Dr Tayyab Riaz Ch

07/03/2026

𝗕𝘂𝗰𝗰𝗶𝗻𝗮𝘁𝗼𝗿 𝗖𝗮𝘃𝗲𝗿𝗻𝗼𝘂𝘀 𝗛𝗲𝗺𝗮𝗻𝗴𝗶𝗼𝗺𝗮
5y old Dua fatima having gradually increaseing right sided cheek swelling from last 2 years. Parents got concerend and reached me for diagnosis and treatment. On clinical examination it was freely mobile, soft to firm, non tender and compressible swelling in right buccinator muscle region. USG confirmed the clinical diagnosis of hemangioma. Small jawline incision planned taking care of the cosmesis and exploration done. Hemangioma was found taking its blood supply from facial artery branches. Feeding vessels were meticulously ligated and hemangioma excised taking care not to damage facial nerve branches. Wound closed in subcut fashion. On followup visit both Dua and parents are happy and satisfied.
A buccinator cavernous hemangioma is a rare, benign, slow-growing vascular tumor arising within the buccinator muscle, often presenting in children and young adults as a progressive, soft tissue mass. Diagnosis is confirmed through imaging and histopathology, with complete surgical excision being the primary treatment, often requiring careful dissection to avoid facial nerve branches.

06/03/2026

𝗜𝗻𝘁𝗲𝗿𝗲𝘀𝘁𝗶𝗻𝗴 𝗰𝗮𝘀𝗲 𝗼𝗳 𝗶𝗹𝗶𝗮𝗰𝘂𝘀 𝗠𝘂𝘀𝗰𝗹𝗲 𝗡𝗲𝗰𝗿𝗼𝘀𝗶𝘀
60y old female presented with complaint of fullness in left iliac fossa region from 2 weeks. History of low grade fever from 1 week. No history of trauma or TB. On examination there was fullness and tenderness in left iliac fossa region with swelling extending into left groin region leading to antalgic posture (flexion) of the left hip - favouring something wrong with iliopsoas.
CT abdomen and pelvis showed an ill-defined collection along the left posterior abdominal wall muscles, showing inferior extension into the left iliacus muscle and further down towards the proximal thigh up to its insertion. Associated muscle swelling and surrounding edema. Spared left psoas muscle.
Exploration done via oblique incision over left iliac fossa placed along and parallel to iliac crest and iliacus muscle reached extraperitoneally which was totally necrosed. Whole muscle till its insertion to lesser trochanter of femur excised, cavity washed with saline and packed. Wound partially closed for later packing and delayed primary closure. Muscle sent for histopathology.

05/03/2026

𝗣𝗿𝗶𝗻𝗰𝗶𝗽𝗹𝗲𝘀 𝗼𝗳 𝗩𝗲𝘀𝗶𝗰𝗼-𝗩𝗮𝗴𝗶𝗻𝗮𝗹 𝗙𝗶𝘀𝘁𝘂𝗹𝗮 (𝗩𝗩𝗙) 𝗥𝗲𝗽𝗮𝗶𝗿 𝘃𝗶𝗮 𝗩𝗮𝗴𝗶𝗻𝗮𝗹 𝗔𝗽𝗽𝗿𝗼𝗮𝗰𝗵
👉 Optimal Timing: Usually delayed for 3–6 months (or up to a year for radiation injuries) to allow inflammation to subside.
👉 Wide Dissection: Complete separation of the bladder and va**na to ensure only healthy, well-vascularized tissue is approximated.
👉 Tension-Free Closure: Tissues must be freely mobilized to prevent pull on the suture line, which can lead to recurrence.
👉 Water-Tight Closure: Meticulous, layered closure (usually 2-3 layers) is essential. The bladder and va**nal tissues should be closed separately.
👉 Interposition Flaps (Omentum/Muscles/Martius flap): Used for complex, recurrent, or radiated fistulas to separate bladder and va**nal suture lines and improve blood supply.
👉 Water-Tight Testing: The integrity of the closure must be verified using dye (methylene blue).
👉 Bladder Drainage: Prolonged postoperative drainage (10–14+ days) via a Foley catheter is mandatory to allow healing.

𝗣𝗼𝘀𝘁-𝗼𝗽 𝗖𝗮𝗿𝗲
The most critical care is ensuring continuous, unobstructed bladder drainage to prevent tension on the repair site.
👉 Foley catheter is kept for 10 to 21 days. For simple fistulae, the WHO recommends a period of 7–10 days.
👉 Before catheter removal, dye test with methylene blue can be performed to confirm the complete healing of fistula
👉 Strenuous exercise, heavy lifting, and straining should be avoided for at least 6 weeks.
👉 Sexual in*******se is strictly prohibited for 6 to 12 weeks to allow the va**nal wall to heal fully.

**nalfistula
**nalfistula

25/02/2026

Modern health culture is obsessed with optimization.
Track everything.
Measure everything.
Improve everything.
But the longest-living populations in the world don’t live in optimization mode.
They live in balance.
As a surgeon, I see the long-term effects of chronic stress, social isolation, suppressed emotions, and burnout.
Longevity is not intensity.
It is alignment.
Which rule resonated with you the most?
Comment the number below.

18/02/2026

𝗞𝗻𝗼𝘄𝗹𝗲𝗱𝗴𝗲 𝘀𝗵𝗮𝗿𝗲𝗱 𝗶𝘀 𝗸𝗻𝗼𝘄𝗹𝗲𝗱𝗴𝗲 𝗺𝘂𝗹𝘁𝗶𝗽𝗹𝗶𝗲𝗱 😇
From the Scalpel to the Silver Play Button.
100,000 amazing people walking this journey with me.
Grateful for every view, comment, and message. This Button is yours as much as mine.
“100k today—many more lives to impact tomorrow.”
Channel Link 👉🏻 https://youtube.com/user/Tayyabcpmc

14/02/2026

Long Segment Microscopic Varicocelectomy ✔️💯

11/02/2026

Witzel tunnel feeding Jejunostomy step by step procedure

Feeding Jejunostomy - Witzel Tunnel Feeding Jejunostomy step by stepTypes of feeding jejunostomy:Witzel Tunnel Longitudinal jejunostomy - it is most commonly...

11/02/2026

100K strong! Grateful for every single one of you who watched, shared, and supported this journey—13 million views and counting. Your trust and encouragement keep me motivated to teach, operate, and grow every day. Thank you for being part of this milestone! 🤩😇🪅🎊

05/02/2026

𝗥𝗲𝘀𝘂𝗹𝘁𝘀 𝗼𝗳 𝗶𝗻𝗷𝗲𝗰𝘁𝗶𝗼𝗻 𝗡𝗮𝗹𝗯𝘂𝗽𝗵𝗶𝗻𝗲 𝗔𝗱𝗱𝗶𝗰𝘁𝗶𝗼𝗻
This patient came to me in OPD with bilateral forearm and lower-leg ulcers with surrounding skin discoloration, scarring, and depigmented patches. He is injecting inj Nalbuphine at these sites from last 15-20 years leading to this picture. It is very typical of chronic injectable drug abuse–related skin and vascular damage. In patients addicted to injectable Nalbuphine, several mechanisms can lead to this appearance including.
1) Repeated local tissue injury and scarring
2) Chemical irritation and adulterants
3) Infection
4) Vascular damage and thrombosis
5) Malnutrition and poor immunity

05/02/2026

Simple and Easy cases dont fascinate me any more 😁

01/02/2026

Nephrecyomy for Huge non-Functioning left kidney along with removal of previously placed DJ stent. It was having massive hydro-pyonephrosis.