re-do- roux-en-y billroth 2 gastrojajunostomy for benigh gastric outletobstruction in old G-J STOMY

GROSSLY DILATED STOMACH UP TO PELVIS DUE TO GASTRIC OUTLET OBSTRUCTION,AND OLD G.J STOMY STENOSIS

old g.j. site near prepyloric area from which the stenosed loop of jajunum was seperated.

Billroth 2-gastrectomy closed partialy to allow revision g.j. by roux- en- y- loop

stomach specimen

all anastomosis completed.

a 35 yr old male presented with severe abdominal pain presented in emergency.he had h/o some abdominal surgery 15 years back,no papers available. o.g.d. scopy revealed complete pyloric stenosis with severe gastric dilatation .no g.j stomy was appreciable.on ct scan , stomach showed severe gastric dilatation and block. on exploration , old stenosed gj stomy was found in prepyloric region with ? mass, loop separated an on table frozen section  done which was negative for malignancy.so revision billroth2 gastrectomy with roux-en-y g.j.stomy was done. uneventfully post op,on 7 the day pt was discharged home absolutely fine , taking orallyfood .done by ME,DR DHAVAL PATEL, DR VYAS, DR RANPARIA,emergency frozen section done by DR PRANAV DESAI.

huge left lobe liver cyst-laparoscopic fenestration and omentopexy

left lobe nonprasitic hepatic cyst

about 2.5 to 3 liters of amber clour fluid aspirated.

hepatic cyst wall falgurated with bowa vessel sealer

fenestration completed, wall sent for biopsy,lavage given

omentopexy done

a 55 yr male having c/o lump in abdomen with heaviness in abdoman since 6 months,unable to take food, persistent vomiting.the huge intraabdominal mass covering all quadrants of abdomen turned to be diagnosed as huge left lobe nonparacytic hepatic cyst on sonography and CT SCAN. no other cyst in pancreas or kidney.his LFT and other blood reports were normal, with low hb. hydatid antigen test was not done.alfa fetoprotein was boarderline raised,laparoscopic aspiration was done, about 2.5 litre of amber colour fluid drained which was not bile-stained. pus-flakes we removed, liver cyst wall was falgurated with BOWA VESSEL SEALER DEVICE( recommended because there are chances of bile leak from the cyst wall).thorough wash was given , omentopexy done , 32 no. abdo drain kept in cavity .done with four port technique. biposy confirmed the diagnosis of benign hepatic cyst. done by ME, dr bhavin bhuva, dr chetan morawala at naveli hospital. post-op phase was uneventful, pt was discharged on 4rth postopday .now after about 10 months ,pt is fine and without recurrence.

laparoscopic myomectomy for multiple fibroids with infertility

done by me and dr reshma yagnik.

low anterior resection for ca. rectosigmoid junction using circular staplers

rectal mobilization

intraluminal view of adenocarcinoma of rectosigmoid jn

stapler and anvil fixed with sutures before locking

complete donut after firing

55yr old male operated for adeno ca at rectosigmoid junction by using circular staplers.