trichilemmal cyst and a parotid
Posted on: April 25, 2008
1. TAH for DUB – patient did not want gynae to do the operation!
2. breast fibroadenoma – sonia 16F d/o kammo. excised under local
3. swelling on back, diagnosed as lipoma. 35F. excised under local. photo attached. the opened up cyst shows some hair too besides the pultaceous material, so thought ot be a dermoid, but the site (back) seems to be strange.
histopathology – trichilemmal cyst.
4. 40M from chupki with a parotid swelling and facial N palsy for 2 months. FNA – benign pleomorphic adenoma. the tumour densely adherent to the trunk and its bifurcation (cause of palsy) sharply excised here. thereafter the branches of the nerve were intact.
22.4.08
1. diagnostic laparoscopy: 45M fed up with no diagnosis being made for non-specific abdominal pain. the urologist had diagnosed a small ureteric stone which was allegedly removed (no record available). pain still continuing. At laparoscopy, had adhesions in both iliac fossae with abdominal wall; these were easily divided. Appendicectomy too carried out.
2. a quick, easy and neat lap chole
3. a submuscular lipoma left lower chest wall excised under local anaesthesia 25M
4. an extended right hemicolectomy for big tumor transverse colon. Young 25 M with family history of cancer, neglecting his symptoms for 2 years; now reported with bleeding per rectum and at Hb level of 4G%. had 5 blood transfusions.
ascites small amount present. liver clear. but the tumour was locally adherent with omentum and nearly encroaching upon the greater curve of the stomach. was also adherent with the very first part of jejunum being stuck in the DJ flexure. Palliative resection carried out with ileotransverse anastomosis.
nephrectomy
Posted on: April 14, 2008
13.4.08
60 M, diagnosed with tumor lower pole left kidney when US and CT were done for pain in the flank. Hypertensive patient with a previously scarred abdomen (operation details not known) was taken up under SA and in kidney position for the nephrectomy which was easy.
NCASI conference at Rohtak
Posted on: April 4, 2008
went to Rohtak
for the conference with dr as grover, dr jagbir singh, dr sukhpreet singh, dr pawandeep singh dang
1. Small umbilical hernia PUH, Dr Karnail Singh’s pt. 55 M. Mesh repair.
2. IGTN both sides of right big toe. Yadwinder Singh 20 M from bakrana
3. chole and CBDE open. 60F diabetic with jaundice due to CBD stones. c/o hardam OT employee. ERCP scope in GMC Chandigarh out of order, so decided to go open. Right decision in the end; big stone in neck ( mucocele) as well as 5 big stones in common duct. All extracted. Very wide cystic duct. Fogarty tried in the end to confirm clearance. T-tube put in.
4. Presumably simple parotidectomy became very difficult. 60 M Dr Karnail Singh’s patient. All tumour under the nerve trunk and its branches. Very big bossellated tumour, extending up to the right parapharyngeal space and right submandibular area. difficult procedure. The trunk of the facial N was longer than expected (possibly had become longer due to chronic stretching over the big tumour); its upper division was saved nicely but a branch from the lower division was avulsed.
4. Presumably simple parotidectomy became very difficult. 60 M Dr Karnail Singh’s patient. All tumour under the nerve trunk and its branches. Very big bossellated tumour, extending up to the right parapharyngeal space and right submandibular area. difficult procedure. The trunk of the facial N was longer than expected (possibly had become longer due to chronic stretching over the big tumour); its upper division was saved nicely but a branch from the lower division was avulsed.
meeting with dr Kuldip Singh
Posted on: March 31, 2008
22.3.08
Dr Kuldip Singh from Ludhiana had a meeting with Patiala surgeons in gymkhana club in connection with the forthcoming ASI conference at Ludhiana in december 08.
Dr Ajmer Singh, Dr DN Bhardwaj, Dr Harkirat Singh, Dr MK Bandlish, Dr Mahesh Gupta, Dr RPS Walia, Dr Janak Arora, myself, Dr Jagbir Singh, Dr Sukhpreet, Dr Darshan Walia, Dr Paras Pandov and Dr Pawan Dang attended.
It was contribute as much as possible for the success of this conference.
Transfer back from Amritsar
Posted on: March 25, 2008
Was transferred back from Amritsar to Patiala.
Was relieved from GMC Amritsar yesterday afternoon. Joined today before noon in GMC Patiala.
a month’s backlog
Posted on: March 21, 2008
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.
FIAGES
Posted on: February 18, 2008
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.
Transfer to Amritsar
Posted on: January 20, 2008
17.1.08
Just when I had reached home after finishing the operation list ( a pyeloplasty and a ureterolithotomy), got a phone call from the Principal office. On reaching there, found transfer orders and relieving orders to Amritsar along with 2 other professors (dr Ashok Sharma and Dr Bir Singh); to report to Amritsar immediately.
18.1.08
Joined Amritsar medical college in the morning. The MCI team had arrived there and the 3 vacant posts of professors in surgery were filled for the MCI inspection.
Dr Mohinder Singh's blog 