Publications by authors named "Chinnusamy P"

Acute appendicitis is one of the most common emergency surgical conditions, typically treated by laparoscopic appendectomy in most centres. Post-operative ascites is a rare complication after laparoscopic surgery, especially in the absence of a bowel, urinary tract or lymphatic injury. This condition creates a diagnostic challenge for surgeons, even after thorough investigation.

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Article Synopsis
  • A giant inguinoscrotal hernia can extend below the midpoint of the thigh and is often due to patient neglect and fear of surgery.
  • Patients usually experience lower urinary tract symptoms and may develop ulcers from urine dribbling, with rare cases of obstruction or strangulation.
  • This case involved a successful laparoscopic repair of an uncomplicated giant inguinoscrotal hernia through preoperative optimization techniques, including BOTOX and progressive pneumoperitoneum, highlighting the importance of patient preparation for surgical interventions.
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Introduction: Ventral hernia repairs, particularly laparoscopic ventral hernia repair (LVHR), have become common procedures among general surgeons worldwide. Despite the benefits of LVHR, acute postoperative pain remains a significant concern. Transversus abdominis plane (TAP) blocks have been employed to alleviate postoperative pain in various laparoscopic procedures.

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Total extraperitoneal approach for laparoscopic inguinal hernia repair (L-TEP) allows for better dissection, lesser chance of bowel injury, and quicker operating time. However robotic groin hernia repair is currently performed only through transabdominal route as it allows for more mobility of the arms. This study is aimed at studying the feasibility and outcomes of robotic totally extraperitoneal (R-TEP).

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Background: Most studies on minimally invasive pancreatoduodenectomy (MIPD) combine patients with pancreatic and periampullary cancers even though there is substantial heterogeneity between these tumors. Therefore, this study aimed to evaluate the role of MIPD compared to open pancreatoduodenectomy (OPD) in patients with non-pancreatic periampullary cancer (NPPC).

Methods: A systematic review of Pubmed, Embase, and Cochrane databases was performed by two independent reviewers to identify studies comparing MIPD and OPD for NPPC (ampullary, distal cholangio, and duodenal adenocarcinoma) (01/2015-12/2021).

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Objective: Assessment of minimally invasive pancreatoduodenectomy (MIPD) in patients with pancreatic ductal adenocarcinoma (PDAC) is scarce and limited to non-randomized studies. This study aimed to compare oncological and surgical outcomes after MIPD compared to open pancreatoduodenectomy (OPD) for patients after resectable PDAC from published randomized controlled trials (RCTs).

Methods: A systematic review was performed to identify RCTs comparing MIPD and OPD including PDAC (Jan 2015-July 2021).

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Purpose: There is a paucity of data regarding the comparison of robotic and laparoscopic hepaticojejunostomy (HJ) for the treatment of paediatric choledochal cysts. Thus, our primary objective was a comparison of early complications namely post-operative bleeding, anastomotic leak, intestinal obstruction and the need for reoperation in both techniques. Our secondary objectives included a comparison of the mean time for surgery and HJ, conversion of procedure to open, intraoperative blood loss, late complications like cholangitis, stricture and post-operative outcomes like time to start oral feeds and length of post-operative stay.

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Giant lumbar hernia, with loss of domain, is a complex scenario to treat. Abdominal compartment syndrome is a dreaded post-operative complication. This can gravely impair the patient's respiratory function and also cause insufficient perfusion of the viscera.

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Background: Rectal prolapse is more common in elderly women worldwide, but in India, it predominantly occurs in young- and middle-aged males. While ventral mesh rectopexy is proposed as the preferred procedure in females, the debate on the best procedure in men is still wide open.

Methods: A retrospective review of all adult male patients operated for external rectal prolapse (ERP) between January 2005 and December 2019 was performed.

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Article Synopsis
  • - Thoracolaparoscopic esophagectomy (TLE) shows better short-term outcomes for esophageal cancer compared to open esophagectomy, while the use of robot-assisted laparoscopic esophagectomy (RALE) is less established.
  • - A study analyzed patients undergoing TLE and RALE, focusing on lymph node yield, surgery duration, cost, and other complications, with 90 patients in TLE and 25 in RALE, matched to 22 each for comparison.
  • - Results indicated that while both techniques had similar lymph node yields and comparable post-operative outcomes, RALE had longer surgeries and higher costs than TLE, indicating it may not be the preferred choice despite similar oncological results.
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Purpose: Laparoscopic rectal surgery has moved from being experimental to getting established as a mainstream procedure. We aimed at analysing how rectal cancer surgery has evolved at our institute.

Methods: A retrospective review of 1000 consecutive patients who underwent laparoscopic anterior resection for rectal adenocarcinoma over a period of 15 years (January 2005 to December 2019) was performed.

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Introduction: Data on laparoscopic treatment of operable gastric cancer from India is sparse. This study aims to document outcomes of laparoscopic D2 gastrectomy in an Indian population.

Materials And Methods: Data of patients who underwent laparoscopic D2 gastrectomy for operable advanced gastric cancer between February 2012 and January 2017 were collected from electronic hospital records supplemented by telephonic interviews and analyzed.

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ALK+ large B cell lymphoma (LBCL) is a very rare aggressive neoplasm. It accounts for less than 1% of diffuse large B cell lymphoma (DLBCL). This is a case report of ALK+ DLBCL in a 34-year-old woman with an ileocaecal mesenteric mass.

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Context: The definitive surgical treatment of severe endometriosis remains to be hysterectomy whether done by laparoscopy or laparotomy.

Aim: The aim of this study was to assess the feasibility and outcome of laparoscopic hysterectomy in severe pelvic endometriosis.

Settings And Design: This retrospective study was carried out in a tertiary center over a period of 5 years (January 2013-December 2017).

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Aims And Objectives: To assess the outcome of minimally invasive paravaginal repair of symptomatic cystocele and to correlate postoperative outcome with preoperative presentation. The primary outcome was the anatomical outcome measured by postoperative physical examination and the functional outcome was assessed by subjective symptoms and questionnaires. The secondary outcomes were perioperative and postoperative complications.

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Introduction: Parastomal hernia (PH) is a common late complication of stoma formation for which laparoscopic repair is a well-accepted modality of treatment. Keyhole repair has been frequently reported with recurrence, but our modification in surgical technique have lesser and acceptable recurrence rates. The present study aimed to assess the results of modified laparoscopic keyhole plus repair in the treatment of symptomatic PH.

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Article Synopsis
  • This study evaluates the outcomes of two surgical techniques for distal pancreatectomy: spleen-preserving distal pancreatectomy (SPDP) versus distal pancreatectomy with splenectomy (DPS), and splenic vessel preservation (SVP) versus Warshaw's technique (WT).
  • It found that SPDP results in fewer infectious complications, reduced pancreatic fistula rates, shorter surgical times, and less blood loss when compared to DPS.
  • Additionally, SVP demonstrates lower rates of splenic infarction and subsequent splenectomy compared to WT, indicating better overall outcomes with spleen preservation strategies.
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Solid pseudopapillary tumour (SPT) is one of the uncommon benign cystic neoplasms of pancreas occurring predominantly in young females. Being benign in nature, surgical resection is the treatment of choice with excellent 5-year survival. A 14-year-old girl presented with pain abdomen for 1 week.

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Median arcuate ligament (MAL) syndrome is an uncommon condition caused by the external compression of the celiac trunk by the median arcuate ligament. In the current era of technological advancement, this syndrome may be corrected through the laparoscopic approach. We report two patients who were diagnosed as MAL syndrome and underwent laparoscopic division of MAL fibers at our institute.

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Although minimally invasive surgery has evolved in every field of surgery, its use in vascular surgery is limited to major vessel diseases only. A 23-year-old female presented with a cystic lesion in the distal body and the tail of the pancreas. Triphasic computed tomography (CT) abdomen revealed a 4.

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Persistent Mullerian duct syndrome (PMDS) is one of the three rare intersex disorders caused by defective anti-mullerian hormone or its receptor, characterized by undescended testes with presence of underdeveloped derivatives of mullerian duct in genetically male infant or adult with normal external genitals and virilization. This population will essentially have normal, 46(XY), phenotype. We hereby present a case of PMDS, presented with incarcerated left inguinal hernia associated with cryptorchidism and seminoma of right testes.

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Background: Gall bladder cancer (GBC) is the most common and aggressive malignancy of the biliary tract with extremely poor prognosis. Radical resection remains the only potential curative treatment for operable lesions. Although laparoscopic approach is now considered as standard of care for many gastrointestinal malignancies, surgical community is still reluctant to use this approach for GBC probably because of fear of tumor dissemination, inadequate lymphadenectomy and overall nihilistic approach.

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Background: With technological innovations especially newer parenchymal transection devices, improved understanding of hepatic anatomy facilitated by better imaging, and reconstructions along with experiences gained from advanced minimal invasive procedures, laparoscopic liver surgery is gaining momentum with more than 5300 reported cases worldwide. Most of the published literature comprises nonanatomical and segmental resections with only few case series having major hepatic resections performed by minimally invasive approach. Aim of this article is to share our technique and experience of total laparoscopic major hepatectomy.

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Laparoscopic pancreaticoduodenectomy (LPD) remained a formidable challenge owing to retroperitoneal location, difficult dissection near great vessels and critical intracorporeal anastomoses. Recent reviews of literature have established the feasibility and comparable short term outcomes of laparoscopic pancreaticoduodenectomy (LPD) with that of open pancreaticoduodenectomy (OPD). This study was undertaken to compare the pathological radicality of LPD with OPD.

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