anushtup de - Academia.edu (original) (raw)
Papers by anushtup de
Asian Journal of Case Reports in Surgery, Oct 24, 2019
International Surgery Journal, 2018
Background: Endovenous Radiofrequency Ablation (RFA) is gradually gaining widespread acceptance a... more Background: Endovenous Radiofrequency Ablation (RFA) is gradually gaining widespread acceptance as a minimally invasive modality for treatment of varicose veins (VV). The objective of this study was to evaluate the efficacy based on Venous Doppler and Venous Clinical Severity Score (VCSS) and the safety of radiofrequency ablation for varicose veins.Methods: This is a prospective study of 58 consecutive patients who underwent Radiofrequency ablation of Varicose veins from January 2015 to January 2017 in a single unit of a Multispecialty Tertiary Care Hospital. The mean age was 44.10±13.74 years (19-75 years). A total of 78 limbs were treated in 58 patients. RFA was performed using Closure FastTM catheter according to the manufacturer’s recommendation. Treatment outcomes were estimated 15 days, 3 months, 6 months and 1 year after the procedure using Doppler scan and VCSS score.Results: There was 100% occlusion of the treated veins with no evidence of partial/complete recanalization. H...
International Surgery Journal, 2021
Background: Minimally invasive surgeries are currently advocated in hemorrhoidal disease for bett... more Background: Minimally invasive surgeries are currently advocated in hemorrhoidal disease for better patient satisfaction. The aim of our study is to assess the feasibility, efficacy and safety of a hybrid hemorrhoidal artery ligation under digital guidance with laser hemorrhoidoplasty (Hybrid HAL-LHP) in patients with grade II to III hemorrhoids.Methods: In a prospective clinical study, hybrid HAL-LHP was performed in 75 consecutive patients between May 2018 to February 2020 with grade II to III hemorrhoids. Hemorrhoidal artery ligation was done by digital palpation followed by laser hemorrhoidoplasty using a 1470 nm diode laser. Postoperative pain and bleeding, return to work, resolution of symptoms, recurrence and reoperation was assessed on a follow up upto 1 year.Results: Postoperative pain assessed on Visual analog score (VAS) was 2.82 on 3rd day, 1.28 on 7th day and till 14th day was extremely low. None of the patients had significant intraoperative or spontaneous postoperativ...
Indian Journal of Case Reports, 2018
The development of newer techniques in the field of surgery is associated with its own set of pos... more The development of newer techniques in the field of surgery is associated with its own set of possible complications. Laparoscopic mesh repair is now widely accepted as the standard of care for inguinal hernias. Both transabdominal preperitoneal approach and totally extraperitoneal approach are almost equally popular worldwide. We report a case of intestinal obstruction following herniation of small bowel through the peritoneal defect and resultant adhesions to the mesh. We also present a literature review of instances of small bowel herniation through the peritoneal defect and resultant intestinal obstruction after inguinal hernia repair.
Saudi Journal of Obesity, 2015
Portal vein thrombosis is a rare and life-threatening complication following surgery. Extension o... more Portal vein thrombosis is a rare and life-threatening complication following surgery. Extension of thrombosis with involvement of the mesenteric vein is rarer. There have been some case reports documenting successful management of portomesenteric venous thrombosis (PMVT) following laparoscopic surgery. This case report describes a patient developing extensive hepatic and bowel infarction due to PMVT following laparoscopic sleeve gastrectomy.
Indian Journal of Surgery, 2009
Mesenteric cyst and cystic mesenteric tumour are very rare abdominal growth, which is generally e... more Mesenteric cyst and cystic mesenteric tumour are very rare abdominal growth, which is generally encountered, in the second decade of life. Pseudomesenteric cyst is another variant with traumatic and infective etiology is rare in itself. Only 14 cases have been reported previously in the Japanese literature. Emergency operation was performed in only 3 patients. The etiology of the pseudocyst manifested by acute abdomen was unknown [1]. A case of pseudomesenteric cyst presented in the emergency with acute abdomen is reported here.
International Journal of Tropical Medicine, 2010
Langenbeck's Archives of Surgery, 2010
Objective The aim of this pilot study is to assess the safety, feasibility, and short-term outcom... more Objective The aim of this pilot study is to assess the safety, feasibility, and short-term outcomes of single-incision laparoscopic trans-abdominal preperitoneal (TAPP) mesh hernioplasty using conventional laparoscopic instruments. Methods During a 3-month study period, data from all consecutive patients referred for inguinal hernia repair to the general and minimally invasive surgery unit of our institution who agreed to undergo single-incision TAPP mesh hernioplasty were included in the prospective study. Outcome measures included completion rate of the attempted procedure, operative time, length of hospital stay, postoperative pain, and assessment of complications. Follow-up was done for 3 months. Result Fifteen patients completed our protocol. Two patients had bilateral inguinal hernias while all other patients had unilateral hernia. Two patients had sliding hernia on the left side which had sigmoid colon as content. None of the patients required any additional port. There were no intraoperative complications. Conclusions The concept of laparoscopic single-incision surgery is an attractive and understandable innovation as laparoscopic surgery has become more commonplace. Based on our experience, we believe that the procedure is feasible without additional risk. Cosmetic benefit is clear; however, beyond the actual outcome with respect to postoperative pain and long-term complications, needs to be evaluated and compared to standard laparoscopic TAPP mesh hernioplasty.
Journal of Minimal Access Surgery, 2010
Introduction: Despite an exponential rise in laparoscopic surgery for inguinal herniorrhaphy, ove... more Introduction: Despite an exponential rise in laparoscopic surgery for inguinal herniorrhaphy, overall recurrence rates have remained unchanged. Therefore, an increasing number of patients present with recurrent hernias after having failed anterior and laparoscopic repairs. This study reports our experience with single-incision laparoscopic (SIL) intraperitoneal onlay mesh (IPOM) repair for these hernias. Materials and methods: All patients referred with multiply recurrent inguinal hernias underwent SIL-IPOM from November 1 2009 to October 30 2013. A 2.5-cm infraumbilical incision was made and a SIL surgical port was placed intraperitoneally. Modified dissection techniques, namely, "chopsticks" and "inline" dissection, 5.5 mm/52 cm/30°angled laparoscope and conventional straight dissecting instruments were used. The peritoneum was incised above the symphysis pubis and dissection continued laterally and proximally raising an inferior flap, below a previous extraperitoneal mesh, while reducing any direct/ indirect/femoral/cord lipoma before placement of antiadhesive mesh that was fixed into the pubic ramus as well as superiorly with nonabsorbable tacks before fixing its inferior border with fibrin sealant. The inferior peritoneal flap was then tacked back onto the mesh. Results: There were 9 male patients who underwent SIL-IPOM. Mean age was 55 years old and mean body mass index was 26.8 kg/m 2. Mean mesh size was 275 cm 2. Mean operation time was 125 minutes with hospital stay of 1 day and umbilical scar length of 21 mm at 4 weeks' follow-up. There were no intraoperative/postoperative complications, port-site hernias, chronic groin pain, or recurrence with mean follow-up of 20 months. Conclusions: Multiply recurrent inguinal hernias after failed conventional anterior and laparoscopic repairs can be treated safely and efficiently with SIL-IPOM.
Journal of Minimal Access Surgery, 2010
Single-incision laparoscopy is being used to carry out a wide variety of laparoscopic operations ... more Single-incision laparoscopy is being used to carry out a wide variety of laparoscopic operations since its introduction in 2007. Various case reports and studies have demonstrated the safety and feasibility of singleincision laparoscopic transabdominal preperitoneal (TAPP) and totally extra-peritoneal mesh hernioplasty. However, till date, its apparent advantages have been mainly cosmetic and related to patient satisfaction. We have been performing single-incision laparoscopic TAPP mesh hernioplasty since June 2009 using conventional laparoscopic instruments. Here, we describe our technique that is aimed at standardising the method.
Journal of Laparoendoscopic & Advanced Surgical Techniques, 2010
The aim of this pilot study was to assess the safety, feasibility, and short-term outcomes of tra... more The aim of this pilot study was to assess the safety, feasibility, and short-term outcomes of transumbilical multiple-port laparoscopic cholecystectomy (TUMP-LC), using conventional laparoscopic equipment, and to compare it with the currently published studies on single-incision laparoscopic Cholecystectomy. During the 4-month study period, data from all consecutive patients referred for cholecystectomy to the General and Minimally Invasive Surgery Unit of our institution who agreed to undergo TUMP-LC were included in a prospective study. Outcome measures included completion rate of attempted TUMP-LC, operative time, conversion rate, length of hospital stay, postoperative pain, and assessment of complications. The data were analyzed and compared with studies obtained from a MEDLINE search on four-port laparoscopic cholecystectomy at its initial period and recently published studies of single-incision laparoscopic cholecystectomy. Fifty patients completed our protocol. In 47 patients, TUMP-LC was completed successfully without any complications. In 2 patients, the procedure was converted electively to a standard four-incision laparoscopic cholecystectomy without any additional morbidity. In 1 patient, an additional epigastric 5-mm port had to be placed to control bleeding from the gallbladder fossa. One patient had a postoperative biliary leak from an accessory duct in the gallbladder fossa, which was managed by endoscopic retrograde cholangiopancreatography and biliary stenting. TUMP-LC is both feasible and safe. It can be performed with standard laparoscopic instruments, and, thus, there is minimal additional challenge to an experienced laparoscopic surgeon. With progressive experience and development in technology, TUMP-LC will probably be performed widely. But, disciplined, evidence-based investigations and randomized studies comparing it to existing techniques must be carried out before the actual place of this procedure in current surgical practice is determined.
Blood Coagulation & Fibrinolysis, 2010
The objective of the present study was to compare the efficacy and safety of low-dose unfractiona... more The objective of the present study was to compare the efficacy and safety of low-dose unfractionated heparin (UFH) and a low-molecular-weight heparin (LMWH) as prophylaxis against venous thromboembolism in critically ill surgical patients undergoing major surgery. This was a randomized prospective study in which critically ill patients scheduled to undergo major elective surgery were allocated to receive subcutaneously either LMWH once daily and a placebo injection containing sterile 0.9% normal saline or 5000 IU UFH twice daily subcutaneously. Each patient was evaluated postoperatively clinically and confirmed by Doppler study for development of deep vein thrombosis (DVT). One hundred and fifty-six patients completed the protocol. There was similar efficacy of UFH as compared with LMWH in the prophylaxis of DVT. There was also no statistically significant difference in the incidence of major complications in the heparin group as compared with the LMWH group. However, minor hemorrhagic complications such as wound hematoma and surgical site bleeding were significantly more in the heparin group as compared with the LMWH group. Both UFH 5000 units subcutaneously twice daily and LMWH 40 mg once daily provide highly effective and well tolerated prophylaxis for critically ill surgical patients. Considering the advantage of once-daily dosing, a wider adoption of prophylaxis with LMWH may be justified on the basis of patient acceptability and saving of nursing time.
International Surgery Journal, 2021
Even though lipomas are most common non-epithelial tumors of the large intestine, they mostly pre... more Even though lipomas are most common non-epithelial tumors of the large intestine, they mostly present with non-specific symptoms. Intussusception is the most common morbidity related to such lesions and may present as intestinal obstruction. We present here a case of a young female who presented to gastroenterology department as a case of pain abdomen and nausea and a provisional diagnosis of subacute intestinal obstruction was kept. Contrast enhanced CT confirmed a diagnosis of intussusception due to an ascending colon mass? likely lipoma. The colonoscopy was done and biopsy was taken which was non-specific for malignancy. Patient, after taking due consent, was taken for surgery and laparoscopic assisted submucosal excision of lipoma was done and we will discuss the same. Endoscopic excision of lipomas has been reported but when failed, mostly segmental resection of the colon has been reported. To the best of our knowledge, this is the second reported case of laparoscopic assisted ...
Asian Journal of Case Reports in Surgery, Oct 24, 2019
International Surgery Journal, 2018
Background: Endovenous Radiofrequency Ablation (RFA) is gradually gaining widespread acceptance a... more Background: Endovenous Radiofrequency Ablation (RFA) is gradually gaining widespread acceptance as a minimally invasive modality for treatment of varicose veins (VV). The objective of this study was to evaluate the efficacy based on Venous Doppler and Venous Clinical Severity Score (VCSS) and the safety of radiofrequency ablation for varicose veins.Methods: This is a prospective study of 58 consecutive patients who underwent Radiofrequency ablation of Varicose veins from January 2015 to January 2017 in a single unit of a Multispecialty Tertiary Care Hospital. The mean age was 44.10±13.74 years (19-75 years). A total of 78 limbs were treated in 58 patients. RFA was performed using Closure FastTM catheter according to the manufacturer’s recommendation. Treatment outcomes were estimated 15 days, 3 months, 6 months and 1 year after the procedure using Doppler scan and VCSS score.Results: There was 100% occlusion of the treated veins with no evidence of partial/complete recanalization. H...
International Surgery Journal, 2021
Background: Minimally invasive surgeries are currently advocated in hemorrhoidal disease for bett... more Background: Minimally invasive surgeries are currently advocated in hemorrhoidal disease for better patient satisfaction. The aim of our study is to assess the feasibility, efficacy and safety of a hybrid hemorrhoidal artery ligation under digital guidance with laser hemorrhoidoplasty (Hybrid HAL-LHP) in patients with grade II to III hemorrhoids.Methods: In a prospective clinical study, hybrid HAL-LHP was performed in 75 consecutive patients between May 2018 to February 2020 with grade II to III hemorrhoids. Hemorrhoidal artery ligation was done by digital palpation followed by laser hemorrhoidoplasty using a 1470 nm diode laser. Postoperative pain and bleeding, return to work, resolution of symptoms, recurrence and reoperation was assessed on a follow up upto 1 year.Results: Postoperative pain assessed on Visual analog score (VAS) was 2.82 on 3rd day, 1.28 on 7th day and till 14th day was extremely low. None of the patients had significant intraoperative or spontaneous postoperativ...
Indian Journal of Case Reports, 2018
The development of newer techniques in the field of surgery is associated with its own set of pos... more The development of newer techniques in the field of surgery is associated with its own set of possible complications. Laparoscopic mesh repair is now widely accepted as the standard of care for inguinal hernias. Both transabdominal preperitoneal approach and totally extraperitoneal approach are almost equally popular worldwide. We report a case of intestinal obstruction following herniation of small bowel through the peritoneal defect and resultant adhesions to the mesh. We also present a literature review of instances of small bowel herniation through the peritoneal defect and resultant intestinal obstruction after inguinal hernia repair.
Saudi Journal of Obesity, 2015
Portal vein thrombosis is a rare and life-threatening complication following surgery. Extension o... more Portal vein thrombosis is a rare and life-threatening complication following surgery. Extension of thrombosis with involvement of the mesenteric vein is rarer. There have been some case reports documenting successful management of portomesenteric venous thrombosis (PMVT) following laparoscopic surgery. This case report describes a patient developing extensive hepatic and bowel infarction due to PMVT following laparoscopic sleeve gastrectomy.
Indian Journal of Surgery, 2009
Mesenteric cyst and cystic mesenteric tumour are very rare abdominal growth, which is generally e... more Mesenteric cyst and cystic mesenteric tumour are very rare abdominal growth, which is generally encountered, in the second decade of life. Pseudomesenteric cyst is another variant with traumatic and infective etiology is rare in itself. Only 14 cases have been reported previously in the Japanese literature. Emergency operation was performed in only 3 patients. The etiology of the pseudocyst manifested by acute abdomen was unknown [1]. A case of pseudomesenteric cyst presented in the emergency with acute abdomen is reported here.
International Journal of Tropical Medicine, 2010
Langenbeck's Archives of Surgery, 2010
Objective The aim of this pilot study is to assess the safety, feasibility, and short-term outcom... more Objective The aim of this pilot study is to assess the safety, feasibility, and short-term outcomes of single-incision laparoscopic trans-abdominal preperitoneal (TAPP) mesh hernioplasty using conventional laparoscopic instruments. Methods During a 3-month study period, data from all consecutive patients referred for inguinal hernia repair to the general and minimally invasive surgery unit of our institution who agreed to undergo single-incision TAPP mesh hernioplasty were included in the prospective study. Outcome measures included completion rate of the attempted procedure, operative time, length of hospital stay, postoperative pain, and assessment of complications. Follow-up was done for 3 months. Result Fifteen patients completed our protocol. Two patients had bilateral inguinal hernias while all other patients had unilateral hernia. Two patients had sliding hernia on the left side which had sigmoid colon as content. None of the patients required any additional port. There were no intraoperative complications. Conclusions The concept of laparoscopic single-incision surgery is an attractive and understandable innovation as laparoscopic surgery has become more commonplace. Based on our experience, we believe that the procedure is feasible without additional risk. Cosmetic benefit is clear; however, beyond the actual outcome with respect to postoperative pain and long-term complications, needs to be evaluated and compared to standard laparoscopic TAPP mesh hernioplasty.
Journal of Minimal Access Surgery, 2010
Introduction: Despite an exponential rise in laparoscopic surgery for inguinal herniorrhaphy, ove... more Introduction: Despite an exponential rise in laparoscopic surgery for inguinal herniorrhaphy, overall recurrence rates have remained unchanged. Therefore, an increasing number of patients present with recurrent hernias after having failed anterior and laparoscopic repairs. This study reports our experience with single-incision laparoscopic (SIL) intraperitoneal onlay mesh (IPOM) repair for these hernias. Materials and methods: All patients referred with multiply recurrent inguinal hernias underwent SIL-IPOM from November 1 2009 to October 30 2013. A 2.5-cm infraumbilical incision was made and a SIL surgical port was placed intraperitoneally. Modified dissection techniques, namely, "chopsticks" and "inline" dissection, 5.5 mm/52 cm/30°angled laparoscope and conventional straight dissecting instruments were used. The peritoneum was incised above the symphysis pubis and dissection continued laterally and proximally raising an inferior flap, below a previous extraperitoneal mesh, while reducing any direct/ indirect/femoral/cord lipoma before placement of antiadhesive mesh that was fixed into the pubic ramus as well as superiorly with nonabsorbable tacks before fixing its inferior border with fibrin sealant. The inferior peritoneal flap was then tacked back onto the mesh. Results: There were 9 male patients who underwent SIL-IPOM. Mean age was 55 years old and mean body mass index was 26.8 kg/m 2. Mean mesh size was 275 cm 2. Mean operation time was 125 minutes with hospital stay of 1 day and umbilical scar length of 21 mm at 4 weeks' follow-up. There were no intraoperative/postoperative complications, port-site hernias, chronic groin pain, or recurrence with mean follow-up of 20 months. Conclusions: Multiply recurrent inguinal hernias after failed conventional anterior and laparoscopic repairs can be treated safely and efficiently with SIL-IPOM.
Journal of Minimal Access Surgery, 2010
Single-incision laparoscopy is being used to carry out a wide variety of laparoscopic operations ... more Single-incision laparoscopy is being used to carry out a wide variety of laparoscopic operations since its introduction in 2007. Various case reports and studies have demonstrated the safety and feasibility of singleincision laparoscopic transabdominal preperitoneal (TAPP) and totally extra-peritoneal mesh hernioplasty. However, till date, its apparent advantages have been mainly cosmetic and related to patient satisfaction. We have been performing single-incision laparoscopic TAPP mesh hernioplasty since June 2009 using conventional laparoscopic instruments. Here, we describe our technique that is aimed at standardising the method.
Journal of Laparoendoscopic & Advanced Surgical Techniques, 2010
The aim of this pilot study was to assess the safety, feasibility, and short-term outcomes of tra... more The aim of this pilot study was to assess the safety, feasibility, and short-term outcomes of transumbilical multiple-port laparoscopic cholecystectomy (TUMP-LC), using conventional laparoscopic equipment, and to compare it with the currently published studies on single-incision laparoscopic Cholecystectomy. During the 4-month study period, data from all consecutive patients referred for cholecystectomy to the General and Minimally Invasive Surgery Unit of our institution who agreed to undergo TUMP-LC were included in a prospective study. Outcome measures included completion rate of attempted TUMP-LC, operative time, conversion rate, length of hospital stay, postoperative pain, and assessment of complications. The data were analyzed and compared with studies obtained from a MEDLINE search on four-port laparoscopic cholecystectomy at its initial period and recently published studies of single-incision laparoscopic cholecystectomy. Fifty patients completed our protocol. In 47 patients, TUMP-LC was completed successfully without any complications. In 2 patients, the procedure was converted electively to a standard four-incision laparoscopic cholecystectomy without any additional morbidity. In 1 patient, an additional epigastric 5-mm port had to be placed to control bleeding from the gallbladder fossa. One patient had a postoperative biliary leak from an accessory duct in the gallbladder fossa, which was managed by endoscopic retrograde cholangiopancreatography and biliary stenting. TUMP-LC is both feasible and safe. It can be performed with standard laparoscopic instruments, and, thus, there is minimal additional challenge to an experienced laparoscopic surgeon. With progressive experience and development in technology, TUMP-LC will probably be performed widely. But, disciplined, evidence-based investigations and randomized studies comparing it to existing techniques must be carried out before the actual place of this procedure in current surgical practice is determined.
Blood Coagulation & Fibrinolysis, 2010
The objective of the present study was to compare the efficacy and safety of low-dose unfractiona... more The objective of the present study was to compare the efficacy and safety of low-dose unfractionated heparin (UFH) and a low-molecular-weight heparin (LMWH) as prophylaxis against venous thromboembolism in critically ill surgical patients undergoing major surgery. This was a randomized prospective study in which critically ill patients scheduled to undergo major elective surgery were allocated to receive subcutaneously either LMWH once daily and a placebo injection containing sterile 0.9% normal saline or 5000 IU UFH twice daily subcutaneously. Each patient was evaluated postoperatively clinically and confirmed by Doppler study for development of deep vein thrombosis (DVT). One hundred and fifty-six patients completed the protocol. There was similar efficacy of UFH as compared with LMWH in the prophylaxis of DVT. There was also no statistically significant difference in the incidence of major complications in the heparin group as compared with the LMWH group. However, minor hemorrhagic complications such as wound hematoma and surgical site bleeding were significantly more in the heparin group as compared with the LMWH group. Both UFH 5000 units subcutaneously twice daily and LMWH 40 mg once daily provide highly effective and well tolerated prophylaxis for critically ill surgical patients. Considering the advantage of once-daily dosing, a wider adoption of prophylaxis with LMWH may be justified on the basis of patient acceptability and saving of nursing time.
International Surgery Journal, 2021
Even though lipomas are most common non-epithelial tumors of the large intestine, they mostly pre... more Even though lipomas are most common non-epithelial tumors of the large intestine, they mostly present with non-specific symptoms. Intussusception is the most common morbidity related to such lesions and may present as intestinal obstruction. We present here a case of a young female who presented to gastroenterology department as a case of pain abdomen and nausea and a provisional diagnosis of subacute intestinal obstruction was kept. Contrast enhanced CT confirmed a diagnosis of intussusception due to an ascending colon mass? likely lipoma. The colonoscopy was done and biopsy was taken which was non-specific for malignancy. Patient, after taking due consent, was taken for surgery and laparoscopic assisted submucosal excision of lipoma was done and we will discuss the same. Endoscopic excision of lipomas has been reported but when failed, mostly segmental resection of the colon has been reported. To the best of our knowledge, this is the second reported case of laparoscopic assisted ...