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When Stomach Pain isn't gas

Dr. Ross Downes: Single port laparoscopy is the wave of the future in appendicitis surgery. General surgeon Dr. Ross Downes had to perform a single port laparoscopy surgery on Independence Day on Cheesecake Haven proprietor Jameel Lightbourne, whose appendix ruptured.

Shavaughn Moss

Guardian Lifestyles Editor

Published: July 28, 2015

Two cups of fever grass tea, one cup each of ginger, green, regular lipton and a cup of peppermint tea - Jameel consumed all of it in the course of a day, as he sought relief from a "bloated, gassy" feeling. As the day progressed, he was not relieved, and the pain got progressively worse, going from a feeling of pressure to excruciating pain that forced him to seek medical attention in the middle of the night.

Lightbourne had to have emergency surgery on independence morning. His appendix had ruptured. Appendicitis is an inflammation of the appendix, a finger-shaped pouch that projects from the colon on the lower right side of the abdomen. The appendix doesn't seem to have a specific purpose. although anyone can develop appendicitis, most often it occurs in people between the ages of 10 and 30. Standard treatment is surgical removal of the appendix.

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Medical Science fiction now reality

Shavaughn Moss

Guardian Lifestyles Editor

Published: March 3, 2015

Medical Science is continually making advances with the development and introduction of new medications and treatments. But the major surgical advancement that has taken place in the last 10 years is minimally invasive surgery, also known as laparoscopic surgery or keyhole surgery. In minimally invasive surgery, surgeons use a variety of techniques to operate, with less injury to the body than with open surgery as major operations are done through a tiny incision. The advantage to the patient is that there is less stress on the body, according to General Surgeon Dr. Ross Downes.

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Single Incision Laparoscopic management of a ruptured Heterotopic pregnancy presenting as an acute appendicitis

Heterotopic pregnancy, defined as the coexistence of an intrauterine pregnancy and an extrauterine pregnancy.  It is a rare entity and theoretically occurs at an incidence of 1 in 30 000 pregnancies (2,3,12). The rise in the incidence of tubal and pelvic diseases has contributed to an increasing rate of heterotopic pregnancies. This rise can also be attributed to the increasing use of assisted reproductive technology such as In Vitro Fertilization (IVF) and Gamete intra-fallopian transfer (GIFT) (2,3,11,12).  After assisted reproductive technology procedures, the incidence of heterotopic pregnancy is at a concerning 1 in 100 pregnancies (2,12).

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Single incision cholecystectomy using a clipless technique with LigaSure in a resource limited environment: The Bahamas experience. Downes RO, McFarlane M, Diggiss C, Iferenta J

The present study looks at the experience of a single surgeon using this method with initial evaluation of the safety, feasibility, affordability, and benefits of this procedure.

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A case of intra-abdominal hemorrhage secondary to peliosis hepatis. Downes RO, Cambridge CL, Diggiss C, Iferenta J, Sharma M.

We report a case of peliosis hepatis diagnosed post laparotomy. She required a re-look laparotomy with removal of packs peritoneal lavage, placement of intraseed and subhepatic drain. The patient was discharged after an 11-day recovery period.

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Implementation of single incision laparoscopic appendectomy at a tertiary institution in the Bahamas. Ross Downes

The aim of this study was to examine the inauguration of single-port laparoscopic appendectomy (SILA) for un-complicated appendicitis and demonstrate its efficacy and safety. Thirty-two patients who underwent single-port laparoscopic appendectomy between January 2014 and December 2014 were compared retrospectively with 20 prior consecutive patients who underwent surgery in the three-port manner. Length of hospital stay, operative time, conversion rate, and complications were used as the indicators of effective implementation. Demographics were similar between the single-port and three-port groups. In the SILA series, operative duration was unchanged after the first 10 cases. An operative duration less than that of the conventional three-port method could be achieved after 30 cases.

CONCLUSIONS:

Single-port laparoscopic appendectomy is a safe and feasible procedure. The learning curve could be overcome safely without major complications. Our preliminary analysis showed that 30 cases are sufficient to achieve an equivalent operative duration compared with conventional three-port laparoscopic appendectomy.

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A case of a paraduodenal hernia Downes R1, Cawich SO.

Paraduodenal hernias are rare hernias that result from error of rotation of the mid-gut. It can be discovered incidentally at laparotomy, seen on radiological imagining or infrequently cause intestinal obstruction.

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Colonic perforation: a lethal consequence of cannabis body packing. Cawich SO1, Downes R, Martin AC, Evans NR, Mitchell DI, Williams E.

Body packing is one method of smuggling cannabis across international borders. The practice is prevalent in Jamaica. There has been one reported death from this practice in medical literature. We report a second fatal case of cannabis body packing, reinforcing the dangerous nature of this practice.

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