28.9.14

Attended a CME (by IMA) at Khanna and chaired a session on ‘mini gastric bypass’ by Dr Robert Rutledge.

6.10.14

Some difficult lap choles, in one of which the Rouviere’s sulcus showed a pulsating vessel in its base.

20.10.14

A relaparotomy for a mass in the right colon which had been deemed unresectable by the residents and a proximal ileostomy had been done. At operation, the mass was indeed found to be  fixed to the posterior abdominal wall, encasing the ureter which was dissected clear. However, it remained a palliative resection. The ileostomy was taken down and an EEA (Ileocolic) performed. Biopsy was adenocarcinoma. To be referred for chemotherapy.

30.10.14

Incisional hernia at the medial end of a Kocher incision for open cholecystectomy. A 55 years old lady, known to Dr Didar Singh Walia (forensic medicine). Mesh placed in a the preperitoneal space.

3.11.14

A lap chole in a young (25 years old) male, who was admitted with acute cholecystitis. The gall bladder was thick-walled and showed patched of gangrene in the fundus. Difficult dissection of the triangle of Calot.

8.11.14

A Spigelian hernia in a hefty 40 years old patient, weighing over 90 kg. Presented like appendicitis with pain in the right lower quadrant. The CT however made the diagnosis. Through a lower midline laparotomy, the congested ileal loop trapped in the hernial sac was released from the neck of the sac. The sac was excised and a prolene suture repair, reinforced with a patch of mesh between the muscles and the peritoneum, performed.