Dr Rajesh Kol

24/09/2025

🩺 Case Update – Left Hemithyroidectomy

A 40-year-old female presented with a solitary swelling in the front of the neck.
• Clinically: Euthyroid, no voice change, no lymph nodes.
• Ultrasound: Solitary nodule in left thyroid lobe.


👉 Planned for Left Hemithyroidectomy.

🔹 Intra-op Findings:
• Solitary well-defined nodule confined to left lobe
• Superior pedicle ligated close to capsule (nerve preserved)
• Recurrent laryngeal nerve & parathyroids preserved
• Left lobe with isthmus removed completely

🔹 Post-op: Smooth recovery, no voice change, no hypocalcemia.
🔹 Histopathology: Follicular adenoma (benign).

✅ Final Outcome: Patient discharged on Day 3 in stable condition.

✨ A reminder that timely evaluation of thyroid swellings with clinical exam + FNAC + imaging helps in safe and effective management.

18/09/2025

🔬 Rare Pediatric Surgical Case:Hepatoblastoma

I recently encountered a 3-year-old male patient who presented with progressive abdominal distension. On clinical evaluation, the swelling was firm, non-tender.

📋 Imaging
Ultrasound and CT revealed a large, heterogeneous cystic-solid mass arising from the liver, suggestive of a Hepatoblastoma.

🩺 Surgical Findings
• A large lobulated hepatic mass was identified, arising from the right lobe.
• Careful dissection and resection were performed, ensuring preservation of major vascular structures.
• The tumor was excised successfully, with minimal blood loss.

🧾 Histopathology
Confirmed the diagnosis of Hepatoblastoma rare tumor usually seen in infants and young children.

✅ Takeaway
This case highlights:
• The importance of differentiating benign liver masses from malignant lesions in children.
• The critical role of meticulous surgical planning to achieve complete resection while preserving hepatic function.

Such cases remind us of the value of early diagnosis, multidisciplinary teamwork, and surgical precision in pediatric surgery.

18/09/2025

🩺 Challenging Case: Massive Splenectomy in Thalassemia Major

A 22-year-old male with thalassemia major presented with progressive abdominal distension, transfusion-related hypersplenism, and discomfort due to a massively enlarged spleen extending well below the iliac crest.

📋 Clinical Considerations
• Long-standing transfusion dependence with hypersplenism.
• Risks: massive blood loss, adhesions, vascular anomalies.
• Goal: improved transfusion requirement, better quality of life.

🔪 Surgical Findings
• The spleen was enlarged to >25 cm, occupying the entire left abdomen and crossing midline.
• Dense perisplenic adhesions with multiple collateral vessels were encountered.
• Careful stepwise devascularization was performed, followed by controlled mobilization and successful splenectomy.

🧾 Outcome
• The patient tolerated the procedure well.
• Post-op: stable hemoglobin, reduced transfusion requirement, and symptomatic relief.

💬 Reflections
“Operating on a spleen larger than life is not just a surgery—it’s a balance between precision and resilience.”
“In thalassemia major, the spleen becomes both a protector and a burden. Surgery transforms that paradox into hope.”

✅ Key Learning Points
• Pre-op optimization (vaccination, blood preparation) is crucial.
• Massive splenectomy requires meticulous dissection and teamwork.
• Splenectomy can significantly improve transfusion dynamics in selected thalassemia patients.

Such cases remind us of the importance of surgical judgment, preparedness, and multidisciplinary care in managing complex hematological disorders.

# MP53 Sidhi MP

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Would you like me to also prepare a shorter, more public-friendly version (focusing on patient impact and hope), alongside this academic-style version for surgeons?

09/05/2025

60y/F
Neck swelling since 1 year gradually progressive ,painless without affective voice or symptoms of breathlessness..
Diagnosis?

04/08/2024

Massive mucinous cyst adenoma of o***y weight About 6kg and occupying almost abdominal cavity succefully removed

13/05/2024

Bladder stone of 7.5*5 *3.5 cm size in a patient having history of Neobladder construction surgery 5 years back.. 🤞

11/12/2023

Post Burn contracture Surgery in Life care Hospital and trauma centre Sidhi🫡🤞

12/11/2023

Happy diwali🪔🪔🪔🪔💣⚕️🏥
Stay Healthy ,Keep smiling..Share happiness

01/08/2023

11/06/2023

Cyst-adenoma Bilateral ovarian Tumour of size 30cm X 24cmX 8cm dimension and of Approx weight 5.654Kg successfully excised without any Complication