Monday, November 5, 2018

Thoracoscopic Denture removal from esophagus : Dr Keyur Bhat

Thoracoscopic Denture removal from esophagus

An Elderly Female with a history of accidental ingestion of denture 8 days before two uncessfull attempts of removal was tried.

Surgery: Thoracoscopic Removal of mid Esophageal denture & FJ



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Tuesday, October 23, 2018

Lap Mirizzi Syndrome / CBD Exploration : Dr Keyur Bhatt

Lap Mirizzi Syndrome / CBD Exploration

Middle aged female with a history of pain in cenral abdomen and jaundice
underwent ERCP and CBD stenting posted for lap chole with CBD Exploration.



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Wednesday, October 17, 2018

Laparoscopic Repair of peptic perforation : Dr Keyur Bhatt

Laparoscopic Repair of peptic perforation

A 38-year male patient presented with complaints of severe generalized abdomen pain since one day.

History of two episodes of vomiting, No History of fever.

Per abdomen - generalized tenderness and guarding TLC Raised
Chest x-ray was normal.

CT scan abdomen showed free gas under the right dome of the diaphragm.



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Wednesday, October 3, 2018

Boerhaave's syndrome : Dr Keyur Bhatt

Boerhaave's syndrome

An Elderly male with a history of pain in a left chest for 2 hours, on investigations, found to have gross left hydropneumothorax ICD
Kept and a patient was conservative.

Day 3 - CT Chest was done s/o empyema left chest thoracoscopy and lavage was given patient continued to have 1000ml/day ICD output Repeat chest CECT with oral contrast done on DAY 7 which s/o gross leak of contrast from lower one-third of an esophagus in the left thoracic cavity.

Transferred to SIDS Hospital & Research Center OGD Scope was done with CO2
s/o: Lower end left sided 3 cm esophageal perforation.

PLAN : Laparoscopy and repair of perforation feeding jejunostomy Thorascopy / Mini thoracotomy and lavage.



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Wednesday, September 26, 2018

Lap Splenectomy for ITP : Dr Keyur Bhatt

Lap Splenectomy for ITP

Young female with History of ITP for 4 years steroid dependent and resistant to other all medical management Platelets counts persistently near 10,000/cmm

Plan: Lap Splenectomy

Platelet counts 8,000/cmm on Day of Surgery



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Monday, September 24, 2018

Lap Subtotal Colectomy : Dr Keyur Bhatt

Lap Subtotal Colectomy lleo rectal anastomosis

24 Years young male with a history of constipation for 15 years No other significant medical history.

Colonoscopy: s/o Normal mucosa and no other significant abnormality.



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Sunday, September 16, 2018

Lap ICG Cholecystectomy : Dr keyur Bhatt

Lap ICG Cholecystectomy with ICG

Young female with a history of pain in abdomen On evaluation found to have acute cholecystitis with the impacted stone in GB Neck.

Surgery: Lap Cholecystectomy with ICG Dye

ICG Dye injected 1 ml 45 Must prior to surgery.


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Monday, September 10, 2018

Lap Right portal vein ligation with AR : Dr Keyur Bhatt

Right portal vein ligation with AR for Ca Sigmoid (NEC) + Extensive Right Lobe liver Mets

55 Years male with a history of constipation and 1 kg wt loss On Colonoscopy found to have: Ca Sigmoid (Neuroendocrine)
CEST: s/o Sigmoid mass with extensive right lobe liver Mets

Surgery Plan: Laparoscopic Right Portal vein ligation & sigmoid colectomy


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Tuesday, August 28, 2018

Lap cholecystectomy (Gangrenous GB) : Dr Keyur Bhatt

Lap cholecystectomy Gangrenous cholecystitis (Intrahepatic GB)

Middle-aged male with a history of pain in upper abdomen for 3 days known diabetic for 15 Years.
TLC: 14000/CM
LFT: Normal

USG: s/o Acute cholecystitis with pericholecystic fluid.

Surgery: Lap Cholecystectomy



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Lap APR For Ca Anal Canal : Dr Keyur Bhatt

Lap APR For Squamous cell Carcinoma Anal canal

Middle-aged male with perianal pain and bleeding P/R.
Operated for MIPH & Perianal fissure with Bx from a fissure

Bx - Squamous cell Carcinoma of anal canal after three months patient had taken 60 Gy radiotherapy.

Post-treatment patient had persistent peri anal for 3 months, Underwent internal sphincterotomy for the same!

Two months later again underwent peri anal bx
s/o: Persistence of Squamous cell ca

PET Scan: s/p Locally active disease in the perianal region.

we received the patient after all the work up Advise: Lap APR

Surgery and post-op recovery was uneventful patient discharged on POD 5.

Biopsy: s/o T2N0 Squamous cell ca



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Monday, August 27, 2018

Tuesday, August 21, 2018

Lap Liver cyst excision : Dr Keyur Bhatt

Lap Liver cyst excision

Middle aged female with pain in central abdomen On evaluation found to have a complex cyst in left in the left lobe of liver Hydatid serology and tumor markers were negative

Plan: Lap excision of the cyst.

A patient was discharged on next day.


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Tuesday, August 14, 2018

Lap Choledochal cyst excision and RYHJ : Dr Keyur Bhatt

Lap Choledochal cyst excision and RYHJ

32 years male with a complaint of intermittent pain in RHC found to have CDC Type 1 MRI Confirmed the diagnosis.

Surgery: Lap CDC Excision with RYHJ Patient discharged on POD 5



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Friday, July 13, 2018

Completion cholecystectomy for biliary fistula : Dr Keyur Bhatt

Completion cholecystectomy for biliary fistula

Elderly male history of pain in abdomen x  6 months diagnosed to have gall stone disease and had undergone Lap converted Open cholecystectomy (done in peripheral hospital)

A patient had persistent biliary fistula following surgery (10days - 400ml.day)

MRCP was done suggestive of residual significant GB with multip;e stones & a large juxta papillary diverticula

Surgery: Lap completion cholecystectomy

Patients were discharges uneventfully postoperatively on POD 2 Without Drain



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Lap Whipples Dissection

Lap Whipple's Dissection

Middle age male with a history of pain in center abdomen and occasional back radiation, no h/o jaundice or significant weight loss

USG: S/o mass in the head of the pancreas

CECT: Confirmed the mass in the head of the pancreas

EUS FNAC: S/o Adenocarcinoma of pancreas

Surgery: Lap assisted Whipple surgery

Wednesday, July 11, 2018

lap Band release : Intestinal obstruction - Dr Keyur Bhatt

Lap release of band/obstruction

Young boy with a complaint of severe pain in abdomen for 4 days with mild distension of abdomen and vomiting(Bilious)

Operated 1 year back for open appendectomy

CECT S/o band in the lower abdomen with intestinal obstruction

Surgery: Lap Release of band

Mucocele of appendix : Lap Resection : Dr Keyur Bhatt

Mucocele of appendix Lap resection

76 years female with nonspecific pain in RIF on investigation found to have Mucocele of appendix

CECT: S/o mucocele of appendix

Surgery: lap Staple appendectomy 

Monday, July 9, 2018

TLH : Large fibroids upto 24 weeks size - Dr Keyur Bhatt

TLH-More than 24 weeks size Uterine fibroid

39 years female with lower abdominal pain
USG: S/o Large uterine multiple fibroids up to 24 weeks size of a uterus

Plam: Laparoscopic total abdominal hysterectomy patient was discharged uneventfully on POD 1

Tuesday, June 26, 2018

Three port lap Splenectomy for ITP - Dr Keyur Bhatt

Three port lap Splenectomy in ITP

A 22 year female with history op ITP for last 5 years not responding to conventional medical and immunological treatment
Persistent refractory thrombocytopenia
the patient was operated on platelet count 4000/cm
Surgery: Reduced port lap splenectomy
The patient recovered well after surgery and discharged with 85000 platelets on POD 1

Wednesday, June 20, 2018

Hiatus hernia with gastric volvulous -Lap Reduction and partial wrap

Hiatus hernia with gastric volvulus -Lap Reduction and partial wrap

An elderly female with upper GI Symptoms for more than 3 years presented with sudden pain in the upper abdomen & Chest, Distress, and vomiting

On Investigation found to have large intrathoracic gastric volvulus

Surgery: laparoscopic reduction of the stomach and partial fundoplication

Reduced port Laparoscopic Sleev gastrectomy

Reduced port Sleev Gastrectomy

26 year recently married female with morbid obesity
BMI of 32, Borderline Hypothyroidism and HTN
Surgery: Lap vertical sleev gastrectomy
Discharged on POD 1 after normal dye study

Thursday, February 8, 2018

Lap CBD exploration with Cholecystectomy : Dr. Keyur Bhatt

Lap CBD exploration with Cholecystectomy

Elderly, male with a history of pain in the right upper quadrant of the abdomen, gradually increasing jaundice & clay-colored stool for 15 days

On work and USG found to have one impacted stone in lower CBD&One large stone in mid-CBD? Mirrizi syndrome.

CECT was done to confirm the findings.
Pre-op/procedure Bilirubin Level was 19.5mg/dl ERC&stentiting with removal if the impacted stone was done larger stone could not be retrieved with ERC.

Surgery: Lap Cholecystectomy with CBD exploration.

Saturday, February 3, 2018

Lap Diphragmatic hernia repair : Dr Keyur Bhatt

Lap Diaphragmatic hernia repair

Middle-aged female with a history of pain in upper abdomen& coughing

  • 2012: Taken AKT for left lower zone consolidation
  • 2013: Underwent diagnostic laparoscopy for pain in the abdomen
  • 2014: Underwent lap TLH for persistent pain in the abdomen
  • 2017: Got ICD on the left side for suspected left pleural effusion
Finally diagnosed to have a left-sided diaphragmatic hernia


Wednesday, January 10, 2018

Lap Meckel's diverticular excision : Dr Keyur Bhatt

Lap Meckel's Diverticulectomy

A young male presented with a history of lower GI bleeding, No history of fever or pain. No History of surgery in the past

Required 4 units of PCV transfusion, (Hb dropped to 6 gm/dl)
USG: NAD, Colonoscopy outside: normal, UGIE: Normal
CECT: Did not reveal any source of bleeding.

Repeat CECT angio was done: suggestive of a lesion in terminal ileum? Meckel's diverticula?NET

Surgery: Lap excision of Meckel's diverticula and appendectomy

Monday, January 1, 2018

SMA Syndrome : Lap Duodeno Jejunostomy : Dr Keyur Bhatt

SMA SYNDROME - LAP DUODENO JEJUNOSTOMY

18 Years male with a history of pain in Central abdomen and recurrent vomiting
8 kg weight loss in the last 3 months

CECT: S/O SMA Syndrome
Surgery: Laparoscopic Duodeno Jejunostomy