9.5.09

55 M (uncle of dr Pawan)- Thick walled gall bladder and unclear Calot’s triangle, eventually dissected out to find a wide thick cystic duct which was endlooped with vicryl and tied. While passing the ligature through the window, the instrument carrying the ligature had gone too far into the right loge of liver which bled, continuously and vigorously. Coagulating with diathermy spatula and passing a suture under having failed and with the patient getting into hypotension, converted into open surgery. However, the bleeding had stopped by then. Nonetheless, the injury was underrun. safe result eventually.

11.5.09

Difficult lap chole again. 45F with thickwalled empyema with big stone impacted at the neck. Fundus first dissection and neck of gall bladder closed from within.

13.5.09

Another difficult lap chole. 50 F. Big multiple stones, with one impacted in the neck, could not be disimpacted. The neck was opened up and all  stones removed from within the gall bladder. Gall bladder cut up into 2 long ribbons to enable its removal without dilating the port.

15.5.09

2 lap appys at home.

A laparotomy for ileocaecal tuberculosis with intestinal obstruction. Had completed ATT. REEA done. Young (30) unmarried mentally disturbed patient (c/o Dr Phul Chandra).

17.5.09

day case lap chole 4

19.5.09

Vault prolapse following abdominal hysterectomy 12 years back. 60 F. Sacrocolpopexy with prolene 1.

20.5.09

Attempted TEP failed due to poor space maintenance. Converted to open.

21.5.09

Laparoscopic ovarian cystectomy left side. Medical student final year. Had pain lower abdomen, US showed a big ovarian cyst. Had ruptured leading to considerable blood loss.