Dr Mohinder Singh's blog

1. routine looking lap chole; 50F from MKH (had kidney stones too)

dissection immediatiely presented a clear cystic artery right in front of the camera and seen nicely dividing into 2 branches. After clipping it, dissection under could not define the junctional anatomy; looked like a wide duct or neck and so a sessile gall bladder. This neck was ligated with vicryl and divided. While dividing a lot of stones present in it aroused second thoughts of a lower lying cystic artery which was found later after some further dissection.

2. horrible empyema with thick walled gall bladder. took more than 2 hours and left the posterior wall of gall bladder intact and cauterised it 

transverse loop colostomy done 3 months back  (for a faecal fistula after TAH at Malerkotla; found at exploration to have leak from injured sigmoid and extensive faecal soiling); splenocolic ligament high and in the pelvis sigmoid colon had extensive adhesions); took nearly 3 hours. In the end a satisfactory colorectal anastomosis  

21.8.07  –  35 thin female, with h/o previous TAH at which time a mass in sigmoid was palpable; had no bowel symptoms then

at operation palpable mass in sigmoid excised with 10 cm proximal and 5 cm distal margins and EEA colorectal constructed manually

cut section of specimen showed an ulcerating lesions involving all circumference 

13.7.07

had to go despite vacation for a lap appy

25M from nabha – c/o nimma’s sister

easy, quick and bloodless operation 

vacation till 14 August:

20.7.07: called to help at laparotomy for intestinal obstruction.

Actually an abdominal cocoon, enclosing all of small bowel except 2 feet of proximal jejunum ; the cocoon was thicker distally and became progressively thinner proximally. All trapped bowel freed by extensive adhesiolysis.

30.7.07

laparotomy 8 years old male child, with mass in right lower abdomen : no intestinal obstruction but had fever off and on.

At operation mass > 10 cm , involving terminal ileum 2 feet proximal to ICJ; diffuse thickening of wall and mesentery and lots of mesenteric nodes. Mass excised and EEA made. Possibly lymphoma

Biopsy report –  NHL