Archive for March 2015
Adrenal indicentaloma
Posted on: March 18, 2015
18.3.15 A frustrating experience with laparoscopic attempt at removal of a large (>6 cm) adrenal incidentaloma of the right adrenal gland in an obese 40 years old man (c/o dr sandhu, senior resident). Poor unhelpful liver retraction of a large pendulous liver by the absent-minded assistants who would rather injure the liver than retract it strongly upwards, poor camerawork by the other unhelpful assistant who would just fail to concentrate on his job, and poor anaesthesia by the junior residents who would just not accept that the patient needs good relaxation, led eventually to conversion to open procedure at which the tumour was easily removed. 
the biopsy was reported as benign – myelolipoma.
Adhesive intestinal obstruction, a lap chole using harmonic scalpel, a twisted big fibroid misdiagnosed as appendicitis, and a pulsatile vessel seen in the floor of the Rouviere sulcus
Posted on: March 11, 2015
14.2.15
An elderly female (70 years old) admitted with intestinal obstruction (previous history of 2 caesarean sections) kept on conservative treatment but did not respond in about a week’s time. At laparotomy, a jumbled up mass of some 6 inches of ileum containing a tight stricture had to be excised, and an EEA made.
23 and 24.2.15
PG class on CRC and seminar on faecal fistula on consecutive days.
28.2.15
A lap chole for acute cholecystitis using Harmonic scalpel (for thesis) throughout the dissection, helped in saving time and blood loss. Also made the operation easy by reducing the smoke compared with cautery.
4.3.15
Bilateral TEP repair for inguinal herniae in 40 years old mess servant.
A planned appendicectomy in a 60 years old female actually turned out to be a big twisted fibroid revealed at diagnostic laparoscopy. Converted to open to remove the big fibroid, the pedicle of which had taken three turns.
11.3.15
Lap chole following pancreatitis. Turned out to be quite difficult with a big Hartmann pouch hanging much below the level of the Rouviere’s sulcus. The notable feature of the sulcus was a visible pulsating vessel in its floor.
Dr Mohinder Singh's blog 