Author Archive
7.1.09
Wedge excision of cancer lip – 45 M with zarda addiction.
9.1.09
A satisfactory TEP after a long time. Right indirect inguinal hernia.
2.1.09 to 16.1.09 vacation
16.1.09
An easy appearing appendicectomy became a hemicolectomy. A fit young 30 M with presentation like appendicitis. On palpation at surgery, the appendix was found to be densely adherent with a high-lying caecum which also had a palpable mass in it, and the right colon was quite considerably shortened. A few small lymph nodes were also palpable in the mesentery. All this was excised and an ileocolic anastomosis made. Path report later was non-specific inflammation. Nonetheless, the treating physician decided to give a course of ATT.
24 and 25 jan –
Conference in Delhi on ‘complications in laparoscopic surgery’ attended. Nicely organised by delhi chapter of ASI.
1.2.08
a shocker of a news – 5 babies in phototherapy unit of rajendra hospital paediatric department burnt alive.
2.2.09
Principal of medical college (dr JPK shergill) and junior resident on duty suspended.
3.2.09
Strike by juniour doctors association against the suspension.
5.2.09
Suspensions of both the JR and principal withdrawn!.
6.2.09
Information that transfers to Amritsar are being made tommorow led to my decision to resign from service.
7.2.09
Gave my premature retirement notice to Principal’s office and resigned.
8.2.09
Gave departure report to Principal’s office.
9.2.09
Inguinal canal of a 6-year-old male child explored for undescended testis on the right, only to find that one was easily found in the canal and another one coming through the ring from inraabdominal location. Thus both testes coming from same side. Never had seen or heard of such a thing.
ASI conference at Ludhiana, urethral stone in navicular fossa and partial urethral duplication.
Posted on: January 4, 2009
27.12.08 to 30.12.08
ASI conference at Ludhiana, actually a big mela. Attended for two days 26 and 27 december. Chaired a session on 27th.
1.1.09
25 M with presumed urethral stricture. Bouginage sounded a stone in the navicular fossa. The stone simply removed with a curved haemostat and a scoop.
4.1.09
A partial urethral duplication, just a small 1 cm tunnel above the actual urethra (with a septum between the two) in the distal penile urethra at the tip. 20 M with no symptoms, but rejected from entry into military service on this account. The septum was excised with the tip of Bovie diathermy.
12.12.08
Rectovaginal fistula arising as a result of prolonged labour (home conducted delivery by dai) . Easily approached from below (vaginally) and easily repaired. Patient from some outside town.
16.12.08
In a busy lap day, had the horror of seeing the so-called safety trocar (used for the umbilical camera port entry) causing intraperitoneal bleeding, shock (sudden unrecordable BP) and a big retroperitoneal haematoma seen in front of the scope on introduction of the telescope. Immediately converted and the rent in the aorta controlled with finger pressure and then sutured with 3-0 prolene. Continued to do open cholecystectomy with the courageous anesthetist’s consent. Needed 2 units of BT immediately for resuscitation and 2 more in the ward later.
Good quick recovery afterwards, although the patient was left with a long laparotomy incision.
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25.11.08
TEP thought to be easy, turned out to be a real pain in the neck. Initial space created nicely, but the sac was big and omentum in it adherent to the sac , adhesions had to be divided after opening the sac. this led to loss of space and so struggled thereafter for a long time, what with the anaesthetist not helping also. Mesh spread also not satisfactory.
28.11.08
closed a transverse colostomy done in some other unit for unknown reasons. 55F with extensive adhesions between small gut loops with one another and with abdominal wall, the ileum got injured at 3 places in the process of liberating the small bowel, all three perforations closed and the colostomy closed.
3.12.08
attempted TAH had to be abandoned as soon as the abdomen was opened and intestines packed up. Patient in cardiorespiratroy arrest; revived with immediate intubation and CPR, kept in ICU till evening. ?spinal shock, anaesthetist not very vigilant.
7.12.08
a patient posted for AHpyeloplasty had a close save from the surgeon’s knife on the kidney. On looking at IVP, a questionable grade I hydronephrosis, history: no pain in lumbar area, ?haematuria, US reporting prostatic calculi. History more suggestive of RIF pain , so appendicectomy done instead.
7.11.08
25M with bilateral undescended testes, right orichiopexy 3 weeks before now for left orchiopexy. Testis high, intraabdominal; could be brought down only after division of testicular vessels (FowlerStephen).
14.11.08
APR: 50 obese lady presenting with tight stenosis of anus, colostomy done 3 weeks before. CT low rectal tumor involving levators. At operation tumour adherent to pelvis side wall too on right side. Removed incompletely, for later radiochemotherapy.
18.11.08
4 lap choles, one after the other, all difficult.
21.11.08
retention cyst minor salivary glands floor of mouth (small ranula) excised under GA 50F.
Trichobezoar removed from a 16F psychotic. helped in stomach closure.
3 lap choles and a big thyroid
Posted on: November 6, 2008
4.11.08
three seemingly easy lap choles, spilles stones in all!!. retrieved.
big m n goitre, much bigger on left side, but small nodules with calcification on right side too. Dunhill – whole of left lobe and most of right lobe removed. Patient a 35 F gynaecologist practising in Sunam.
3.10.08
A pilonidal sinus was closed primarily after excision.
10.10.08
A one week old infant with advanced (grade III hydronephrosis) underwent AH pyeloplasty.
14.10.08 – 19.10.08
ICS conference:
Went to Delhi in the evening with 3 others. Then from Delhi to Chennai by air, Chennai to Trichi by train, reaching Trichi by 11 pm.
16,17,18: Stayed at Trichi for the annual conference of ICS (IS).
18th evening: from Trichi to Chennai by train.
19.10.08: Chennai to Delhi by air, and Delhi to Patiala by taxi, reaching back home by 7 pm.
21.10.08
At a lap appy, an area over ileum was inadvertently scored with diathermy , closed with 3-0 silk.
5 and 6 september
went to kullu to attend NCASI conference Midterm CME organised by dr Gautam
one month of vacation
Posted on: August 28, 2008
vacation from 9-7-08 to 14-8-08
26.8.08
difficult day after the vacation
1. TEP converted into open Lichtenstein once it was found that the trocar entry had created a pneumoperitoneum.
2. lap chole easy
3. lap chole easy
4. lap chole male 50 M supposed to be routine became very difficult. Thick walled gall bladder with calots triangle not clear due to excessive fat. After a lot of effort to define the anatomy, the neck of gall bladder eventually end looped.
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