Int J Cardiol. 2014;172(1):e182-3. doi: 10.1016/j.ijcard.2013.12.140. Epub 2014 Jan 4.
2.Takotsubo cardiomyopathy or transient left ventricular apical ballooning syndrome: A systematic review. Pilgrim TM, Wyss TR. Int J Cardiol. Mar 14 2008; 124(3):283-92.
3.Singh K, Carson K, Usmani Z, et al. Systematic review and meta-analysis of incidence and correlates of recurrence of Takotsubo cardiomyopathy. Int J Cardiol. Jul 1 2014; 174(3):696-701.
4.Kawai S, Kitabatake A, Tomoike H. Guidelines for diagnosis of Takotsubo cardiomyopathy. Circ J. Jun 2007; 71(6):990-2.
Source of funding: None
Competing interest / Conflict of interest: The author(s) have no competing interests for financial support, publication of this research, patents and royalties through this collaborative research. All authors were equally involved in discussed research work. There is no financial conflict with the subject matter discussed in the manuscript.
Disclaimer: Any views expressed in this paper are those of the authors and do not reflect the official policy or position of the Department of Defense.
Copyright © 2015 Pathak LK, Chavda C, Mohamed M, Vijayaraghavan V. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.