Advanced Gastro and Liver Surgery

07/09/2019

Let's Barium swallow speak itself.
• Acquired Tracheo- oesophageal fistula ( TEF).
- Due to complexity of disease, it has dramatic impact on patient's health.
- It demands major meticulous surgical intervention.

A 19 years girl presented with cough - swallow reflex, Diagnosed to have TEF ( Acquired , Benign, 18 cm, post tracheostomy / corrosive intake) underwent Cervicotomy - lateral approach, resection of fistula tract, Repair of TEF, muscle flap Interposition (SCM).

Another 24 y male patient have TEF at 23 cm, underwent thoracoscopic repair with mediastinal flap.

Both patients recovered well, came in follow up with taking their oral diet and happy face. 😊

It's our pleasure to share...

23/08/2019

Intraoperative Pancreatoscopy ( IOP )during Pancreatic surgery
-MD - IPMN ( Main Duct - intraductal papillary mucinous neoplasm ) with invasive carcinoma ( एक तरह का पैन्क्रियाज का कैन्सर ) in Head of Pancreas

- Not a uncommon entity

- A 32 years young man presented with pain abdomen and jaundice

His radiological studies and side view endoscopy were suggestive of MD - IPMN with high risk stigmata ( jaundice , cystic lesion in hop , PD - dilated more than 1 cm ) , intra ductal enhancing mural nodule

- Underwent Laparoscopic Whipple's Pancreatico- duodenectomy ( Hybrid tech. ) with intra operative Pancreatoscopy (IOP )
- Postoperative course remains uneventful and discharged today (POD 6 ) , his right and left DFA on pod 3 were 23/11, and pod 5 were 18/ 11
Intraoperative Pancreatoscopy have advantage in such patient to evaluate intraductal multicentric nodules so as to choose our extension of Surgical resection

sharing pic of happy patient with his permission

Special thanks to my respected teachers ( Prof. Abhijit Chandra sir, Prof.A.K.Mathur sir, Dr. Jeevan Kankaria sir, Dr. Vivek Gupta sir ) seniors and friends

22/08/2019