Day 1 :
Fortis Merorial Reaserch Institute ,Gurugram, India
Time : 9.50-10.20
Adhishwar Sharma has completed his MBBS at the age of 25 years from Berhampur University and post graduate taining from PGIMER.He was Senior Resident in surgery in same department.He did his plastic surgery training from Safdurjang hospital under Delhi University. He has done fellowship in microvascular surgery from Amrita institute Kochi . He is in practice sine 2012, He is regularly presenting his work in various conference.At present he is working in FMRI Gurugram India .
Brachial plexus inuries is a major challenge in devloping country like India. Both adult and birth palsy are present . Disease load is significant and facilities to treat these are far and few. Trained doctors , anaesthesia ,nerve monitoring facillites are major challenges . In my practice the brachial plexus injuries are significant part of work .In brachial plexus surgery we basucally work to restore shoulder and elbow movements .One nerve transfer for shoulder and one nerve transfer for elbow .Elbow flexion is fine but getting shoulder to move it becomes tricky. It takes almost eight muscle to move shoulder, so plan was to do two nerv transfer for shouder. This showed good results as shoulder abduction improved . So I made part of my practice to do two nerve transfer for shoulder function and on transfer for elbow function.
Punjab Institute of Medical Sciences [PIMS]Punjab,India
Keynote: Tightening of seton using Roeder’s knot in Complex Fistula - in - ano : with knot pusher (specially designed)
Time : 10.20-10.45
Rajneesh Kumar is an Associate Professor in Department of surgery at Punjab Institute of Medical Sciences [PIMS]
Objective: There are two main complications after surgery of complex fistula-in-ano: i.e. faecal incontinence and recurrence.
Summary Background Data: To prevent incontinence of stools and flatus we require saving the anal sphincter muscle with tightening of seton using Roeder’s knot with specially designed Rajneesh’s seton knot pusher.
Method: The study includes 40 patients who had undergone treatment of complex and high fistula-in-ano at Civil Hospital, Jalandhar from January, 2010 to September 2012 and from September, 2012 to January, 2017 at Punjab Institute of Medical Sciences (PIMS).
Results: 40 patients of complex fistula-in-ano were taken up for study with the age (mean ± standard deviation) of 35 ± 10.6 years. The Roeder’s knot was tightened with a median of 5 times (3-10 times) as OPD procedure. All the patients were on follow up for minimum period of 6 months and none of the patient had any incontinence. Recurrence occurred in one case. There was breakage of thread at knot site with knot pusher in two cases.
Conclusion: Tightening of seton using Roeder’s knot with Rajneesh’s knot pusher is safe, cost effective treatment for complex fistula-in-ano and follow up is easy. Tightening of fistula is an outdoor procedure rather than replacing the loose seton. Patients were on follow up every week and seton with Roeder’s knot tightened in O.P.D after application of 2% xylocain jelly. Incontinence was assessed according to wexner’s score.