Right Versus Left Laparoscopic Donor Nephrectomy: Initial 3 year Experience from a Single Centre Transplant Program

Laparoscopic living donor nephrectomy is the standard of care at high volume transplant centers. Despite this there is still reticence to harvest the right kidney laparoscopically because of concerns regarding the shorter renal vein, higher complexity of dissection and potentially higher complication rates and worse renal allograft outcomes.

The aim of this single-center study of 72 consecutive laparoscopic donor nephrectomies was to compare left versus right-sided laparoscopic donors in terms of surgical difficulty, complication rates and outcomes.There were 56 left-sided and 16 right-sided donors. There was no significant difference in surgical outcomes or complication rates.

Similarly, the recipient surgery complication rates and allograft outcomes were no different between kidneys procured laparoscopically from the left or the right.

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PRF in Oral Surgery: A Literature Review

The research of adjuvant surgical to promote the healing is a challenge. A lot of processes were done especially the PRF (platelet rich fibrin) that owes its action to its slow polymerization which permits to pick up the growth factors inside the fibrin mesh.

These factors and due to a slow release permit a local stimulation of the healing time as well. Nowadays, with the use of the PRF, the oral surgery undergoes a lot of controversies.

The clinical observations are in advance in regard to the scientific evidence. In spite of the encouraging results, research is to be depending to get a complete scientific validity.

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Extra-corporeal Circulatory Support: A Resurgence of a Life Saving Therapy in the Digital Information Age

Extra-corporeal membrane oxygenation represents an evolving therapeutic tool for the treatment of acute severe cardiac and respiratory failure in patients failing maximal medical therapy.

Advances in technology along, increasing worldwide clinical successes, and broadening applications have encouraged renewed interest in what was previously considered a salvage intervention associated with poor outcomes.

Hopefully, the use of digital media and timely on-line access to scientific advances will allow clinicians and patients who depend on ECMO for survival to benefit in a field in which there is clearly room for improvement in outcomes and understanding.

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Noninvasive Flap Monitoring using Sidestream Dark Field Microscan: A Method for Real-Time Observation of Submilimmetric Vessels

A timely diagnosis of vascular compromise improves free flap survival. The aim of this study was to determine the feasibility of monitoring flap vascular patency through noninvasive microcirculation monitoring using SDF.

An experimental study was performed in five volunteers. A radial forearm flap was simulated in both upper extremities and cutaneous microcirculation assessment devices were used (SDF and NIRS), and compared with clinical and doppler evaluation.

Conditions of venous occlusion (VO) and total vascular occlusion (TVO) were mimicked by using a cuff. The results of the Microscan SDF monitoring during VO and TVO showed a reduced microcirculatory flow at 16.5 (6-30) and 6 (2-11) seconds respectively.

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Portal Hypertension Model in Pigs

Every year in western countries millions of people are diagnosed with portal hypertension (PHT) which rapidly complicates hepatic cirrhosis and causes esophageal varices, ascites and encephalopathy.

This determines higher risk of morbidity and mortality and contributes to elevate costs for the Health Care System. PHT is defined as the elevation of the portal vein pressure gradient over 5-10 mmHg.

Common causes are: Pre-hepatic such as portal vein thrombosis or congenital atresia; intra-hepatic as liver cirrhosis, hepatic fibrosis and less commonly non-cirrhotic causes such as schistosomiasis, massive fatty change and granulomatous diseases; post-hepatic including obstruction that occurs at any level between liver and right heart (i.e., Budd Chiari syndrome and veno-occlusive disease VOD).

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Prevalence of Surgical Site Infections in Non-Diabetic Patients Undergoing Major Surgery at St. Francis Hospital Nsambya

Surgical site infection (SSI) is an infection occurring in an incision wound within 30 days of surgery and significantly effects patient recovery and hospital resources.

To determine the prevalence of SSI among non-diabetic patients undergoing major surgery at St.Francis hospital Nsambya. This was a Cross-section prospective study, the study was carried out at St. Francis Hospital Nsambya in Kampala.

This is one of the tertiary level referral and teaching hospital for MKPG Nkozi University. It has a bed capacity 342 beds. Approval to conduct the study was obtained from the institutional review board prior to commencement of data collection.

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Pilon Fractures of Middle Phalanx Managed with Lag Screw and Early Mobilisation

Proximal interphalangeal (PIP) joint injuries are commonly seen in athletes and especially the pilon fractures are quite common due to axial loading injuries.

It is associated with volar lip fragment with dorsal subluxation of middle phalanx with varying degree of comminution of the base of middle phalanx.

Varied treatment options have been described ranging from extension block splint, external frame finger distraction and open reduction internal fixation. The key is in restoring the joint congruity with early controlled mobilisation thereby preventing joint stiffness or deformity.

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Infra Mammary Approach for Major Duct Excision in the Management of Multiple Duct Ectasia

In some cases, non-lactating women can experience nipple discharge that can be highly distressing. Such discharge is commonly caused by mammary ductal ectasia (MDE).Factors that can lead to mammary duct ectasia are still undefined.

However, possible causes of MDE can include congenital abnormalities of the ductal system, autoimmune reactions, trauma or infections.The pathogenesis of duct ectasia includes the dilatation of one or more of the large lactiferous ducts that are filled with a stagnant secretion.

These fluids trigger an irritation reaction in the surrounding tissues causing periductal mastitis or abscess and fistula formation. In some instances, a chronic indurated mass formation can take place underneath the areola that may resemble a carcinoma.

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Advances in Targeted Re-innervation

In recent years there have been numerous advances in the field of prosthetics. Targeted reinnervation is a newly developed surgical procedure used to improve the motor control and sensation of the affected limb.

In this procedure, the residual nerves from the amputated extremity are identified and transferred to new “targets” that have otherwise lost their function. These newly innervated muscles and targets are then used as amplifiers for the amputated nerves in order to restore the functional loss.

Use of these newly innervated muscles or at times even only parts of muscles (two heads of pectoralis after a forequarter amputation) would allow a more innate control of the bio-prosthetics.This will not only allow the new muscle contractions to be sensed and used to control prosthesis, it will also enable the overlying skin to have protective sensation.

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Genitourinary Hydatid Disease

The most important parasitic diseases involving the genitourinary system in humans are helminthic, where schistosomiasis is the commonest followed by hydatid disease (HD) and filariasis [1]. HD is a parasitic infestation, caused by tape worms of the genus Echinococcus, that usually involves the liver and lungs, although no organ is spared.

The varied presentations and complications of HD present routine surgical problems in endemic areas, although HD of the urinary tract is uncommon, comprising 2–4% of all cases. This article reviews the epidemiology, etiopathogenesis, clinical features and presentations, medical and surgical treatment of genitourinary and pelvic echinococcosiswith special reference to individual organs.

In addition our own experience at our hospital in the last 4 years that we treated 4 cases of hydatid cysts of which 3 were renal HD and one was primary pelvic HD.

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