Military Injuries: Helocasting Accident.

Background: Accidental injuries sustained during helocasting remain unexamined.

Methods: Conditions prevalent during a helocasting exercise performed at a still water body and the resulting casualties were analyzed.

Results: Despatch from greater-than-ideal height (>7 m) and speed (>5 knots) causes a high-velocity impact of the body with water in a non-aerodynamic configuration, exposing maximal body area at penetration.

Minimal access surgery of corrosive and thermal strictures of the foregut.

Background And Aim: : Conventional surgery for caustic/thermal strictures (CS/TS) entails considerable trauma, which may be mitigated by minimal access surgery (MAS). Experience with its use in CS/TS is both heterogeneous and limited, hence, warrants a comprehensive review.

Methods: : Medical literature/indexing databases were systematically searched for pertinent articles published in English, from 1990 to 2021, and analysed.

Applications of hepatic round ligament/falciform ligament flap and graft in abdominal surgery-a review of their utility and efficacy.

Background And Purpose: Despite their ubiquitous presence, easy availability and diverse possibilities, falciform ligament and hepatic round ligament have been used less frequently than their potential dictates. This article aims to comprehensively review the applications of hepatic round ligament/falciform ligament flap and graft in abdominal surgery and assess their utility and efficacy.

Methods: Medical literature/indexing databases were searched, using internet search engines, for pertinent articles and analysed.

Evidence-based adoption of purse-string skin closure for stoma wounds.

Background: Opinion is divided on the optimal technique of skin closure after stoma reversal as most conventional techniques compromise either on speed/neatness of wound apposition or on the incidence of surgical site infection (SSI). Evidence suggests that purse-string skin closure (PSSC) may achieve both objectives. This study aims to compare conventional primary closure (PC) with PSSC to determine the efficacious technique for stoma wound closure.

Modified Makuuchi incision for major upper abdominal surgeries.

Unlabelled: ackground: Numerous incisions are described for abdominal operations. However, opinion is divided regarding the correct choice of incision for major upper abdominal surgeries.

Materials And Methods: Experience of 3 surgical centres with the use of modified Makuuchi incision, for major upper abdominal surgeries, from Mar 2014-Dec 2018, was audited.

Minimally Invasive Repair of Acquired Benign Thoracic Tracheo-Esophageal Fistula.

Background: Repair of large, upper thoracic, cuff-induced, tracheo-esophageal fistula (TEF) is technically demanding and is conventionally performed by open surgery. Minimal access approach is, hitherto, unreported. T echnique & Case: Minimally invasive repair of TEF involving fistula isolation - by thoracoscopic oesophageal exclusion, and simultaneous establishment of alimentary continuity - by laparoscopy-assisted sub-sternal colonic transposition, is described.

Buttressing hepaticojejunostomy's with hepatic round ligament flap may be beneficial.

Background: Bile leaks and anastomotic strictures are important complications of hepaticojejunostomy (HJ). Evidence suggests that the use of hepatic round ligament (HRL) to buttress HJ may be beneficial. This study evaluates the feasibility of this approach.

Female sex hormone receptors in gallbladder cancer.

Background: Higher incidence of gallbladder cancer among women suggests a role of female sex hormones in its etiopathogenesis.

Objectives: This paper aims to study the estrogen/progesterone receptor (ER/PR) expression in gallbladder cancer and to correlate the receptor expression with the clinicopathological profile of patients to understand its implication.

Materials And Methods: Forty-seven patients of gallbladder cancer were studied.

Evidence based switch to perianal block for ano-rectal surgeries.

Background: Evidence suggests that switch from spinal/general anaesthesia (SA/GA) to perianal block (PAB) may prove advantageous for proctologic surgeries. This study evaluates the practicability of this evidence based switch.

Methods: Feasibility and efficacy of PAB for proctologic surgeries was prospectively evaluated on 100 consecutive patients over 11 months.

Management of necrotizing myositis in a field hospital: a case report.

Necrotizing myositis is a rare and fatal disease of skeletal muscles caused by group A beta hemolytic streptococci (GABHS). Its early detection by advanced imaging forms the basis of current management strategy. Paucity of advanced imaging in field/rural hospitals necessitates adoption of management strategy excluding imaging as its basis.

Laparoscopic ligation of internal ring-three ports versus single-port technique: are working ports necessary?

Background: From three ports, technical refinements in laparoscopy have facilitated the ligation of the internal ring (IR) with a single port.

Objectives: The aims of this study were to determine whether, when, and where working ports are needed by assessing the differences in outcome between the three-port technique (TPT) and the single-port technique-subcutaneous endoscopically assisted ligation (SEAL).

Methods: Short-term outcomes of 163 children operated on by either technique (51 with TPT, and 112 with SEAL) were audited.

Intra-peritoneal duodenal perforation caused by delayed migration of endobiliary stent: a case report.

Endoscopic biliary stenting is an accepted modality of palliation of malignant biliary obstructions. Delayed stent migration causing intra-peritoneal perforation of duodenum, is a rare life threatening complication. Proximal adhesion of stent to the tumor is believed to increase the intensity of distal trauma produced by the intra-duodenal segment, preventing its adaptation to intestinal peristalsis and causing perforation.

Ectopic thymoma with pure red cell aplasia--ambiguity with indolence.

Two cases of thymomas with pure red cell aplasia (PRCA) are presented, highlighting variability in their anatomic location, ambiguity in presentation, indolence of course and unpredictability of response to treatment. Multi-modality approach is necessary for both diagnosis and management of this combination. Duration and side effects of treatment determine the overall prognosis.

Pediatric inguinal hernia: laparoscopic versus open surgery.

Background And Objectives: Herniotomy/open surgery (OS) has been the time honored treatment for pediatric inguinal hernia (PIH). Laparoscopic surgery (LS) has recently emerged as an alternative in its management. However, controversy is rife on its feasibility and wider adoption.

How we "SEAL" internal ring in pediatric inguinal hernias.

"Subcutaneous endoscopically assisted ligation" is a novel technique in minimal access surgery of pediatric inguinal hernias. We describe our modifications of subcutaneous endoscopically assisted ligation, which confer greater ease, safety, speed, and success to this operation.

Minimal access surgery of pediatric inguinal hernias: a review.

Inguinal hernia is a common problem among children, and herniotomy has been its standard of care. Laparoscopy, which gained a toehold initially in the management of pediatric inguinal hernia (PIH), has managed to steer world opinion against routine contralateral groin exploration by precise detection of contralateral patencies. Besides detection, its ability to repair simultaneously all forms of inguinal hernias (indirect, direct, combined, recurrent, and incarcerated) together with contralateral patencies has cemented its role as a viable alternative to conventional repair.