Dr. Anthony Lim Laparoscopic Surgery

02/10/2025

Kahit maliliit ang mga bato sa apdo basta’t marami sila pwede magkumpul kumpul at magbara sa gallbladder neck at maging sanhi ng matinding sakit.
ang pasyente na ito ay na emergency at inoperahan kaagad para mawala na ang sakit.

01/10/2025

Ganito ang hitsura ng almoranas na maga at dinudugo.
Manipis ang balot nito at konting galaw sa kanya ay sumisirit na ang dugo.
Kapag ganito na ang hitsura ng almoranas niyo, urgent na ito at dapat na talagang maoperahan.

27/09/2025

Namimilipit siya sa sakit at nanggaling na sa ibang ospital. Malaki na rin nabawasan sa HMO dahil na emergency siya. Nung Sumakit ulit, minessage ako ng kuya niya. Sabi ko wag na siya mag ER, diretso sa admit sa kwarto na.
Nakinig naman at inadmit sa Alabang Medical Center. Inumpisahan ko ng pain killers na de swero. 24/7 ito para mawala ang sakit. After 24 hrs, inoperahan ko na ng . Medyo mahirap aNg operasyon at inabot ng 3 oras.
Napauwi ko naman kinabukasan. Ngayon nag send siya sa akin ng picture ng sugat niya. 3 araw lang nakalipas, at halos magaling na ang sugat.

26/09/2025

This video shows a pulsating structure crossing the liver. This is in fact the posterior cystic artery fully preserved along its course. Fully separated from the and ligated at its very end.
This is something you don’t see everyday.

24/09/2025

Paano nating masasabi na kailangang operahan na ang almoranas?
Marami pong dahilan kung bakit inooperhan ang almoranas, ngunit para sa akin, 2 lang ang rason.
1. Matinding pagdudugo
2. matinding sakit.
Itong 2 ay tinatawag na absolute indication.
Katulad sa picture Makikita natin na may sugat ang almoranas at kapag ito’y dumugo, sisirit ito.
Gumagamit na kami ng harmonic scalpel o Ligasure para mag opera, gawa dito, wala nang dugo at Hindi na kailangang itahi ang inooperahan.
Meron pa isang dahilan kung bakit ito’y kailangang operahan.
Ito ay kung babae kayo at may kalakihang almoranas at may balak mabuntis.
Dahil Pag buntis kayo at sumakit ang almoranas, walang papansin sa inyong doktor dahil lahat ng gagawin ay may kasamaan sa bata.

20/09/2025

Pancholedocholithiasis… wow. There is such a term.
Haven’t seen a common bile duct filled with stones and I hope I never see one.
***not my patient***
Just saw this pic on X.

18/09/2025

Ang pinaka dahilan kung bakit nag open chole imbis na mag lap chole ay kung dikit dikit na ang lamang loob sa apdo. Ang lap chole ay gumagamit ng maliliit at Mahahabamg instrumento sa pag oopera. Sa ganitong paraan, hindi nararamdaman ng surgeon ang inooperahan niya. Kaya napaka halaga ng camera at monitor.
Katulad ng pasyenteng ito, magang maga ang apdo at nakadikit ang bituka sa apdo. Hindi natin pwedeng mabutas ang bituka. Sa tyaga, nalang hiwalay natin ng maayos, Kitang kita ang kabuoan ng apdo at tinanggal ang apdo ng walang sugat sa kahit anumang structura.
Ang pasyente ngayon may nag papahinga na sa bahay.
Salamat sa Team AMC!
Natapos din natin!

15/09/2025

Not all are the same. And the goal of every surgery is to end the surgery safely.
So, in order to have a safe surgery there are certain landmarks that need to be identified and visualized properly!
First is the area with the blue arrow or the right hepatic sulcus. It is very important that you do not dissect below that level.
Second, see the 3 yellow arrows? That is the triangle of calot. And this triangle comprises the cystic plate, edge of the gallbladder and the common bile duct. Inside the triangle is where you find the cystic artery.
If these structures are identified, surgery is smooth and safe.
Even in difficult surgeries, the goal is to expose these structures.
Always go back to the basics. And you are sure to have a safe surgery and patient will go home smiling.

11/09/2025

The last cut showing the edge where the gallstones are seen impacted at the gallbladder neck. Opening the area reaffirms that the impression is indeed the gallstone.
No more pain, No more stone!
Just like that in an hours time, no more problem!
Thank you to my Team AMC!

08/09/2025

04/09/2025

A seemingly easy turned into a 4 hour surgery.
It seems that there is no end. I kept looking of the Hartmann’s pouch so I could mark where to stop. I found the right hepatic sulcus which usually is the landmark where the cystic duct meets the common duct. But the Hartmann’s pouch was sagging way below this line. When I saw the cystic duct it was bulging and true enough, it was hard as it was filled with stones.
I milked the stones upward so as not to include it during the tie. You can see some stones already cracked in the picture. Finally, I had to use a surgitie to secure the cystic duct. The hemolok was just too small.
Because of this obstruction, we see a very long gallbladder. Around 11cm and thinned out.
Patient is now safe at home


Thank you again Team AMC!

03/09/2025

Find the Hidden Mickey….
Rarely do I get cases where I could finish in 30minutes.
This is one of them…
thanks to Team AMC for a smooth operation !