exudates and Blood-Loss--Surgical

Single-incision laparoscopic cholecystectomy (SILC) is an evolving concept in minimally invasive surgery. It utilizes the concept of inline viewing and a single incision that accommodates all of the working instruments. Here, we describe a single surgeon's initial experiences of using this technique in a tertiary hospital.. Between January and September 2010, 21 patients underwent SILC for symptomatic cholelithiasis. The umbilicus was the point of access into abdomen for all patients using a 2.0-2.5-cm incision. The surgeries were performed using the Covidien SILS port with a 30° angled scope and two 5-mm conventional laparoscopic instruments.. Nineteen patients successfully underwent surgery (8 males and 11 females; mean age: 43 years). The mean body mass index was 25.9 kg/m(2) (range: 19.0-38.2 kg/m(2)). The mean operative time was 89 minutes (range: 55-135 minutes). Minimal blood loss was noted in each patient. The mean length of the postoperative stay was 1.1 days (range: 1-3 days). No complications or mortalities were associated with the technique. The visual analogue score for pain at the 1-day and 6-week follow-up examinations was 2 (range: 1-7) and 0.6 (range: 0-3), respectively. At 6 weeks, the mean satisfaction score for the resultant scar was 8.8 (range: 4-10) and the mean overall satisfaction score was 9.2 (range: 7-10). The mean time until returning to work or normal activities was 8.8 days (range: 1-21 days).. SILC is feasible and demonstrates a good clinical outcome.

Topics: Adult; Aged; Blood Loss, Surgical; Cholecystectomy, Laparoscopic; Cholelithiasis; Female; Follow-Up Studies; Humans; Length of Stay; Malaysia; Male; Middle Aged; Pain Measurement; Patient Satisfaction; Prospective Studies; Treatment Outcome

A prospective cross-sectional study involving 14 government hospitals was undertaken for a period of 6 months in Malaysia to study the patterns of hysterectomy for gynaecological indications. A total of 707 patients were enrolled in the study consisting of 612 abdominal hysterectomies and 95 vaginal hysterectomies. Fibroids (47.6%) and uterovaginal prolapse (13.4%) formed the main indications for surgery. The initial preoperative diagnosis was accurate in 82.8% of cases. A different pathology from that initially suspected was noted in 118 cases. The overall complication rate was 7.9% but vaginal hysterectomies carried a statistically higher complication rate compared to abdominal hysterectomies. Urinary tract infection was significant in vaginal hysterectomies. Blood transfusion was required in 25.0% of abdominal and 6.3% of vaginal hysterectomies. There were no laparoscopic hysterectomies or mortality in this series.

Topics: Adult; Aged; Aged, 80 and over; Blood Loss, Surgical; Blood Transfusion; Cross-Sectional Studies; Female; Health Surveys; Humans; Hysterectomy; Hysterectomy, Vaginal; Malaysia; Middle Aged; Multicenter Studies as Topic; Prospective Studies