Biomedical subjects

Chinnusamy Palanivelu

Publications and source records attributed to Chinnusamy Palanivelu.

7 recordsLinked to original sources

PubMed2007

A rare cause of intermittent dysphagia: giant fibrovascular polyp of the proximal esophagus.

Fibrovascular polyps account for only 0.5-1% of all benign esophageal tumors and causes intermittent dysphagia. The patient was a 63-year-old gentleman with gradually progressive intermittent dysphagia of 40 days duration. Investigations revealed a submucosal tumor of the proximal esophagus causing luminal compromise. Excision was performed through a cervical esophagotomy and specimen was subject to histopathological examination. Postoperative recovery was uneventful and he was completely relieved of his symptoms.

Deglutition Disorders↗

PubMed2006

Laparoscopic suture gastropexy for gastric volvulus: a report of 14 cases.

BACKGROUND: Gastric volvulus is an uncommon condition that affects mostly older men. It occurs mainly as a result of congenital laxity of the stomach's attachments and might be accompanied by a diaphragmatic hernia. This sometimes causes the stomach to herniate into the thorax, giving rise to respiratory compromise. A patient can have acute or chronic disease. We present our series of 14 patients who were managed with simple laparoscopic suture gastropexy. METHODS: We managed 14 patients with gastric volvulus during the past ten years; 2 patients had primary type and 12 had secondary type gastric volvulus. Elective surgery was performed for the ten patients with chronic volvulus and emergency surgery was done for the four patients with acute volvulus. One of the patients with diaphragmatic hernia was six months pregnant and presented with acute symptoms. RESULTS: All patients recovered well from surgery, including the pregnant patient. The average hospital stay was five days; the pregnant woman was discharged on the sixth postoperative day. DISCUSSION: Symptoms of chronic gastric volvulus resemble those of reflux disease, whereas the acute condition is a surgical emergency. Gastric volvulus is a rare disease, so chances of laparoscopic management are also rare. There are also combined endoscopic and laparoscopic approaches for treatment; even percutaneous endoscopic gastrostomy has been tried with good results. In secondary volvulus, the diaphragmatic defect has to be repaired, preferably with mesh. Gastropexy is performed in all cases. CONCLUSION: Even though worldwide experience in laparoscopic surgery for gastric volvulus is limited, the results are encouraging. Based on our experience, laparoscopic management seems to be safe and feasible in acute and gastric volvulus.

Acute Disease↗

PubMed2006

Minimally invasive esophagectomy: thoracoscopic mobilization of the esophagus and mediastinal lymphadenectomy in prone position--experience of 130 patients.

BACKGROUND: To evaluate outcomes after minimally invasive or thoracolaparoscopic esophagectomy (TLE) with thoracoscopic mobilization of the esophagus and mediastinal esophagectomy in prone position. Esophagectomies are being performed increasingly by a minimally invasive route with decreased morbidity and shorter hospital stay compared with conventional esophagectomy. Most series report thoracoscopic mobilization of the esophagus and mediastinal lymphadenectomy in the left lateral position with respiratory complications up to 8% and prolonged operative time, probably because of inadequate stance of the surgeon during the thoracoscopic part. This study shows the potential of the thoracoscopic part of the procedure in prone position to ease these difficulties. STUDY DESIGN: From January 1997 through April 2005, TLE was performed in 130 patients. All patients had histologically proved squamous cell carcinoma of the middle third of the esophagus. Only one (0.77%) patient received neoadjuvant chemotherapy. The thoracoscopic part of the procedure was performed in prone position with excellent ergonomics, translating into less operative time and better respiratory results. We performed a minilaparotomy to retrieve the specimen owing to bulky tumors. Feeding jejunostomy and pyloromyotomy were performed in all patients. RESULTS: There were 102 men and 28 women. Median age was 67.5 years (range 38 to 78 years). There was no conversion to open method. Median ICU stay was 1 day (range 1 to 32 days) and median hospital stay was 8 days (range 4 to 68 days). Perioperative mortality was 1.54% (n = 2). Anastomotic leak rate was 2.31% (n = 3). There was no incidence of tracheal or lung injury and a very low incidence of postoperative pneumonia. At mean followup of 20 months (range 2 to 70 months), stage-specific survival was similar to open and other minimally invasive series. CONCLUSIONS: TLE with thoracoscopic part in prone position is technically feasible, with a low incidence of respiratory complications and less operative time required. It provides comparable outcomes with other techniques of minimally invasive esophagectomy and most open series. In our experience, we observed a low mortality rate (1.54%), hospital stay of 8 days, and low incidence of postoperative pneumonia. It has the potential to replace conventional and other techniques of minimally invasive esophagectomy.

Adult↗

PubMed2005

Laparoscopic repair of high rectovaginal fistula: is it technically feasible?

BACKGROUND: Rectovaginal fistula (RVF) is an epithelium-lined communication between the rectum and vagina. Most RVFs are acquired, the most common cause being obstetric trauma. Most of the high RVFs are repaired by conventional open surgery. Laparoscopic repair of RVF is rare and so far only one report is available in the literature. METHODS: We present a case of high RVF repaired by laparoscopy. 56-year-old female who had a high RVF following laparoscopic assisted vaginal hysterectomy was successfully operated laparoscopically. Here we describe the operative technique and briefly review the literature. RESULTS: The postoperative period of the patient was uneventful and after a follow up of 6 months no recurrence was found. CONCLUSION: Laparoscopic repair of high RVF is feasible in selected patients but would require proper identification of tissue planes and good laparoscopic suturing technique.

Female↗

PubMed2003

Abdominal cocoon: sonographic features.

An abdominal cocoon is a rare condition in which the small bowel is encased in a membrane. The diagnosis is usually established at surgery. Here we describe the sonographic features of this condition.

Adolescent↗

PubMedDate not supplied

Laparoscopic appendectomy for mucocele of the appendix: Report of 8 cases.

Mucocele of the appendix is an aseptic dilatation secondary to obstruction. Surgical excision is the treatment of choice in benign mucocele. The incidence of mucocele of the appendix in our center is 0.15%, of a total of 6000 appendectomies over 8 years. We operated on 9 cases; laparoscopic appendectomy was done in 8 of them. One patient had pseudomyxoma peritonei, so open surgery was done. Other organs were also examined as there is a possibility of concurrent tumors. As there is risk of malignancy of the appendix leading to port-site metastasis we used a non-permeable bag to remove the resected specimen.

Appendectomy↗

PubMedDate not supplied

Laparoscopic appendectomy in pregnancy: a case series of seven patients.

BACKGROUND: Appendicitis in the pregnant patient presents with diagnostic difficulties and more serious problems. Open surgery has its own limitations, mostly governed by the stage of the disease and the trimester of pregnancy. Laparoscopic appendectomy is beginning to be recognized as standard appendicitis treatment, as evidenced by several studies. In pregnancy, laparoscopy is even more controversial. Several studies prove the safety of laparoscopy and some studies disprove it. METHODS: We have treated 7 patients in the last 10 years; 6 had acute appendicitis and 1 had a perforated appendix. Ultrasound diagnosed 5 patients, and CT scan identified the other 2 patients. The patient with the perforated appendix had free fluid in the right iliac fossa and pelvis. Laparoscopic appendectomy was done in all patients. DISCUSSION: Pregnancy poses its own unique problems to the surgeon and anesthesiologist. The normal physiology becomes altered, and sound knowledge of this is necessary to handle these patients. Clinical presentation was mostly straightforward. Both ultrasound and CT scan were useful investigations. CONCLUSION: Most studies support the use of laparoscopy in the management of appendicitis. There was no mortality (for mother and fetus) or morbidity in our patients.

Adult↗