nilesh mangam - Academia.edu (original) (raw)
Papers by nilesh mangam
Background: The present study was conducted to study the pattern of presentation of patients with... more Background: The present study was conducted to study the pattern of presentation of patients with diabetic limb in surgery opd and casualty, to evaluate the efficacy of available treatment options salvaging the diabetic limb, and to evaluate the amount of health care resource utilization, health care related quality of life. Material and methods: It was a hospital based, prospective randomized control study, conducted at department of General Surgery, Government Medical college and Hospital Nagpur during June 2012 to October 2014 among 101 patients with various diabetic limb are being managed with standard care and with HBOT. Results: The distribution of bacteria isolated is shown in the table number 2. Study group shows singificant reduction in the percentage of bacteria isolated among the study subjects. According to culture sensitivity reports most commonly isolated organism was E.coli in both the groups. Conclusion: Diabetic wounds are one of the most dreaded wounds to heal for ...
Asian Journal of Medical Sciences
Background: Appendicitis is one of the common pathologies encountered in surgical practice. Excep... more Background: Appendicitis is one of the common pathologies encountered in surgical practice. Except in minority of the cases, the treatment is usually surgical. Till recent past, open appendectomy has been the procedure of choice for appendicitis. With increasing expertise in laparoscopic surgeries more and more surgeons are utilizing the laparoscopic approach for appendectomy. Laparoscopic surgeries have distinct advantages such as less surgical trauma, improved and quick postoperative recovery, and esthetic results. Single-incision laparoscopic surgery (SILS) is rapidly gaining acceptability in young population because of its cosmetic advantages. Moreover, these surgeries also avoid the risk of port-site hernias and the possibility of wound infection. Aims and Objective: The purpose of this study is to present our initial experience with this surgery using a single incision laparoscopic appendectomy (LA) using conventional instruments. Materials and Methods: This was a prospective ...
Journal of Evidence Based Medicine and Healthcare, 2020
Background: Laparoscopic inguinal hernia surgery frequently is performed with mechanical fixation... more Background: Laparoscopic inguinal hernia surgery frequently is performed with mechanical fixation of polypropylene mesh. This mechanical fixation, though is necessary to prevent mesh migration, may be associated with pain syndromes and buckling. Recently an anatomically contoured 3D mesh (developed by Dr. Philippe Pajotin) has been introduced which is made up of monofilament polypropylene and resembles normal inguinal area curvature. Aims and Objective: This study was conducted to know whether elimination of tacking the 3D mesh during Total extraperitoneal approach (TEP) inguinal hernia repair results in decreased postoperative pain without increasing the incidence of hernia recurrence. Materials and Methods: This was a prospective interventional study in which 63 patients with clinical diagnosis of inguinal hernia were included on the basis of a predefined inclusion and exclusion criteria. All selected patients underwent laparoscopic TEP inguinal hernia repair using anatomically contoured 3D mesh. Patients were assessed for postoperative pain (using visual analogue scale) during their stay in the hospital as well as in the follow up period. Results: In this study of Laparoscopic inguinal hernia surgery using anatomically contoured 3D mesh of 63 male patients the most common affected age group was found to be 41-50 years (25.3%) with a mean age of 47.12 years +/-13.01. Most common inguinal hernia was of indirect type (50.7%) and was seen on right side (52.3%). Mean operative time was 113.57+/-29.04 minutes in unilateral and 170.6 ± 5.85 minutes in bilateral inguinal hernias. Postoperative mean VAS score (12 hrs) was found to be 3.46 ± 1.51. During follow up at 1 week, 1 month and 3 months mean VAS scores were found to be 0.46 ± 0.50, 0.14 ± 0.35 and 0.01 ± 0.12 respectively. Common complications included seroma (12.6%), pneumoscrotum (7.9%) and peritoneal breech (6.3%). None of the patients developed recurrence during follow up period. Conclusion: An anatomically contoured mesh for laparoscopic preperitoneal hernia repair usually requires no fixation and has minimal complications. It is associated with excellent recovery and marked reduction in pain.
Traditionally, thoracic surgery performed for diagnosis or treatment of chest conditions has requ... more Traditionally, thoracic surgery performed for diagnosis or treatment of chest conditions has required access to the chest through thoracotomy or sternotomy incisions. But, both incisions have the potential for causing significant pain that may last for extended periods and both result in bony fractures that require a minimum of six weeks to heal during which time patients must refrain from heavy lifting or strenuous activity. Now, many diseases of the chest can be diagnosed by VATS due to ease of look and biopsy. The great advantage of VATS over sternotomy or thoracotomy is avoidance of muscle division and bone fractures that allows for diminished duration and intensity of pain and a shorter time to return to full activity.
BACKGROUND Conventional Dissection Surgery (CDS) and Plastibell Device (PD) are the commonly used... more BACKGROUND Conventional Dissection Surgery (CDS) and Plastibell Device (PD) are the commonly used techniques for male circumcision. We wanted to evaluate and compare the postoperative problems and aesthetic results, and the patient’s / parent’s acceptance, of the two techniques of circumcision in boys. METHODS This was a prospective study in which children in the age group 0 - 12 years attending the surgery outpatient department for various indications of circumcision were enrolled on the basis of a predefined inclusion and exclusion criteria. The subjects were randomized and allocated into two groups, group PD and group CDS. Group PD was subjected to circumcision by Plastibell device technique. Group CDS was subjected to circumcision by conventional dissection technique. Duration of the circumcision and intra-operative complications if any were recorded, from starting the retraction of prepuce to completion of the procedure. Early and late complications were also compared during fo...
Journal of Evidence Based Medicine and Healthcare
BACKGROUND Conventional Dissection Surgery (CDS) and Plastibell Device (PD) are the commonly used... more BACKGROUND Conventional Dissection Surgery (CDS) and Plastibell Device (PD) are the commonly used techniques for male circumcision. We wanted to evaluate and compare the postoperative problems and aesthetic results, and the patient’s / parent’s acceptance, of the two techniques of circumcision in boys. METHODS This was a prospective study in which children in the age group 0 - 12 years attending the surgery outpatient department for various indications of circumcision were enrolled on the basis of a predefined inclusion and exclusion criteria. The subjects were randomized and allocated into two groups, group PD and group CDS. Group PD was subjected to circumcision by Plastibell device technique. Group CDS was subjected to circumcision by conventional dissection technique. Duration of the circumcision and intra-operative complications if any were recorded, from starting the retraction of prepuce to completion of the procedure. Early and late complications were also compared during fo...
International Surgery Journal
Background: An incisional hernia is defined as any abdominal wall gap with or without bulge in th... more Background: An incisional hernia is defined as any abdominal wall gap with or without bulge in the area of postoperative scar perceptible or palpable by clinical examination or imaging. It occurs in about 3 to 20 percent of patients undergoing laparotomy. Open hernia repair methods have an increased incidence of wound infections and wound-related complications. These problems have been overcome by laparoscopy. The placement of a large mesh by laparoscopy allows for an even distribution of forces along the surface area of the mesh, which account for the strength of the repair and the decreased recurrence rates associated with it. The merits of the laparoscopic approach are decreased rates of recurrence, reduced risks of wound complications. The aims and objective of this study were to evaluate etiological factors of incisional hernia, various techniques of laparoscopic repair of incisional hernia, and to investigate the influence of laparoscopic approach on hospital stay, complicatio...
International Surgery Journal
Background: Conventional thyroidectomy results in transverse scar formation on neck. These scars ... more Background: Conventional thyroidectomy results in transverse scar formation on neck. These scars are uncomfortable and cosmetically unacceptable. Endoscopic thyroidectomy is widely accepted technique in specialized centers. The potential advantages of endoscopic technique include better cosmetic result, decreased hospital stay and better patient comfort. Author started performing endoscopic thyroidectomy at the centre to demonstrate the feasibility of operating thyroid gland endoscopically by axilla breast approach.Methods: Author performed 26 cases of endoscopic thyroidectomy by axilla breast approach from June 2014 to July 2017 in patients presenting with indication for surgical thyroid excision. Author did hemithyroidectomy in 19 patients, total thyroidectomy in 3 patients and near total thyroidectomy in 4 patients. All patients underwent endoscopic thyroidectomy by axilla breast approach by creating subplatysmal space with carbon dioxide insufflation at the pressure of 8 to 10mm...
International Journal of Contemporary Medicine, Surgery and Radiology
Background: The present study was conducted to study the pattern of presentation of patients with... more Background: The present study was conducted to study the pattern of presentation of patients with diabetic limb in surgery opd and casualty, to evaluate the efficacy of available treatment options salvaging the diabetic limb, and to evaluate the amount of health care resource utilization, health care related quality of life. Material and methods: It was a hospital based, prospective randomized control study, conducted at department of General Surgery, Government Medical college and Hospital Nagpur during June 2012 to October 2014 among 101 patients with various diabetic limb are being managed with standard care and with HBOT. Results: The distribution of bacteria isolated is shown in the table number 2. Study group shows singificant reduction in the percentage of bacteria isolated among the study subjects. According to culture sensitivity reports most commonly isolated organism was E.coli in both the groups. Conclusion: Diabetic wounds are one of the most dreaded wounds to heal for ...
Asian Journal of Medical Sciences
Background: Appendicitis is one of the common pathologies encountered in surgical practice. Excep... more Background: Appendicitis is one of the common pathologies encountered in surgical practice. Except in minority of the cases, the treatment is usually surgical. Till recent past, open appendectomy has been the procedure of choice for appendicitis. With increasing expertise in laparoscopic surgeries more and more surgeons are utilizing the laparoscopic approach for appendectomy. Laparoscopic surgeries have distinct advantages such as less surgical trauma, improved and quick postoperative recovery, and esthetic results. Single-incision laparoscopic surgery (SILS) is rapidly gaining acceptability in young population because of its cosmetic advantages. Moreover, these surgeries also avoid the risk of port-site hernias and the possibility of wound infection. Aims and Objective: The purpose of this study is to present our initial experience with this surgery using a single incision laparoscopic appendectomy (LA) using conventional instruments. Materials and Methods: This was a prospective ...
Journal of Evidence Based Medicine and Healthcare, 2020
Background: Laparoscopic inguinal hernia surgery frequently is performed with mechanical fixation... more Background: Laparoscopic inguinal hernia surgery frequently is performed with mechanical fixation of polypropylene mesh. This mechanical fixation, though is necessary to prevent mesh migration, may be associated with pain syndromes and buckling. Recently an anatomically contoured 3D mesh (developed by Dr. Philippe Pajotin) has been introduced which is made up of monofilament polypropylene and resembles normal inguinal area curvature. Aims and Objective: This study was conducted to know whether elimination of tacking the 3D mesh during Total extraperitoneal approach (TEP) inguinal hernia repair results in decreased postoperative pain without increasing the incidence of hernia recurrence. Materials and Methods: This was a prospective interventional study in which 63 patients with clinical diagnosis of inguinal hernia were included on the basis of a predefined inclusion and exclusion criteria. All selected patients underwent laparoscopic TEP inguinal hernia repair using anatomically contoured 3D mesh. Patients were assessed for postoperative pain (using visual analogue scale) during their stay in the hospital as well as in the follow up period. Results: In this study of Laparoscopic inguinal hernia surgery using anatomically contoured 3D mesh of 63 male patients the most common affected age group was found to be 41-50 years (25.3%) with a mean age of 47.12 years +/-13.01. Most common inguinal hernia was of indirect type (50.7%) and was seen on right side (52.3%). Mean operative time was 113.57+/-29.04 minutes in unilateral and 170.6 ± 5.85 minutes in bilateral inguinal hernias. Postoperative mean VAS score (12 hrs) was found to be 3.46 ± 1.51. During follow up at 1 week, 1 month and 3 months mean VAS scores were found to be 0.46 ± 0.50, 0.14 ± 0.35 and 0.01 ± 0.12 respectively. Common complications included seroma (12.6%), pneumoscrotum (7.9%) and peritoneal breech (6.3%). None of the patients developed recurrence during follow up period. Conclusion: An anatomically contoured mesh for laparoscopic preperitoneal hernia repair usually requires no fixation and has minimal complications. It is associated with excellent recovery and marked reduction in pain.
Traditionally, thoracic surgery performed for diagnosis or treatment of chest conditions has requ... more Traditionally, thoracic surgery performed for diagnosis or treatment of chest conditions has required access to the chest through thoracotomy or sternotomy incisions. But, both incisions have the potential for causing significant pain that may last for extended periods and both result in bony fractures that require a minimum of six weeks to heal during which time patients must refrain from heavy lifting or strenuous activity. Now, many diseases of the chest can be diagnosed by VATS due to ease of look and biopsy. The great advantage of VATS over sternotomy or thoracotomy is avoidance of muscle division and bone fractures that allows for diminished duration and intensity of pain and a shorter time to return to full activity.
BACKGROUND Conventional Dissection Surgery (CDS) and Plastibell Device (PD) are the commonly used... more BACKGROUND Conventional Dissection Surgery (CDS) and Plastibell Device (PD) are the commonly used techniques for male circumcision. We wanted to evaluate and compare the postoperative problems and aesthetic results, and the patient’s / parent’s acceptance, of the two techniques of circumcision in boys. METHODS This was a prospective study in which children in the age group 0 - 12 years attending the surgery outpatient department for various indications of circumcision were enrolled on the basis of a predefined inclusion and exclusion criteria. The subjects were randomized and allocated into two groups, group PD and group CDS. Group PD was subjected to circumcision by Plastibell device technique. Group CDS was subjected to circumcision by conventional dissection technique. Duration of the circumcision and intra-operative complications if any were recorded, from starting the retraction of prepuce to completion of the procedure. Early and late complications were also compared during fo...
Journal of Evidence Based Medicine and Healthcare
BACKGROUND Conventional Dissection Surgery (CDS) and Plastibell Device (PD) are the commonly used... more BACKGROUND Conventional Dissection Surgery (CDS) and Plastibell Device (PD) are the commonly used techniques for male circumcision. We wanted to evaluate and compare the postoperative problems and aesthetic results, and the patient’s / parent’s acceptance, of the two techniques of circumcision in boys. METHODS This was a prospective study in which children in the age group 0 - 12 years attending the surgery outpatient department for various indications of circumcision were enrolled on the basis of a predefined inclusion and exclusion criteria. The subjects were randomized and allocated into two groups, group PD and group CDS. Group PD was subjected to circumcision by Plastibell device technique. Group CDS was subjected to circumcision by conventional dissection technique. Duration of the circumcision and intra-operative complications if any were recorded, from starting the retraction of prepuce to completion of the procedure. Early and late complications were also compared during fo...
International Surgery Journal
Background: An incisional hernia is defined as any abdominal wall gap with or without bulge in th... more Background: An incisional hernia is defined as any abdominal wall gap with or without bulge in the area of postoperative scar perceptible or palpable by clinical examination or imaging. It occurs in about 3 to 20 percent of patients undergoing laparotomy. Open hernia repair methods have an increased incidence of wound infections and wound-related complications. These problems have been overcome by laparoscopy. The placement of a large mesh by laparoscopy allows for an even distribution of forces along the surface area of the mesh, which account for the strength of the repair and the decreased recurrence rates associated with it. The merits of the laparoscopic approach are decreased rates of recurrence, reduced risks of wound complications. The aims and objective of this study were to evaluate etiological factors of incisional hernia, various techniques of laparoscopic repair of incisional hernia, and to investigate the influence of laparoscopic approach on hospital stay, complicatio...
International Surgery Journal
Background: Conventional thyroidectomy results in transverse scar formation on neck. These scars ... more Background: Conventional thyroidectomy results in transverse scar formation on neck. These scars are uncomfortable and cosmetically unacceptable. Endoscopic thyroidectomy is widely accepted technique in specialized centers. The potential advantages of endoscopic technique include better cosmetic result, decreased hospital stay and better patient comfort. Author started performing endoscopic thyroidectomy at the centre to demonstrate the feasibility of operating thyroid gland endoscopically by axilla breast approach.Methods: Author performed 26 cases of endoscopic thyroidectomy by axilla breast approach from June 2014 to July 2017 in patients presenting with indication for surgical thyroid excision. Author did hemithyroidectomy in 19 patients, total thyroidectomy in 3 patients and near total thyroidectomy in 4 patients. All patients underwent endoscopic thyroidectomy by axilla breast approach by creating subplatysmal space with carbon dioxide insufflation at the pressure of 8 to 10mm...
International Journal of Contemporary Medicine, Surgery and Radiology