Background and Objectives: This is a survey study of adverse events in the postanesthesia care unit (PACU) at the University Malaya Medical Center (UMMC). Patients and Methods: After obtaining the hospital ethics committee approval, 2704 patients who were operated and admitted to the PACU at UMMC were included in the survey. The survey period was from July 1, to September 30, 2005. The modified Aldrete score was used in the PACU. If it was <9 on a 10-point scale that was defined as a patient complication. A patient diagnosed with a complication was immediately notified by the recovery nurse to the attended anesthesiologist who managed the case, and a survey report was completed. Results: Nearly 9.7% reported incidents of adverse events included two accidents of cardiac arrests. The majority of which were due to hypothermia and cardiovascular instability. Most incidents were in American Association of Anesthetists 3 and 4 category. General surgery was associated with the highest incidents. Most of the incidents resulted in prolonged PACU stay. Conclusions: This study provides auditing information on adverse incidence in the PACU with issues of care delivery; besides, it highlights a roadmap for quality improvement for a better patient care.

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Introduction: The successful maintenance of peritoneal dialysis is the outcome of well functioning of the peritoneal catheter. Catheter outflow obstruction may cripple the usage of the peritoneal catheter. Catheter migration, omental entrapment, and fibrin clots are the usual causes of this failure. Oviduct fimbriae can cause obstruction rarely. Materials and Surgical Technique: We describe a case of a a 65-year-old woman, in whom the obstruction fimbriae was the cause of the obstruction and was managed by cleaning the catheter, and the right  fimbraepexy to the lateral wall of the peritoneal wall in the dependent part with no salpingectomy is required. Discussion: In follow-up of 20 months, the catheter is working; this technique can be used in young patients who need to balance the risk of infertility with the risk of malfunction of peritoneal dialysis catheter. Conclusions: Ovarian fimbria entrapment in the PDC is rarely the cause of dialysis flow obstruction, if occurs, laparoscopic management is ideal way to manage such presentation.

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Femoral hernias account for 3% of all hernias and can frequently present with incarceration of omentum, preperitoneal fat, small bowel and colon, and more rarely a Meckel's diverticulum or appendix. De Garengeot's hernia (GH) is a rare type of femoral hernia representing 1% of all femoral hernias and contains the vermiform appendix. The purpose of this report is to present a case of GH with discussion of the clinical findings along with description and details of the surgical technique applied for its repair.

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Introduction: Laparoscopic approach had enormously advanced the surgical intervention. Such advancement had its own difficulties. One of this is the visualizations of internal structures by the endoscopic camera. Camera lens condensation or contamination by blood and/or fat obscures such view. Materials and Surgical Technique: Here, we present an additional technique in which the use of sterile surgical strips by its specific absorptive and availability in different widths and lengths to clean the endoscopic entry ports with special focus over 5 mm ports that can be combined to the other well-known anticondensation methods for the overall better visualization. Discussion: Different modalities to clean laparoscopic entry ports have been described but with difficulties and associated risks and limitations. The use of sterile packing strips in cleaning laparoscopic ports avoids the disadvantages descried in other modalities and in the same time being easy, adjustable, and have low cost.

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Revisional bariatric surgery is increasingly becoming popular as the number of primary procedures for the treatment of obesity gains popularity. It is estimated that about 10% of patients who underwent a bariatric procedure will need revisional surgery. The most common indications for revisional bariatric surgery are inadequate weight loss (<25% of excess body weight loss) and weight regain (gain of more than 10 kg based on the nadir weight); however, procedure-specific complications are also indication of the need for revisional surgery. In this article, we review the current most common bariatric procedures with its complications, indications for revision, alternative procedures, and outcomes.

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The rise in popularity of bariatric surgery has been accompanied by a considerable increase in complications observed. Foot drop is a rare, but recognized complication after bariatric surgery. Early studies suggested the combination of rapid weight loss in the setting of postural compression of the nerve as main contributory factors. However, further research has also emphasized the role of postbariatric malnutrition and inflammation in the development of this neuropathy. The cause of this neuropathy is likely to be multifactorial, and understanding these mechanisms will assist multidisciplinary specialists in providing care to postbariatric patients suffering from this condition.

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