Dr Mohinder Singh's blog

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.

10.3.14 An incisional hernia gone wrong. A young man with incisional hernia (following laparotomy for ileal perforation) had a mesh repair of the same. However, postoperatively, the suction drain started discharging darkish brown content. At relaparotomy, a loop of small bowel had been caught in the suture meant to fix the mesh. Ileostomy was carried out along with peritoneal lavage.

20.3.14 An attempted TEP hernia repair had to be converted to open repair due to poor creation of space and poor muscle relaxation.

24.3.14 A nephrectomy (anterior approach) for renal cell cancer of the left kidney in an obese 60 years old lady, c/o Dr Walia our assistant professor.

31.3.14 A difficult lap chole in a 50 year old female admitted for acute cholecystitis 3 days back. Surgery very difficult due to thick-walled empyema. The gallbladder was removed piecemeal, after ligating its neck with vicryl.

3.4.14 An open prostatectomy after a long time in a 70 years old man, with the prostate more than 120 grams in weight.

4 and 5 April, 2014 Attended the AMASI conference in Simla.

7.4.14 An easy TEP hernia repair in a direct right inguinal hernia.

10.4.14 A lap chole for acute cholecystitis turned out to be very easy!

12.4.14 Presented a case of ‘mesenteric fibromatosis’ in the clinical meeting held in the medical education cell of the college. An 11 years old child was shifted from paediatrics ward, with a history of fever but was found to be having a big palpable mass in the right iliac fossa. A CT scan showed a 10 cm big well-defined mass in the peritoneal cavity. At operation, the mass was found to be arising from the mesentery of the distal ileum. The mass and the adherent loop of ileum were resected. Biopsy revealed an aggressive fibromatosis of the mesentery.

Mesenteric fibromatosis presenting as a diagnostic dilemma: a rare differential diagnosis of right iliac fossa mass in an eleven year old-a rare case report.Mahajan A¹, Singh M¹, Varma A¹, Sandhu GS¹, Singh M¹, Nagori R¹.

18.4.14 A VVF (poor 45 years old lady) following an abdominal hysterectomy in UP, was repaired abdominally. The fistula was high in the fundus of the bladder.

1.5.14 Huge sebaceous cysts on the scalp removed painstakingly, taking more than 2 hours!.

published in:

Journal of Clinical and Diagnostic Research. 2015 Nov, Vol-9(11): PJ01-PJ02

25.4.13
BDI (at lap chole 18.3.13) repaired by Roux-en-Y hepaticojejunostomy. High (type III) injury at hilum, both ducts (right and left hepatic) exposed at hilum, left duct exposed further by lowering the hilar plate and enlarging its lumen to avoid stricture later. Follow up so far satisfactory.
6.5.13
A 25 years old female, with a CT diagnosis of hepatic hydatid taken up for laparotomy. Turned out to have a retroperitoneal cyst on exploration, and on further dissection was found to be arising from the head of pancreas (?cystic neoplasm of pancreas). A large amount of haemorrhagic fluid aspirated and a lot of degenerated material evacuated from within the cavity, the walls of which were also excised. May need resection of pancreas later, depending on the biopsy report.
9.5.13
A difficult lap chole in a young Nigerian (undertrial here for drug trafficking) male, with a thick walled empyema, neck of gallbladder ligated, and the gallbladder removed piecemeal.
13.5.13
Lap chole in a young (20 y o) male with spherocytosis. Will have splenectomy later.
16.5.13
A young unmarried girl from gynae (dr khushpreet’s case) with bilateral ovarian cysts, for laparoscopic removal. Large left cyst had twisted, the thick walls removed piecemeal, the right one was a small paratubal cyst, removed intact.
17.3.13
Attended the annual ABSI conference at PGI Chandigarh. Lectures mainly on breast reconstruction.
30.5.13
TEP repair of right inguinal hernia in a tall young (25) rural man, addicted to bhukki and alcohol. Complete sac, transected and reduced.
2.6.13
A free medical camp organized by Akal academy, held at Cheema sahib in Mansa district. Examined more than 50 patients with surgical problems. Will be taken up for free surgery.
6.6.13
Displaced Cu-T found, at laparotomy, to lie embedded in the omentum part of which was excised. An earlier attempt to find the Cu-T at laparoscopy had failed on 22.2.13.
Lap chole 45 F, easy. Small Rouviere’s sulcus.