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Biomedical subjects

D S Bhandarkar

Publications and source records attributed to D S Bhandarkar.

At least 19 recordsLinked to original sources
PubMed2004

Laparoscopically guided transperitoneal percutaneous nephrolithotomy for calculi in pelvic ectopic kidneys.

Although percutaneous nephrolithotomy is a well-established endourological modality for the management of calculi in the normally placed kidney, it is not easy to apply in the management of calculi in pelvic ectopic kidneys. We report the cases of three patients who were found to have large calculi in pelvic ectopic kidneys and subsequently underwent laparoscopically guided transperitoneal percutaneous nephrolithotomy, all with successful outcome. In all patients, complete stone clearance was achieved in a single operation with no intraoperative or postoperative morbidity. They remain asymptomatic and recurrence-free at a follow-up ranging from 2 to 38 months. Laparoscopic guidance allows the transperitoneal route to be used safely for percutaneous nephrolithotomy in patients with calculi in pelvic ectopic kidneys. We believe it to be a feasible, safe, and valid minimally invasive management option for this uncommon but challenging urological condition.

Abdominal Pain↗
PubMed2004

Intrahepatic subcapsular hematoma complicating laparoscopic cholecystectomy.

A 64-year-old woman underwent endoscopic retrograde cholangiopancreatography for bile duct stones, followed 2 days later by an uneventful laparoscopic cholecystectomy. She presented after 10 days with upper abdominal discomfort, nausea, and pyrexia. Investigations revealed a decrease in hemoglobin, and computed tomography identified a large intrahepatic subcapsular hematoma in segments V and VI. There was no intraabdominal collection and the rest of the viscera were normal. The collection was drained percutaneously under ultrasound guidance and a wide-bore catheter placed. She was treated with intravenous antibiotics and the catheter was removed 14 days later upon cessation of drainage. Serial ultrasonographic examinations showed a reduction in the size of the hematoma and complete resolution at 4 months. She remained well and asymptomatic at follow-up 16 months later. We report this case due to its rarity and review the previously documented cases of this complication.

Cholangiopancreatography, Endoscopic Retrograde↗
PubMed2003

Laparoscopic drainage of a peripancreatic tuberculous abscess.

A 28-year-old woman presented with abdominal pain, anorexia, low-grade pyrexia, and a palpable abdominal lump. An abdominal CT scan revealed a mass in the region of the pancreatic head comprised of enlarged lymph nodes interspersed with loculi of pus. Because a fine-needle aspiration failed to establish a diagnosis, the abscess was drained laparoscopically and biopsy specimens were obtained; the specimens confirmed lymph nodal tuberculosis. Postoperatively, the patient received a 9-month course of antitubercular therapy; she remains asymptomatic on follow-up. To the best of our knowledge, this is the first report describing the use of laparoscopy for the drainage of a peripancreatic tuberculous abscess.

Abscess↗
PubMed2003

Laparoscopic ureterolysis and reconstruction of a retrocaval ureter.

A 32-year-old man was investigated for repeated episodes of right-sided flank pain. Ultrasonography showed a dilated right pelvicalyceal system and upper ureter as well as multiple gallstones; subsequent intravenous urogram demonstrated a retrocaval ureter. At surgery, a right-sided double-J ureteric stent was placed under fluoroscopic guidance. Initially, three laparoscopic ports were used. The dilated pelvis and upper ureter were mobilized, followed by the lower ureter. The pelvis was transected and transposed anterior to the inferior vena cava. Reconstruction was carried out with an intracorporeally sutured anastomosis over the double-J stent. A fourth port was added for completion of cholecystectomy. The patient had an uneventful recovery and was discharged on the third day. Fourteen months later he remains well, with a recent intravenous urogram showing regression of hydronephrosis. We review the previously reported cases of laparoscopic and retroperitoneoscopic reconstruction of retrocaval ureter to compare and contrast these minimal access approaches.

Adult↗
PubMed1999

Spray of phospholipid powder reduces peritoneal adhesions in rabbits.

BACKGROUND: The possible effects of peritoneal dialysis and a combination of two exogenous phospholipids, dipalmitoylphosphatidylcholine (DPPC) and phosphatidylglycerol (PG), on experimentally induced intraperitoneal adhesion formation in rabbits were compared. METHODS: Fifty New Zealand rabbits equally divided in five groups underwent a midline laparotomy to create a right iliac fossa 5 x 1 cm parietal peritoneal defect and a matching defect over the adjacent large bowel. In 10 control rabbits (group I) the abdominal wound was closed without any further intervention. Twenty rabbits forming groups II and III underwent two sessions of peritoneal dialysis, one following abdominal closure and the second 24 h later, through a catheter placed at surgery. Rabbits in group III received an intraperitoneal injection of DPPC and PG after each session of dialysis. In 10 animals (group IV) a DPPC gel was applied to the defect over the large bowel and in 10 animals (group V) the peritoneal cavity was sprayed with a 'puff of DPPC:PG (7:3) powder prior to abdominal closure. All the animals were killed a week after the laparotomy to assess the extent of adhesion formation. RESULTS: The formation of adhesions was reduced in all the groups compared to the controls but a statistically significant difference was observed only in the group receiving the intraperitoneal 'puff' of DPPC:PG powder. CONCLUSION: A combination of DPPC and PG sprayed as a 'puff' intraperitoneally reduces experimentally induced peritoneal adhesions in rabbits.

1,2-Dipalmitoylphosphatidylcholine↗
PubMed1993

Benign cystic peritoneal mesothelioma.

The well defined but rare entity of benign cystic mesothelioma is reported. The aetiology of this neoplasm remains obscure. The presenting features make a precise preoperative diagnosis difficult; information provided by computed tomography and cytology may help. A firm diagnosis can only come from electron microscopic or immunohistochemical examination of the tumour. Diagnostic accuracy and diligent follow up are essential because, although the tumour is considered benign, it does tend towards local recurrence.

Cysts↗
PubMed1993

Carcinoma of the breast at the site of migrated pacemaker generators.

We report two patients in whom breast malignancy developed in the proximity of 'migrated' pacemaker generators. These cases and the similar ones reported in the literature raise concerns whether this association is merely coincidental or whether the pacemaker generator is responsible for the occurrence in some inexplicable manner. We urge for a routine, careful examination in all patients with implanted pacemaker generators at follow-up visits. This would help in (a) timely detection of migration of the pacemaker generators and (b) earlier diagnosis of any mass developing close to the migrated generators.

Aged↗