16.7.12

An incisional hernia following cesarean section 20 years back in UP. Uterus and bladder adherent to abdominal wall through the hernia. UB got injured and was repaired. A large mesh to repair the defect. Satisfactory recovery.

19.7.12

A bilateral TEP repair in a 65 years old man. Left hernia bigger and direct; the right one indirect and smaller. Bilateral mesh implant.

19.7.12

A young female (30 yrs old) with a breast lump – reported to be tubercular in nature on FNAC. At excision under GA – turned out to be a thickwalled abscess with thick pus inside. The whole wall of the abscess excised and sent for biopsy.

Two difficult empyemas of gallbladder. The first one, preoperatively thought to be easy on US and LFTs, a younger 30 years old female, surprisingly turned out to be tense and turgid, full of pus which was aspirated. The duodenum was densely adherent, but was dissected away. The big stone in the neck came in the way of dissections and so was taken out first. The the cystic duct could be identified but the cystic artery could not and was simply coagulated. The gall bladder had to be cut into 6 pieces to remove because it would not come out thru the 1 cm port.

The second one was not as difficult but turned out to be sessile gallbladder with a previous history of ERCP and ES for duct stones. The gallbladder was simply ligated at the neck with no 1 vicryl.