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Vinay G Mehendale

Publications and source records attributed to Vinay G Mehendale.

4 recordsLinked to original sources
PubMed2003

Laparoscopic sigmoidopexy by extraperitonealization of sigmoid colon for sigmoid volvulus: two cases.

Sigmoid colectomy-open or laparoscopic-has been advocated as the treatment of sigmoid volvulus. This has a higher incidence of morbidity and mortality. We have successfully treated 2 cases of recurrent sigmoid colon volvulus with laparoscopic sigmoidopexy by extraperitonealization of the sigmoid colon. Laparoscopic sigmoidopexy by this technique has not been reported before. The first patient was a 20-year-old male and the second was a 72-year-old female. In both patients, initial detorsion of volvulus was achieved by rectal tube. As the colon was nongangrenous, elective laparoscopic sigmoidopexy by extraperitonealization of the sigmoid colon was performed 4 days after the detortion. Operative times were 50 minutes and 70 minutes. Both patients were discharged from the hospital on the third postoperative day. There has been no recurrence of volvulus over a period of 6 and 7 months. There were no complications. In conclusion, laparoscopic sigmoidopexy by extraperitonealization of the sigmoid colon may become a superior alternative for the treatment of sigmoid volvulus with nongangrenous colon.

Adult↗
PubMedDate not supplied

Laparoscopic versus open surgical closure of perforated duodenal ulcers: a comparative study.

BACKGROUND: Laparoscopic closure of duodenal ulcer perforation may be an alternative to open surgery due to lower morbidity. Most published series have used omental plug for laparoscopic closure. We performed simple closure of the perforation laparoscopically and compared the results with those obtained by open surgery. METHODS: Of 77 consecutive patients with duodenal ulcer perforation 10 were excluded due to their high risk for laparoscopic surgery. 34 (age 18-61 years; one woman) were treated by laparoscopic surgery while 33 (age 23-63 years; two women) underwent laparotomy. Closure of the perforation was achieved by suturing the edges of the perforation. RESULTS: 27 patients had successful closure of perforation by laparoscopy; one had sealed perforation and did not need closure. Conversion to open surgery was necessary in 6 patients (17.8%). Median operating time was 50 minutes (range 25 to 120) and median hospital stay was 4 days (range 4 to 6) for laparoscopy. There was no postoperative leak. Corresponding figures for open surgery were 55 minutes (45 to 75) and 9 days (7 to 13). Patients in the laparoscopy group returned early to work (median 13 days, range 10 to 15 days postoperatively) as against 26 days (21 to 35) in the open surgery group (p < 0.001). CONCLUSION: Laparoscopic closure of duodenal ulcer perforation is safe and effective. It is a better method of treating duodenal ulcer perforation when the patient's condition allows pneumoperitoneum and laparoscopy.

Adolescent↗
PubMedDate not supplied

Devadhar's operation for complete rectal prolapse: 25 years' experience.

BACKGROUND: Numerous abdominal and perineal operations have been described for the treatment of complete rectal prolapse. We describe our results with Devadhar's rectopexy, which avoids dissection in the presacral space and hence may be expected to have a low risk of sexual and urinary disturbances. METHODS: Case records of 72 consecutive patients (40 men), aged above 18 years, with complete rectal prolapse who were treated with Devadhar's operation were reviewed. RESULTS: The only complication observed was mucosal prolapse in 3 patients. None of the 40 men had erectile dysfunction or retrograde ejaculation after a median follow-up of 10 (range 3-48) months. No patient had disturbance in micturition. Two patients (2.7%) had recurrence of rectal prolapse. In four patients (8.5%), constipation persisted. CONCLUSION: Devadhar's rectopexy for complete rectal prolapse was not associated with disturbances in sexual or micturition function, and low rates of recurrence of prolapse.

Adult↗