Kenichi T. Miyata, MD - General Surgeon

02/02/2026

Inside the OR with - excising a pesky angiolipoma in the office under local anesthesia (patient is awake).
This lipoma is extra bloody because it is an angiolipoma. These feel just like a regular fatty tumor but is usually much more tender than normal, which gives you the main clue that it is an angiolipoma. They are treated the same way, just cut them out.
I use my scalpel to sharply dissect around the edges of the lipoma. I can “feel” the edges because the lipoma is more firm and is an actual mass that feels different than the normal surrounding fatty tissues.
I closed the wound in multiple layers to stop the bleeding and get rid of the dead space.

01/06/2026

12/19/2025

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I have the best office hynas in the world! I run my practice like General Patton but I’m lucky to have these two working for me and making my life easier! They are reliable, efficient, trust worthy, put up with my mood swings, and make it fun to go to work. They don’t make as many careless mistakes as they used to but we are still working on that.
Now it’s time for their annual (and first time) bonus for their efforts. I’ll let you all determine how much they get lol. Comment which of the four options you want them to get and I’ll make it so!

12/18/2025

Aw yeah! Back to the classic specimen slam with my favorite organ! Watch to the end to see the different types of gallstones in these two !

12/15/2025

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This lipoma was yuge and gave me heartburn just thinking about how I was going to remove this huge thing without injuring any of the several nerves and blood vessels and muscle that this fatty tumor was wrapped around.
As you can see, I used a lot of digital blunt dissection to achieve my goal of removing this thing through a relatively small incision. Watch until the end to see his two week post op results!!!

12/04/2025

This is what happens when my patients can’t follow the simple instruction of removing their bandage after 48 hours.
This is actually caused when flies leave their eggs in open wounds, usually in patients with untreated open wounds from diabetic neuropathy or gangrene. The squiggly things (which is my worst nightmare other than grubs (ew!)) are the larvae wiggling around 🤢

11/20/2025

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Website:
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10/15/2025

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The answer to the previous post is…a thyroglossal duct cyst! A TGDC is a congenital anomaly that forms due to incomplete involution of the thyroglossal duct. This patient presented later in life with this painless mass (usually this is diagnosed at younger ages). Surgery (by an ENT surgeon) is required to remove the cyst (the Sistrunk procedure - which requires removing the center of the hyoid bone).
Diagnosis requires a physical exam and usually an ultrasound to confirm it’s a TGDC and not a thyroid mass, lipoma, swollen lymph node, etc. I forgot to record him sticking out his tongue because a TGDC will move with protrusion of the tongue, whereas the other pathologies would not.
There are a lot of USMLE pearls in this post! There are frequently questions about a TGDC. The main things to remember are: TGDC is a congenital lesion caused by leftover embryonic tissue, it moves with sticking out the tongue, and treatment is the Sistrunk procedure with the key part being removing the center of the hyoid bone and the segment of the TGDC at the base of the tongue (which is why the cyst moves with tongue protrusion).

10/05/2025

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What is your differential diagnoses?
Healthy 40 year old male spontaneously developed this neck mass. It has gotten larger over the past four years. It has never been infected and has never been painful. No weight loss, no change in energy. On exam, it feels fixed and somewhat compressible.
What could it be?

10/03/2025

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Last week marks the 6th anniversary of my stem cell recipient’s transplant and cure from acute myeloid leukemia! Not only is she is full remission, but she went on to get her law degree and is now a practicing lawyer (the good kind that actually helps people).
This is, and will always be, the greatest accomplishment of my life. I can leave this world knowing I’ve made a positive impact for at least one person and her beautiful family.
If you haven’t done so already, please sign up for life saving registries such as !

09/30/2025

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I’ve been putting in work to get into proper shape to watch dominate UFC 320 this weekend! Now I’m ready to get into three hour snacking position and enjoy this stacked card with my sweet Poatan merch!
I also can’t believe I won the redemption card (swipe left)! CHAMA! LFG!!!
(I do not represent Team Alpha Male in any way. UFC fighters just happen to be the most generous, and down to earth athletes. Special thanks to and for these unique and special moments!)

07/04/2025

Happy Independence Day!
Bitcoin is the modern day revolution. Educate yourselves before you and the people that rely on you for financial security get left behind.
is going to skyrocket in value in the near future. A massive supply crunch is incoming, institutional and nation demand is surging, and mass adoption is happening. All while the dollar plummets in value every day (it has had 10% basement in 2025 alone thanks to uncontrolled money printing).
I’ve been trying to educate people since Bitcoin was $9000. It’s more than 10X that in 8 years. It’s still early but not for much longer. What are you waiting for?
#🚀