6.1.19

An obese (>100 kg) lady, related to Dr Mrs Shalley, with a previous lap ventral hernia repair with a prolene mesh, needed a careful umbilical port entry under vision through a small scope brought in through Palmer’s point.

15.1.19

A young (35 years old) female, thought to have an easy lap chole, turned out to be a disaster, with the very shrunken gall bladder with a small stone in the fundus (which was possibly the whole gall bladder on retrospective analysis) having such dense fibrotic adhesions with the underlying bile duct so as to make them to look like a single structure. So the dissection was continued down for a couple of centimeters and the supposed neck of gallbladder ligated there. Bile continued to pour through the drain and the patient had to undergo a BDI repair in PGI.

Lesson learnt – in non-distended gall bladders on ultrasound, always have an MRCP roadmap before attempting surgery.