Papers by Surendra Mantoo
South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde
Surgical Laparoscopy, Endoscopy & Percutaneous Techniques, 2015
This study aims to evaluate the early results of endoscopic pilonidal sinus treatment (EPSiT) in ... more This study aims to evaluate the early results of endoscopic pilonidal sinus treatment (EPSiT) in the Asian population and illustrate the surgical technique and its modifications by a video presentation (Supplemental Digital Content 1, http://links.lww.com/SLE/A115). Retrospective review of 9 patients with pilonidal sinus disease treated with EPSiT is performed in a single institution. Surgical outcomes of sinus healing, pain, and discharge were reviewed in the outpatient clinic and patient satisfaction levels were assessed through a standardized phone interview. The median age was 24 years (range, 16 to 41 y). The median duration of follow-up was 2.5 months (range, 1 to 5 mo). Median duration of sinus healing is 6 weeks (range, 2 to 7 wk). One patient had pain despite sinus healing. Satisfaction rate was 78% (7/9). EPSiT is a minimally invasive and cosmetically favorable procedure. A larger sample size and a longer follow-up is required to determine if it improves healing time and long-term recurrence rate.
Singapore medical journal, 2008
Enterogenous cyst is a rare congenital lesion presumably of endodermal derivation. It is usually ... more Enterogenous cyst is a rare congenital lesion presumably of endodermal derivation. It is usually located in the medistinum, the abdominal cavity, skull or within the spinal canal. To our knowledge, it has not been reported in the subcutaneous tissue. We report the first case of ectopic (left scapular region) subcutaneous enterogenous cyst in a 46-year-old man, who presented with a lump over the left scapular region of several years' duration. Clinical diagnosis of lipoma was made. The final histological diagnosis was enterogenous cyst. Enterogenous cysts at ectopic locations should be kept in mind and studied further especially with respect to their development. A better understanding of the embryology, histopathology and genetics of ectopic enterogenous cyst is desired.
Tips on Laparoscopic and Open Surgery, Therapeutic Endoscopy and Interventional Radiology(with DVD-ROM), 2012
Colorectal Disease, 2014
The study assessed the initial experience with posterior tibial nerve stimulation (PTNS) for faec... more The study assessed the initial experience with posterior tibial nerve stimulation (PTNS) for faecal incontinence and compared it with sacral nerve stimulation (SNS) performed in a single centre during the same timespan. A retrospective review of a prospectively collected database was conducted at the colorectal unit, University Hospital, Nantes, France, from May 2009 to December 2010. Seventy-eight patients diagnosed with chronic severe faecal incontinence underwent neurostimulation including PTNS in 21 and SNS in 57. The main outcome measures were faecal incontinence (Wexner score) and quality of life (Fecal Incontinence Quality of Life, FIQL) scores in a short-term follow-up. No significant differences were observed in patients' characteristics. Of 57 patients having SNS, 18 (32%) failed peripheral nerve evaluation and 39 (68%) received a permanent implant. Two (5%) developed a wound infection. No adverse effects were recorded in the PTNS group. There was no significant difference in the mean Wexner and FIQL scores between patients having PTNS and SNS at 6 (P = 0.39 and 0.09) and 12 months (P = 0.79 and 0.37). A 50% or more improvement in Wexner score was seen at 6 and 12 months in 47% and 30% of PTNS patients and in 50% and 58% of SNS patients with no significant difference between the groups. Posterior tibial nerve stimulation is a valid method of treating faecal incontinence in the short term when conservative treatment has failed. It is easier, simpler, cheaper and less invasive than SNS with a similar short-term outcome.
ANZ Journal of Surgery, 2014
overall did not show a reduction in temporary or permanent RLNP. However, the meta-analysis does ... more overall did not show a reduction in temporary or permanent RLNP. However, the meta-analysis does show non-statistically significant trends to benefit from IONM in some subgroups, for example permanent RLNP in Graves' disease, transient RLNP in retrosternal goitres, and all RLN palsies for patients in the seven comparative trial subgroup (almost half of the meta-analysis patients). We interpreted from this there is only a small amount of evidence in the RCT and meta-analysis to demonstrate the benefit of IONM. This statement was not intended to be misleading, but agree overall evidence for clear benefit is lacking. However, data show some significant results and trends and therefore the jury must be considered still out on the overall value of IONM. Dralle noted that to show a statistically significant difference for RLNP in multi-nodular goitre, with and without IONM, would require nine million cases in each arm of an RCT. 3 Perhaps the greatest value of IONM is in preventing bilateral RLNP. If RLNP occurs, a decision whether to resect the contralateral side can be made. 4 It is also of great value as a prognostic tool to reassure the patient who has sustained a temporary RLNP -a visually intact RLN with an initial normal signal, which is then lost, predicts almost 100% recovery from the neurapraxia. IONM is also a valuable research tool, it has facilitated significant advances in knowledge of neuroanatomy, neurophysiology and neuropathology of the RLN, and its ongoing use will enable its place in thyroid surgery to be further evaluated.
Transdisciplinary Perioperative Care in Colorectal Surgery, 2014
Surgical Endoscopy, 2014
Background The percutaneous endoscopic ceacostomy (PEC) for antegrade colonic enemas (ACE) has re... more Background The percutaneous endoscopic ceacostomy (PEC) for antegrade colonic enemas (ACE) has recently been proposed as a less invasive alternative to the Malone procedure in chronic constipated patients. Although the feasibility and safety of this innovative approach has been demonstrated, its functional results remain unknown. The aim of this study was to evaluate constipation symptoms and quality of life 1 year after the PEC placement.
Journal of Robotic Surgery, 2014
ABSTRACT Robotic-assisted surgery for pelvic floor disorders (PFD) meets the accepted standards f... more ABSTRACT Robotic-assisted surgery for pelvic floor disorders (PFD) meets the accepted standards for laparoscopic surgery. The aim of this study was to describe the technique and the impact of this standardized surgical technique and dedicated operating teams on the operative time for robotic-assisted laparoscopic ventral mesh rectopexy (RALVMR). Data from a prospective database were extracted for all patients who underwent RALVMR between January 2008 and May 2012 for multi-compartment PFD. Patient pre-, intra- and early postoperative data were analysed. To evaluate the impact of both the surgical technique and operating room team on operative time over successive years, we divided the total operation time (TOT) into robot set-up time (RST) and surgeon console time (SCT) including disembarking robotic arms and closure of wounds. A total of 51 patients (3 male) with a mean age of 61.1 [±11, standard deviation (SD)] years were included for analysis. There were no major complications or deaths. Median TOT fell significantly by 23 % from 2008 (270 min) to 2012 (179 min) (p < 0.0001). The largest reduction (>60 %) was seen in RST, from 55 (SD ±3) to 21 (SD ±2) min (p < 0.0001). Similarly, SCT was reduced by 36 % from 216 (SD ±12) to 138 (SD ±8) min (p < 0.0001). Decreased operative time and efficiency were facilitated by a devoted, well-trained and consistent team. A standardized surgical technique for PFD helps to reduce the duration of the surgical procedure.
Expert Review of Medical Devices, 2012
The authors aim to report the concept and technique of implantation and the first results of the ... more The authors aim to report the concept and technique of implantation and the first results of the clinical use of the magnetic anal sphincter (MAS) in the management of fecal incontinence (FI). The MAS device is designed to augment the native anal sphincter. The implant is a series of titanium beads with magnetic cores linked together with independent titanium wires. To defecate, the force generated by straining separates the beads to open up the anal canal. The technique of implantation is simple with no requirement of adjustments. The MAS has a role in the management of severe FI. The device has acceptable and comparable adverse effects to other therapies. FI and Fecal Incontinence Quality of Life scores are significantly improved in the short term. The MAS offers a simple and less invasive option of anal reinforcement. It is one step further in the quest for an ideal artificial anal sphincter device.
Colorectal Disease, 2013
In the short term, implantation of a magnetic anal sphincter (MAS) is a safe and effective treatm... more In the short term, implantation of a magnetic anal sphincter (MAS) is a safe and effective treatment for faecal incontinence (FI). In this paper we show that the initial results stand the test of time and patient satisfaction remains high in the medium term. Data on 23 women [median age 64 (35-78) years] implanted with a MAS device between December 2008 and September 2012 were reviewed from a prospective database. Assessment was based on significant improvement of incontinence scores - the Cleveland Clinic Florida Incontinence Severity (CCF-IS) score, Faecal Incontinence Quality of Life (FIQoL) score - and patient satisfaction at 6, 12, 24 and 36 months after surgery. The device was removed in two patients owing to complications. Median follow-up was 17.6 months. The median preoperative CCF-IS score was 15.2 and fell to 6.9, 7.7, 7.8 and 5.3 at 6, 12, 24 and 36 months, respectively. The median FIQoL score significantly (P < 0.001) improved from 1.97 preoperatively to 3.19, 3.11, 2.92 and 2.93, respectively, at the same time periods. The concordance of the CCF-IS and FIQoL scores was 91%. Sixteen of the 23 patients were satisfied but only 14 would have recommended the MAS to someone else. Lack of improvement was the main reason for dissatisfaction. Good initial results tend to remain stable over time and about two-thirds of patients are satisfied after MAS implantation.
Colorectal Disease, 2013
The impact of anorectal malformation (ARM) on bowel function and social, educational and occupati... more The impact of anorectal malformation (ARM) on bowel function and social, educational and occupational end-points was investigated in adult patients entered on a national database. Data from a national database of adult patients operated on between 1962 and 1999 for ARM were analysed. The database Malformations Ano-rectales et Pelviennes rares (MAREP) was part of a common information system, CEMARA, on rare congenital disorders. A self-administered questionnaire regarding bowel function, academic qualifications, employment and family status was mailed to patients. The type of ARM, subsequent follow-up and management including surgical interventions were retrospectively retrieved from medical records. Of 210 adult patients on the registry since 2008, 68 were included in this study. Only three (8.5%) had had regular follow-up. All reported some disturbance in bowel function. The fertility rate of 1.5 children per woman did not differ from the general population. Anorectal malformation ARM often leads to suboptimal bowel function in adulthood. This has an impact on social integration.
Gastrointestinal Endoscopy, 2011
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Papers by Surendra Mantoo