Compare the Combined Diagnostic Accuracy of Transient Elastography and Visual Liver Score in Assessing Non-Alcoholic Fatty Liver Disease (NAFLD) and Compare it with Liver Biopsy in Morbidly Obese Patients Undergoing Bariatric Surgery: An Observational Study.

Introduction: A liver biopsy is the gold standard for the diagnosis of non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH). Here, we combine preoperative transient elastography (TE) and intraoperative standardized visual liver score (VLS) which is compared with intraoperative liver biopsy for prediction of NAFLD and NASH in patients undergoing bariatric surgery.

Aim: Evaluate the combined diagnostic accuracy of TE and VLS in assessing NAFLD or NASH and compare it with liver biopsy in patients undergoing bariatric surgery.

Randomized single blind trial to compare the short term post-operative outcome and cost analysis of laparoscopic versus ultrasound guided transversus abdominis plane block in patients undergoing bariatric surgery.

Introduction: Laparoscopic Bariatric surgery despite being minimally invasive can cause moderate to severe pain in the immediate postoperative period. Adequate pain management remains a major challenge. Transversus Abdominis Plane (TAP) block is a regional anesthesia technique which blocks the sensory nerve supply of anterior-lateral abdominal wall.

Resection of a large Solid Pseudopapillary Neoplasm of the Pancreas: A multidisciplinary feat and review of literature.

Solid pseudopapillary neoplasm (SPN) is an extremely rare tumor with low malignant potential which is generally located in the tail of the pancreas. The prevalence of SPN has increased with the recent advancement in radiological imaging. CECT abdomen and Endoscopic ultrasound-FNA are excellent modalities in preoperative diagnosis.

Short Bowel Syndrome: An Uncommon Clinical Entity and a Therapeutic Challenge-Our Experience and Review of Literature.

Short bowel syndrome (SBS), one of the commonest types of intestinal failure, usually secondary to extensive bowel resection, traditionally has been associated with a high mortality rate and hence a big challenge for the treating surgeons. It requires comprehensive clinical care to minimise the morbidities and mortality associated with the condition. We report a retrospective review of a series of seven patients with SBS, who presented at our surgical emergency within a period of 1 year and their outcome so as to encourage others in managing such a challenge with more positive mindsets.

Laparoscopic management of a two staged gall bladder torsion.

Gall bladder torsion (GBT) is a relatively uncommon entity and rarely diagnosed preoperatively. A constant factor in all occurrences of GBT is a freely mobile gall bladder due to congenital or acquired anomalies. GBT is commonly observed in elderly white females.

Appraisal of Laparoscopic Liver Resection in the Treatment of Liver Metastasis with Special Reference to Outcome in Colorectal Malignancies.

Treatment of metastatic liver disease is at the crossroads of an evolutionary transformation with more and more reports reiterating the benefits of resectional therapy in various cancers. A quest for application of laparoscopic approaches to the management of liver metastasis has arisen due to the projected benefits of less morbidity, early recovery, and equivalent oncological outcome in selected malignancies. However, the diverse and heterogenous data on indications, operative technique, and outcome evaluation make a comparative analysis of these studies difficult.

Prospective randomized trial comparing laparoscopic transabdominal preperitoneal (TAPP) and laparoscopic totally extra peritoneal (TEP) approach for bilateral inguinal hernias.

Introduction: Bilateral inguinal hernias form a part of the complex spectrum of weakness in the region of the myopectineal orifice. Laparoscopic surgery is one of the standard approaches for bilateral hernias. We describe the results of a randomized trial that was undertaken to compare and evaluate TAPP and TEP repair for bilateral inguinal hernias.

Risk Assessment Tool for Pressure Ulcer Development in Indian Surgical Wards.

The aims of this paper were to compare the predictive validity of three pressure ulcer (PU) risk scales-the Norton scale, the Braden scale, and the Waterlow scale-and to choose the most appropriate calculator for predicting PU risk in surgical wards of India. This is an observational prospective cohort study in a tertiary educational hospital in New Delhi among 100 surgical ward patients from April to July 2011. The main outcomes measured included sensitivity, specificity, positive predictive value (PVP) and negative predictive value (PVN), and the area under the curve of the receiver operating characteristic (ROC) curve of the three PU risk assessment scales.

Rare Presentation of Gall Bladder Tuberculosis in a Non Immuno-Compromised Patient.

The gall bladder is least common intra-abdominal organ to be involved by tuberculosis. It is either part of systemic miliary tuberculosis or abdominal tuberculosis. Isolated gall bladder tuberculosis is even rarer, can presents either as calculus or acalculus cholecystitis.

Laparoscopic management of nonmidline ventral hernia.

Introduction: Ventral hernias may be primary or incisional and classified as midline ventral hernias (MVHs) or non-MVHs (NMVHs). NMVHs are rarer, and their laparoscopic management is technically challenging because of varied anatomic locations, differences in patient positioning at time of surgery, and lack of adequate lateral space for mesh fixation, compounded by the proximity of major organs and bony landmarks. A retrospective review of all the NMVHs operated on in a clinical unit is presented.

Laparoscopic drainage of a large pancreatic pseudocyst.

Laparoscopic cystogastrostomy is an established procedure for the drainage of pancreatic pseudocysts. Cysts are mainly present in the lesser sac (retro-gastric), which is completely amenable to cystogastrostomy. We discuss the problems faced and simple solutions to the problems in managing a huge pancreatic pseudocyst of 22 cm×18 cm in a young boy 18 y of age.

Emergency cholecystectomy and hepatic arterial repair in a patient presenting with haemobilia and massive gastrointestinal haemorrhage due to a spontaneous cystic artery gallbladder fistula masquerading as a pseudoaneurysm.

Background: Haemobilia usually occurs secondary to accidental or iatrogenic hepatobiliary trauma. It can occasionally present with cataclysmal upper gastrointestinal haemorrhage posing as a life threatening emergency. Haemobilia can very rarely be a complication of acute cholecystitis.

Carcinoma Gall Bladder with Bouveret's Syndrome: A Rare Cause of Gastric Outlet Obstruction.

We describe a case of bouveret's syndrome associated with carcinoma gall bladder. This is probably the second reported case of such an association. Computed tomography detected the calculus in the duodenum but endoscopy could not retrieve it.

Pneumothorax during laparoscopic repair of giant paraesophageal hernia.

Giant paraesophageal hernia is an uncommon morbid disorder which may present a risk of catastrophic complications and should be repaired electively as soon as possible. Laparoscopic fundoplication is the mainstay of surgical management of this disorder due to several advantages such as lower post-operative morbidity and pain. We report a case of a 70-year-old patient with a giant paraesophageal hernia, who developed subcutaneous emphysema with pneumothorax during laparoscopic fundoplication.

Laparoscopic treatment of gastric bezoar.

A seventeen-year-old female presented with a symptomatic abdominal mass that was diagnosed by barium meal and computed tomography to be a gastric bezoar. She underwent laparoscopic removal of the bezoar, through an anterior wall gastrostomy in an endobag, which was extracted piecemeal through a 4-cm upper midline incision. The technique is described with a review of a few previous laparoscopic-assisted cases.

Novel technique for closure of defect in laparoscopic ventral hernia repair.

Laparoscopic repair of ventral hernia is the standard of care in today's era. With increasing experience, different theories and techniques have been described by different authors to overcome the intraoperative and postoperative problems. We describe a novel technique for closure of defect in laparoscopic hernia repair which has the added advantage.

Meckel's diverticulum with benign stricture: A very rare cause of intestinal obstruction.

We report a very rare case of Meckel's diverticulum with benign stricture presenting as recurrent small bowel obstruction in a malnourished young adult female. Extensive preoperative investigations were unable to diagnose the cause of recurrent obstruction. Segmental small bowel resection with attached diverticulum was performed.

Laparoscopy for liver hydatid disease: where do we stand today?

Hydatid disease mostly affects the liver with Echinococcus granulosus being the most common organism. Surgery remains the gold standard in terms of therapy for patients with echinococcosis of the liver despite significant economic costs, advances in medical treatment, and interventional radiology. Laparoscopy, as a minimally invasive surgery, has well-known clinical advantages over traditional surgery.

Laparoscopic splenectomy: 16 years since Delaitre with review of current literature.

Since Delaitre reported his first laparoscopic splenectomy it has been accepted universally and today it is probably regarded as a Gold standard in removal of benign and normal sized spleens. We discuss the indications, advantages, techniques, and recent advances of Laparoscopic splenectomy after 16 years of Delaitre.

Arginase activity in carcinoma of the gallbladder: a pilot study.

Carcinoma of the gallbladder is the third most common cancer of the gastrointestinal tract. Recent studies have shown increased arginase activity in various malignancies. The main aim of this study was to evaluate whether arginase activity increases in carcinoma of the gallbladder.