Diaphragmatic perforation at lap chole, and a TEP
Posted on: August 27, 2006
20.8.2006
A lap chole started by Dr Vikram and completed by me due to lots of adhesions in Calot’s triangle. This was dissected with difficulty and the procedure completed. However, at the end of the procedure, a hole in the diaphragm was observed (possibly by the slipping of the fundus grasper upwards into the diaphragm). The telescope could be passed through the hole to see partially collapsed lung. A chest tube was inserted and the rent in the diaphragm sutured laparoscopically with 2-0 vicryl.
24/8/06
TEP for left inguinal hernia in a 35 years old male patient. There was no intraperitoneal leak of gas for the first time! There was a big indirect sac; this was cut midway and not endlooped. The mesh was fixed with one tack and the mesh was unrolled in the preperitoneal space. Had retention of urine with overflow on postoperative day 1. Recovered the next day and discharged. On 29.8.06 at follow-up, had a swelling in the inguinoscrotal area and the worried patient was reassured and observed ? hematoma/ seroma/pseudo-recurrence. The swelling disappeared in 3 weeks.
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