Dr Mohinder Singh's blog

22.2.08

Planned LAVH actually became TLH, as dissection could be continued with simultaneous use of bipolar and monopolar diathermy with a single diathermy machine. enjoyed.

23.2.08

AMCA , AMDAANA meet at Amritsar; attended along with dr Ashok and Dr Bir Singh

25.2.08

Attended purchase committee meeting, along with dr Sharda,  in DRME office for purchase of sutures

1.3.08

lap chole in ASR

2.3.08

TLH using, for the first time, the harmonic scalpel. enjoyed.

5.3.08

Interesting case: obese 50M rural. h/o intestinal obstruction for 10 days. On exam, irreducible hernia left inguinal. Explored through inguinal incision first; foul smelling fluid in the hernial sac, sucked out. Loops of small bowel (had reduced) examined to find dusky and dark spots at several places and lot of foul smelling (feculent) fluid in the peritoneal cavity; so needed a full laparotomy. Opened through midline incision. Small bowel decompressed retrogradely thru nasogastric tube and eventually returned to healthy colour. However, further examination showed a small perforation in the caecum and a large patch of gangrene in the caecal wall; local resection of small ileocecal segment and EEA done.

Did well post op although did give some sleepless nights.

8.3.08

2 lap choles in Amritsar

12.3.08

Burch colposuspension. Obese 50F. difficult procedure

17.3.08

meeting in DRME office again for purchase of sutures

18.3.08

Tuberculosis nuisance: Young (20) F with almost completed anti-tubercular therapy (DOTS), presented with intestinal obstruction, not responding to conservative treatment for 5 days. Explored to find disseminated tuberculosis – ascites + tubercles all over serosa + adhesions of small bowel loops + old caseated mesenteric lymph nodes + transverse colon stuck to anterior abdominal wall. The transverse colon got injured in the upper part of the incision. Small bowel freed from bands and adhesions and  decompressed.  The rent in transverse colon repaired.

feb 14-17 annual conference of IAGES (held at Jaipur) attended along with 5 others from Patiala – dr jagbir, dr sukhpreet, dr grover (with one of his residents) and dr pawan.

Reached jaipur on 13th and stayed at circuit house there.

On 15th saw some of surginet members – dr sayandev and dr ramana from calcutta, dr alexander shoucair from germany, dr samir johna from US and dr danny rosin from israel.

got fellowship of IAGES on 15th

good workshop and conference held at Mahatma Gandhi medical college.

17.12.2007: 3 lap choles

Lap chole in a 50 years old female from Ghagga. Easy.

Another lap chole in a 50 years old female from medical ward.

Lap chole and lap appy in a 55 years old female with persistent pain of appendicitis for more than a week and a previous history of attack of biliary pancreatitis (c/o pharmacist in store, Charanjit Singh).

TEP for bilateral inguinal hernias in a 50 years old male, apparently direct, but turned out to be both indirect sacs, right bigger than left. Quite satisfactory dissection at last. Took nearly 1.5 hours.

8.11.07

GJ for GOO (actually a benign stricture at D2 on UGIE and barium study). 50 years old male patient, a bhukki addict (relative of son of Mehnga Singh from village). GJ done.

19.11.07

TEP26 : after a long time. Young man (30) with a small indirect hernia clinically. At operation, was found to have a direct sac too. The indirect sac got torn ; perhaps the dissection was done too low. Otherwise easy.

11.1.07

Lipoma oral cavity diagnosed as mucus cyst.

Called to help at nephrectomy for big upper pole renal cancer adherent with the liver. The exposure was inadequate.. Improved exposure led to an easy nephrectomy.

16.11.06

A 50 years old patient with a big 45 g prostate with severe prostatic symptoms wanted open surgery for the same; he had been refused TUR by urologists on the grounds of no (0) residual urine. Did a suprapubic transvesical SPTV (freyer’s) after a long time. Ligated the vessels in the prostatic bed and used supraheal (feracrylum) solution on the area to achieve instant hemostasis!

 

17.11.06

A 50 years old female with rheumatic arthritis presented with a small lump in the breast (L) with nipple discharge, A microdochectomy excision of the duct with its duct papilloma was performed.

3,4,5 November

Ludhiana conference of association of surgeons of India north chapter

attended.

Dr RCG Russell from UK and Dr Henri Bismuth from France were present.

Participated in panel discussion on hernia on 4.11.06 while presenting my view on the ‘posterior approach’ to hernia repair.