Dr Mohinder Singh's blog

6.11.2006

A lap chole on a male doctor from Amritsar (Dr Amandeep Singh from SGRDMC) was a difficult one due to thick walls; the port dilated to remove the big gall bladder and so the sheath in that port had to be closed.

A pantaloon hernia in a 65 years old male was repaired with mesh. Both big sacs of the direct type and the indirect type were present.

16.9.2006

Apparently easy case in a 50 years old woman. Actually very difficult due to unexpected empyema;  the pus was aspirated. The grasp at the neck was difficult; broke a grasper. The CD was very short;  the wall of the gallbladder was very adherent to the liver bed; the liver bled badly to cause hypotension; the liver sinus had to be sutured when it could not be controlled by cautery. The port was enlarged to remove the gallbladder and the big hard stone (2 cm) separately in a bag ( the stone could not be grasped).

Another lap chole in a 50 years old female was not so difficult ; but the big stone in neck when held in spoon forceps broke the spoon forceps; the port had to be enlarged to remove the gall bladder.

12.11.06

A parathyroid adenoma  of the left lower parathyroid gland (4X2 cm) was excised through a lower neck transverse incision. The patient had been referred from urology when they investigated her for large bilateral staghorn kidney stones. Earlier the patient had presented to the orthopedics department for backache and generalized weakness. They referred her to urology when they found the bilateral kidney stones.

2.10.06 (Dussehra holiday)

An emergency laparotomy (on a holiday) for obstructing colon cancer. The patient was a staff nurse Paramjit Kaur Hundal 45 years old admitted with large bowel obstruction and bleeding per rectum. Family history of large bowel cancer was present. Colonoscopy showed a lesion at 60 cm, and CT scan showed a big growth at splenic flexure. Biopsy (colonoscopic)  – adenocarcinoma WD.

An extended right hemicolectomy was performed. Specimen showed a big tumor near splenic flexure and lots of ulcerations and nodules in an area of angry-looking field change proximal to the tumor.

Remains well till last seen (2015 November).

28.9.2006

My classfellow in school from Samana (Naresh Peter) presented with a left inguinal hernia and an undescended testis on the same side. The testis was found in the canal and removed; the hernia was repaired with a mesh.

13.9.2006

Thyroid lobectomy in a young 30 years old female for a big goiter (clinically labelled as adenomatous goitre) about 12 cm across. Biopsy report was Hurthle cell tumour.

31.8.2006

Unusual parotid:

Parotidectomy in a 50 years old female with small parotid (R) mass 2 cm, reported on FNAC as lymph node within the  parotid! Actually at operation, the superficial lobe was found to be normal; the deep lobe had a soft swelling about 2 cm in diameter; aspiration yielded brownish fluid – degeneration? in the cyst. The cyst was enucleated intact from under the branches of the facial nerve – between the two trunks of the nerve. At a higher level in the preauricular area just above the parotid tissue was a lymph node. That too was excised. The suction drain came out during shifting of the patient; small hematoma developed as a result. Biopsy report – cyst parotid !  no malignancy.

28.8.2006

Laparoscopic repair of small PUH; the small amount of omentum protruding through the defect was reduced and a mesh 12X12 cm in size was sutured at 4 corners and tacked at 3 more places.

A big staghorn stone (in renal pelvis) along with some small ones (one in upper pole calyx and two in lower pole calyx) were removed via pyelolithotomy in a 60 years old fit rural lady. Easy enjoyable procedure.