Annals of Bariatric Surgery
Volume:6 Issue: 4, Autumn 2017

Colon polyps are a relatively common problem which necessitates a colonoscopic polypectomy. It has its own limitations in surgery. Sessile or large polyps or those at unavailable section (ie: in mesenteric border of colon) are not suitable for a colonoscopic approach for excision. Furthermore, in colonoscopic resection, there is a frustrating risk of a colon wall perforation that not diagnosed intraoperatively. By the help of Combined Endoscopic Laparoscopic Surgery (CELS), a more aggressive polypectomy could be done while the colon wall monitored intraoperatively via laparoscopy and there is an appropriate possibility of colon wall repair if any perforation had occurred .This is a new method in diagnostic and curative surgical approaching to nonmalignant colon lesion that needs a coherent cooperation between laparoscopy and colonoscopy for performing a safe colonoscopic polypectomy.

laparoscopic treatment of hepatic hydatid disease has undergone revolution in parallel to progress in laparoscopic surgery. Controversies about the role laparoscopy in the management of liver hydatid cyst have not been resolved because of scarce experience worldwide.
The aim of our study was to compare surgical outcome of laparoscopic approach with open surgery for the management of hepatic hydatid disease.
It was a retrospective and prospective study conducted in the department of surgery SKIMS Srinagar over a period of eight years from January 2008 to January 2016 in Sheri Kashmir institute of medical sciences Srinagar India, Srinagar. The study included all the adult patients admitted with a diagnosis of hepatic hydatid disease and the total number of patients studied was 80. All patients were pre-operatively and post- operatively treated with Albendazole. The patients were alternately taken either for laparoscopic approach or for open approach. For data that was included retrospectively patients were enrolled in either groups based upon the type of surgery they had undergone. Patients were followed for any recurrence for a period ranging from one year to six years with an average follow up period of 24 months. All the data was entered in detailed proforma and analysed.
Mean age of presentation was 40.27 years in open group and 38.80 years for laparoscopic group. Majority of patients (55%) presented with pain abdomen. Mean operative time was 60.43 minutes in open group and 89.80 min. for laparoscopic group. Two patients (5%) from the laparoscopic group had to be converted to open. In laparoscopic group mean hospital stay was 3.40 days while in open group it was 8.73 days. Mean time to return to work was 8.10 days in laparoscopic group and 20.70 days in open group. In laparoscopic group none of the patients had surgical site infection while as in open group 4 (10%) had surgical site infection. In laparoscopic group, biliary leak was seen in 3 (7.5 %) patients, while in open group it was seen in 2 (5%) patients. Recurrence was seen in 2 (5%) patients who underwent open surgery, while as recurrence was not seen in any of the patients who underwent laparoscopic surgery.
Based on our encouraging results from our current study, we conclude that laparoscopic hydatid surgery is safe and feasible for selected patients in which criteria is met, motivated primarily by lower post-operative morbidity, mortality and recurrence.

Following the widespread approval of laparoscopic procedures, which impose certain restrictions on surgeons’ movements and access to information, extensive research has been conducted on improving ergonomic conditions in this field. Ergonomic studies have indicated high levels of physical workload among laparoscopic surgeons.
The purpose of this study was to clarify the major ergonomic challenges faced by laparoscopic surgeon, their first assistants, and operating room nurses.
This cross-sectional study recruited 62 volunteers with different levels of experience in minimally invasive surgeries between October 2014 and June 2015. Demographic data and the musculoskeletal disorder were collected by demographic questionnaire and the nordic musculoskeletal questionnaire (NMQ). Laparoscopic cholecystectomy procedures and surgical team members’ position were recorded by camera then evaluated via the rapid upper limb assessment (RULA) method by ErgoIntelligence – UEA software. The data were analyzed using T-test, ANOVA Test, pearson and Kendall correlation coefficient by using Spss 16 software.
60%of participates are male and 40%are female. The Mean age of male and female participates are 43.94 and37.62, respectively. There is a significant relationship between weight, height and work experience with musculoskeletal disorders and jobs and RULA score. The surgeons had the highest score in Rulla method. Pearson correlation coefficient also showed a significant relationship between age and RULA score.
The majority of the participants complained of pain and discomfort after laparoscopy, therefore it is imperative to consider ergonomic issues during such procedures.

Laparoscopic stone surgery has some advantages in the anatomical anomalies, comcominant of ureteropelvic junction obstruction and stone, symptomatic stone of diverticulosis, impacted large renal and ureteral stones. The results of the patients’ characteristics and complications who underwent laparoscopic surgery were evaluated and presented.
The patients who were treated by laparoscopic surgery from January 2014 to June 2016 for ureteral and kidney stone were reviewed retrospectively. Transperitoneal method was performed in all patients. In this method; near 1 cm from the umbilicus was incised for to access the abdomen. CO2 was used to create pneumoperitoneum. Operation time, duration of hospitalization, the complications were recorded during and after the surgery.
There are 2 female and 5 male patients. The mean age of the patients and stone size was 46.28 15.52 years and 25.28 5.17 mm respectively. Average hospital stay was 4 3.94 days. There was no major complications such as bleeding, injury to internal organs during surgery. One patient (% 14.28) was converted to open surgery. The mean operation time of the remaining patients was 152 57.61 minutes. The stone free rate was 100%. Double j stent was inserted into four patient during the operation and one patient in postoperative period. The patients who underwent pyelolithotomy did not need stent placement. Percutaneous nephrostomy was performed in one patients because of prolonged drainage and ureteral stricture (16.66%) was detected in postoperative period.
Laparoscopic stone surgery has a high succes rate. The urologist who were taken basic training of laparoscopy can be performed succesfully.