Print ISSN: 1683-3589

Online ISSN: 2409-501X

Keywords : LAPAROSCOPIC


LAPAROSCOPIC VERSUS OPEN REPAIR OF PERFORATED PEPTIC ULCER

Abutalib B Alluaibi; Ali Y Al-Wajeeh; Mansour Amin Mohammed

Basrah Journal of Surgery, Volume 23, Issue 2, Pages 53-61
DOI: 10.33762/bsurg.2017.141321

LAPAROSCOPIC VERSUS OPEN REPAIR OF PERFORATED PEPTIC ULCER

Abutalib B Alluaibi@, Ali Y Al-Wajeeh$ & Mansour Amin Mohammed*
@MB,ChB, FIBMS, General Surgeon, Al-Mawanee General Hospital, Basrah. $MB,ChB, CABS, General Surgeon, Al-Mawanee General Hospital, Basrah. *MB,ChB, DS, CABS, MRCS, Lecturer, Dept. of Surgery, College of Medicine, Basrah, IRAQ.
Abstract
Peptic ulcer is the most common GIT disorder with a prevalence of 2%, peaking around the age of 70 years. Laparoscopic repair of perforated peptic ulcer began to evolve and replace the ordinary upper laparotomy. We studied 47 patients suffering from perforated duodenal or gastric ulcer in Al-Mawanee General Hospital in Basrah in the period 2014-2017, the patients were categorized into 2 groups: 1st group(24 patients) managed laparoscopically and the 2nd group (23 patients) managed by open approach. Perforation found to occur more with duodenal ulcer (29 pt. 61.70%) and more in male patients (26 pt. 55.33%). The peak perforation seen in age group >60 years and the commonest risk factors was the NSAIDs usage. Operative time was insignificantly longer in laparoscopic approach. However, the laparoscopic approach has less post operative pain and less overall complications (4 pt. 16.6% vs. 8 pt. 34.7%).
In conclusion, laparoscopic repair of perforated peptic ulcer is a feasible operation and
considered promising with less postoperative pain, less postoperative complications and better cosmetic results.

LAPAROSCOPIC VERSUS OPEN APPENDECTOMY FOR ACUTE APPENDICITIS

Mansour Ameen Mohammed

Basrah Journal of Surgery, Volume 21, Issue 1, Pages 76-81
DOI: 10.33762/bsurg.2015.102895

Acute appendicitis is still considered the most common cause of acute abdomen in young adult age group. Appendectomy is the most frequent urgent abdominal operation and often is the 1st major procedure performed by surgeons in training. This study aimed to find whether laparoscopic appendectomy is superior to open approach or not.
This study was done in Al-Mawanee General Hospital in Basrah, Iraq. One hundred and sixty seven patients were randomized into open appendectomy group (OA) and laparoscopic appendectomy group (LA). Different parameters were studied to find which approach is the best. The study showed longer operative time in the LA group, while there was no significant difference regarding the hospital stay, post-operative pain and post-operative complication.
In conclusion, laparoscopic appendectomy is not found to be superior to open appendectomy as there was no clear significant difference between them regarding the parameters used in this study.

ACCEPTANCE AND RELIANCE OF LAPAROSCOPIC SURGERY AMONG MOSUL CITY POPULATION

Nashwan Kahtan Mahjob; Samer Al-Saffar

Basrah Journal of Surgery, Volume 17, Issue 2, Pages 69-74
DOI: 10.33762/bsurg.2011.55381

The study is designed to evaluate the confidence, reliance and the degree of acceptance of laparoscopic surgical procedures among Mosul city population after 15 years of work in this field of surgery. This is a prospective data collection study. Participants were eight hundred persons, all of them from Mosul city with complete normal health at time of evaluation; all of them were above 18 years of age. The main outcome measures: The persons involved were divided into 4 groups according to their literate and educational level, each group composed of 200 persons, the first group (literate medical personnel) composed of medical doctors of various specialties, the second group (literate non medical personnel) composed of persons who were graduated from various colleges, apart from medical one. The third group (partially literate personnel) included those who did not complete the secondary school. the fourth group (low literate personnel) included those who did not completed the primary school. The questioners asked the following questions: 1- Did you know what laparoscopic surgery means? A special information score was used to evaluate the questioner knowledge. To those who answer yes for the first question and the information score was acceptable, the second question was: 2- Do you prefer this type of surgery to be used on you or on one of your first relative if feasible and needed? 3- If the answer for question 2 is yes, please tell us why. 4- If the answer for question 2 is no, please tell us why. The data were collected and comparison was done among the groups. All the medical persons were aware about laparoscopic surgery, 183 agreed to underwent such procedure if needed during the coming time, 160 of the second group knew what is laparoscopic surgery and 123 accepted to be used on them if needed, 118 of the third group knew what is laparoscopic surgery and 80 agreed to be used on them, while 85 of the fourth group had information about laparoscopic surgery but only 42 of them accepted it to be used on them if needed. Those who accepted laparoscopic surgery did so because they think that, it is more cosmetic, less painful and needs less hospitalization time, while those who refused it, did so because they afraid from dangerous instrument, the risk of complication and conversion. In conclusion, laparoscopic surgery is a well known surgical procedure among population in Mosul city, it gained acceptance and confidence especially in literate persons, but it needs more verification for low literate population. Cosmetic, less hospitalization and less post operative pain are the stocks for acceptance while complications, conversion and untrusting instrument and surgeon are the reasons for refusal of laparoscopic surgery.

8- LAPAROSCOPIC CHOLECYSTECTOMY IN SICKLE CELL DISEASE: IS IT A SAFE PROCEDURE?

Hashim S Alkhayat; Jassim H Salim; Mohammad M Mohammad; Salim M Albassam

Basrah Journal of Surgery, Volume 17, Issue 1, Pages 0-0
DOI: 10.33762/bsurg.2011.55121

Salim M Albassam*, Mohammad M Mohammad@, Jassim H Salim@&
Hashim S Alkhayat@
*Department of surgery, Basrah Medical College, Iraq. @Department of surgery, Basrah General
Hospital, Iraq.
Correspondence to: Dr. Salim M Albassam, e-mail: albassamsalim@yahoo.ca
Abbreviation: Hb= Hemoglobin. ACS = Acute Chest Syndrome. ASA = American Society of Anesthesiologists
Abstract
The aim of this trial is to determine the safety of laparoscopic cholecystectomy for treatment of
gall bladder stones in patients with sickle cell anemia (a controversial issue). Sixty patients from
both sexes, between 19-35 years old with sickle cell anemia, all of them having gall bladder
stones were included in this study in Endosurgery Center in Basrah General Hospital. The
patients were divided into three groups, group one (19 patients) were selected for laparoscopic
cholecystectomy on random preoperative background, the same thing was applied in group two
(21 patients) whose patients were subjected to open cholecystectomy while patients in group
three (20 patients) were selected for laparoscopic cholecystectomy on conditioned selection.
Three mortalities and two serious morbidities were encountered in the group one and one mild
morbidity seen in group two and no mortalities or morbidities in group three. Laparoscopic
cholecystectomy in sickle cell patients is a debatable issue, an increasing controversy about
serious perioperative and postoperative morbidity were mentioned. The procedure itself was
accused and an entirely opposed results were emerged from different studies all are debatable.
In this study we noticed the big influence of the risk factors, preparation of patients for surgery
and the adherence to the principle anesthetic rules on the outcome after laparoscopic
cholecystectomy in patients with sickle cell disease. This influence was limited in open
procedure. The controversy in the different trials lies on wither the problem is confined to the
disease itself or to the surgical method used for cholecystectomy or both.
According to the results obtained from our study we believe that both the severity of the disease
and the surgical procedure affecting the results, application of intra and post operative protocol
(blood transfusion if Hb less than 9gm/dI, rehydration, oxygenation and respecting general
anesthesia rules are mandatory for the safety of the patients.

4- CAUSES AND INCIDENCE OF LAPAROSCOPIC CHOLECYSTECTOMY CONVERSION

Adnan Y Abdulwahab; Safwan A Taha; Salam T Mutlak

Basrah Journal of Surgery, Volume 15, Issue 1, Pages 20-24
DOI: 10.33762/bsurg.2009.55258

Four hundred cases of laparoscopic cholecystectomy candidates were
prospectively followed at the time of surgery by obtaining a data sheet for the
patient’s age, sex, time from the introduction of ports till decision of conversion
and the cause of conversion if present in two years (2006 & 2007) period.
From 400 laparoscopic cholecystectomy, 20 conversions were obtained and the
causes were; wide cystic duct, empyema of the gall bladder, severe obesity, liver
tumor, abnormal position of gall bladder, vascular variation and dense adhesions
with disturbed anatomy. The percentage of conversion was 5%. Eight conversion
cases were males from the total 45 male patients underwent laparoscopic
cholecystectomy. Twelve cases were females out of 355 female patients
underwent laparoscopic cholecystectomy. The percentage of conversion for male
patients was 17.7% while in female patients was 3.3%. Our results showed that
the conversion rate in this study was 5% and the most common cause for
conversion is dense adhesions. No biliary duct injury or severe bleeding that
need conversion is found in this study and the rate for conversion is higher in
male patients.

11- LAPAROSCOPIC CHOLECYSTECTOMY, TRUE OUTPATIENT PROCEDURE (Is it possible to shorten the hospital stay?)

Hamid Boserwel; Salim M ALBassam; Abdulhadi Mossa Mohamad

Basrah Journal of Surgery, Volume 15, Issue 1, Pages 67-71
DOI: 10.33762/bsurg.2009.55389

Laparoscopic cholecystectomy is currently considered the gold standard for the managment of
gallbladder stones. Many hospitals have employed short stay wards for monitoring patients after
surgery. The meaning of the early discharge as true outpatient surgery is controversial. To
achieve this objective there is a need to shorten the hours of hospital stay by: Appropriate
selection criteria and discharge protocol, Peroperative technical modification and manipulation,
Procedures to control pain, nausea and vomiting. This study was carried at Endosurgery
Centre, Ibensena University Hospital, Sirte, libya.