Biomedical subjects

Rasik S Shah

Publications and source records attributed to Rasik S Shah.

6 recordsLinked to original sources

PubMed2005

Transabdominal preperitoneal repair of a port-site incisional hernia.

A 47-year-old woman presented with an incisional hernia at the site of a 10-mm port placed in the left iliac fossa during laparoscopic oopherectomy performed 6 years previously. The hernia was repaired laparoscopically by a transabdominal preperitoneal approach using one 10-mm and two 5-mm ports. Adherent omentum was reduced from the sac and a wide flap of peritoneum extending 5 cm on all sides of the fascial defect was raised. The peritoneum was circumcised around the neck of the sac, leaving the sac undisturbed. A 12 x 12 cm polypropylene mesh was placed in the preperitoneal plane and secured in place with endoscopic spiral tackers. The peritoneal incision was approximated with a running 2-0 polyglactin suture. The patient had an uneventful recovery and was discharged after 48 hours. She resumed normal activity within 5 days and remains well one year later. A transabdominal preperitoneal repair seems a feasible alternative for repair of port-site incisional hernias that usually occur through a single and small fascial defect.

Female↗

PubMed2005

Laparoscopic repair of idiopathic perforation of urinary bladder.

A 45-year-old man presented with a 10-day history of dysuria and abdominal distention. Clinical examination revealed free intraperitoneal fluid and tenderness in the lower abdomen. Hematological and biochemical parameters were normal except blood urea nitrogen of 76 mg/dL and serum creatinine of 3.4 mg/dL. Ultrasonography confirmed moderate ascites with normal-appearing kidneys. In view of high creatinine level, normal kidneys, and acute-onset moderate ascites, urinary ascites was suspected. A micturating cystogram showed extensive intraperitoneal extravasation of the contrast. Cystoscopy identified a 2.5-cm perforation on the right side of the dome of the bladder. A laparoscopic closure of the perforation was carried out in 2 layers. The histopathology of the excised edge showed nonspecific inflammatory changes, and a subsequent urodynamic study was normal. The patient remains well 3 years later. This case highlights the successful use of laparoscopy in the treatment of a rare urological condition and reviews the previously reported cases of laparoscopic closure of bladder perforation.

Humans↗

PubMed2004

Retroperitoneoscopic drainage of a psoas abscess.

Pyogenic psoas abscess in the pediatric age group is a primary condition caused mostly by Staphylococcus aureus. The preferred treatment is percutaneous or surgical drainage under a cover of systemic antibiotics. Laparoscopic drainage scores over open surgery in terms of minimal invasion, shorter hospital stay, better patient comfort, and more complete drainage compared with the percutaneous approach. The authors report a case of a 4-year-old boy with a psoas abscess that was effectively drained laparoscopically through an extraperitoneal approach.

Anti-Bacterial Agents↗

PubMed2004

Laparoscopy-assisted transperitoneal percutaneous nephrolithotomy for recurrent calculus in isthmic calix of horseshoe kidney.

BACKGROUND AND PURPOSE: Management of urolithiasis in a horseshoe kidney (HSK) poses a unique challenge. Although most patients can be managed by a combination of percutaneous nephrolithotomy (PCNL) and extracorporeal shockwave lithotripsy (SWL), calculi in the isthmic calix remain difficult to treat, as this area is out of reach during rigid PCNL, and, owing to the poor evacuation of the fragments, the results of SWL are suboptimal. CASE REPORT: A 59-year-old man known to have an HSK presented with right-sided lower-abdominal pain and episodes of urinary infection. In the past, he had undergone pyelolithotomy and lithotripsy for lithiasis in the kidney. Imaging studies identified a large recurrent calculus in the anteriorly directed isthmic calix. This was treated successfully by a laparoscopy-assisted transperitoneal PCNL. The laparoscopic view allowed the bowel to be retracted away from the site of the HSK, and PCNL guided by fluoroscopy and laparoscopy was performed. Complete stone clearance was achieved in a single stage. The patient remains free of symptoms and recurrence 3 months later. CONCLUSION: We believe this to be the first report describing this novel approach to lithiasis in an HSK.

Humans↗

PubMed2004

Laparoscopic management of antenatally-diagnosed abdominal cysts in newborns.

We report two newborns each detected to have a large intra-abdominal cyst on antenatal ultrasonography. Postnatal imaging confirmed presence of the cysts and showed a complex cyst with multiple septae in the first patient and evidence of bleeding in both. Laparoscopy performed on the 14th and 19th day of life, respectively, showed ovarian cysts with hemorrhage and torsion. The cysts were treated successfully by laparoscopic oopherectomy. Histopathology revealed an ovarian gonadoblastoma in the first patient and a simple cyst with calcification in the second. Both patients remain well at a follow up of six and four months. Laparoscopic treatment of antenatally detected cystic abdominal masses is a feasible option in the newborn.

Cysts↗

PubMed2003

Gallstone ileus.

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Aged↗