Difficult laparoscopic journeys

Endolaparoscopic bile duct stone surgery.

Whipples Pancreatoduodenectomy
done. ... Now Pancreatojejunostomy in
progress with all pre fixed sutures
on Pancreatic duct .Operation total
time  3hrs 10 mins

8.5 KG abdominal cystuc mass in elderly
thin frail lady who ...presentedwith massive swollen abdomen and pain and compressive symptoms due to pressure on colon and intestines and stomach so couldn't eat or pass stool properly for few months. We did laparotomy and excised the entire mass with left ovary . Absolute bloodless surgery done with no loss or transfusion. Total operation done in 17 to 20 Mins skin to skin as per Anaesthesia team. Patient fine.

8.5 KG abdominal cystuc mass in elderly
thin frail lady who ... presented with
massive swollen abdomen and pain and compressive symptoms due to pressure on colon and intestines and stomach so couldn't eat or pass stool properly for few months. We did laparotomy and excised the entire mass with left ovary . Absolute bloodless surgery done with no loss or transfusion. Total operation done in 17 to 20 Mins skin to skin as per Anaesthesia team. Patient fine.

With Patient

With Patient

With Patient

With Patient

With Patient

Happy Doctors Day

Response Beyond Boundaries

A RARE CASE OF CYSTIC PANCREATIC
CANCER WITH ACUTE ...PANCREATITIS
WITH PANCREATIC NECROSIS- Anterior RAMPS ( Radical Antegrade modular Pancreatosplenectomy) 70 year plus
aged lady presented with severe pain abdomen 1.5 months back and admitted
with suspicion of Acute pancreatitis but
blood amylase lipase levels were normal !
She was diagnosed with a large solid cystic mass in pancreas body tail region. Presented to me with Ct scan and usg report suggestive of pseudocyst or walled off pancreatic necrosis . I wasnt convinced!!! Sent for Endo USG and all tumour marker and fluid studies for mucin ca199 cea amylase ca 15-3 and cell culture and study . All tumour markers in fluid and blood were high in thousands and few linear calcification with fuzzy septa in SOL ( tumour ) Now comes dilemma between cystic pancreatic cancer ( rare type) vs pancreatic necrosis. EUS suggested walled off pancreatic necrosis . So all radiological examination suggested benign necrosis . I was still dubious considering high tumour markers . Did another triphasic CT scan which suggested mixed picture of cancer along with necrosis. The Splenic artery and vein were involved by tumour and replaced by multiple collateral varices ( sinistral hypertension with thin walled multiple abnormal blood vessels all around which increased chances of severe bleed) We explored under high risks today as patient also had other problems of heart lung and diabetes . We found a mixed picture inside . It was a cystic pancreatic cancer which had also given rise to pancreatitis and hence necrosis. So it was a bad double combination . Dissecting involved blood vessels were too difficult and tricky but we could succeed . Finally after dividing pancreas with splenic vein just at level of Portal vein formation ( visible on picture behind pancreas proximal transaction staple line ) . We could complete RAMP ( Radical Antegrade modular Pancreatosplenectomy) where the entire body tail pancreas with tumour with spleen was taken out with all lymphatic and lymph nodes and fibro fatty tissue with the posterior fascia exposing the left kidney and left renal vascular structures after completion of operation . Was really difficult . We have done RAMPS before but hardly any with tumour and pancreatic necrosis combined with past pancreatitis especially with all blood vessels involved and severe collateral vessels in all planes . Total operative time was 2hr 10 mins Blood loss of 200 ml . Patient stable . PS - Whatever the report says , always trust clinical judgement and do what is right . Else both you and the patient can land up in dubious diagnosis and hence the treatment in completely different direction with severe connotations. Dont miss the bus by miles . Be maximum sure before deciding what's right in such atypical cases .

Dr Suddhasattwa Sen as part of
the most successful ...Dept of Surgical Gastroenterology and liver Transplant
at Sir Gangaram Hospital Delhi.

Difficult radical cholecystectomy for gallbladder cancer ...near neck and body junction with extensive lymph nodes along common hepatic artery and portal vein and hepatic ducts . Segment 4B and 5 of liver resected. Non anatomic. Blood loss 30ml Ot time 1 hr 10 mins skin to skin . Elderly 70 + age with comorbidity and increasing pain abdomen . Did at Ashok N H and no special instruments .

Laparoscopic appendectomy for
gangrenous ruptured appendicitis.

The Hazmat suits for covid times
surgery.

The surgery for intestinal obstruction
and perforation... due to fistulisation
of bowel into previous ventral hernia
mesh.

Abdominal wall repair

AWR ..abdominal wall repair for
complex ...multiple midline hernias
with domain loss .

Abdominal wall repair

AWR-abdominal wall repair for complex
multiple midline hernias with domain loss.

Abdominal wall repair

AWR-abdominal wall repair for complex multiple midline hernias with domain
loss.

Chronic pancreatitis re operative
surgery

Chronic pancreatitis re operative
surgery for ...recurrent acute on chronic pancreatitis with pancreatic strictures
and ductal stones with bile duct stenosis
/ stricture with biliary obstruction and jaundice.

Chronic pancreatitis re operative
surgery

Chronic pancreatitis re operative
surgery for ...recurrent acute on chronic pancreatitis with pancreatic strictures
and ductal stones with bile duct stenosis
/ stricture with biliary obstruction and jaundice.

Recurrent left lumber hernia repair .

A 50 plus male who supposedly had Appendectomy by open conventional...
method 25 years back.Presented with recurrent abdominal pain forlast 6 yr.
Pain was typically RIF to start and then
entireabdomen.Had one episode of
Acute pancreatitis diagnosed and
treated in past.Since then had multiple admissions and treatment at local
tertiary care centers and Hyderabad
and other centers of excellence.
And was being treated in lines of
Pancreatitis without obvious CT findings
although everytime CT suggested a
tubular Swelling just adjacent to
Caecum and some suspected
Appendicular stump problem .Was
operated again locally by a senior
surgeon who supposedly had operated adhesions and other findings ( details
not available )Patients pain persisted for
2 years with multiple more admissions.
Finally was referred to us . We found all
CT including present one showing the
same finding . We did Laparoscopic exploration and found a 1.2 cm lump
almost embedded into part of colon
( caecum ) and almost invisible and inseparable. We finally were able to
dissect it out and did realise , it is an
appendix stump with probably a tumor
( high possibility of Carcinoid ie neuroendocrine tumors , found after
opening specimen later ). Ot time was
only 1 hr Blood loss almost none .
Hopefully the patient will now be able
to stop multiple visits and admissions
after some more time for final treatment
( if at all ) . PS - Gallbladder and
Appendix stump or residue may dilate
over time to cause recurrent symptoms . It is not always fault of previous surgery but probably difficult situation on table
during 1st surgery where a little stump
is left as safeguard to major morbidity
or mortality . And if any tumour
develops over time , do understand,
it is more likely misfortune of patient
rather than ignorance of previous
doctors.

A 50 plus male who supposedly had Appendectomy by ... open conventional
method 25 years back.Presented with recurrent abdominal pain forlast 6 yr.
Pain was typically RIF to start and then
entireabdomen.Had one episode of
Acute pancreatitis diagnosed and
treated in past.Since then had multiple admissions and treatment at local
tertiary care centers and Hyderabad
and other centers of excellence.
And was being treated in lines of
Pancreatitis without obvious CT findings
although everytime CT suggested a
tubular Swelling just adjacent to
Caecum and some suspected
Appendicular stump problem .Was
operated again locally by a senior
surgeon who supposedly had operated adhesions and other findings ( details
not available )Patients pain persisted for
2 years with multiple more admissions.
Finally was referred to us . We found all
CT including present one showing the
same finding . We did Laparoscopic exploration and found a 1.2 cm lump
almost embedded into part of colon
( caecum ) and almost invisible and inseparable. We finally were able to
dissect it out and did realise , it is an
appendix stump with probably a tumor
( high possibility of Carcinoid ie neuroendocrine tumors , found after
opening specimen later ). Ot time was
only 1 hr Blood loss almost none .
Hopefully the patient will now be able
to stop multiple visits and admissions
after some more time for final treatment
( if at all ) . PS - Gallbladder and
Appendix stump or residue may dilate
over time to cause recurrent symptoms . It is not always fault of previous surgery but probably difficult situation on table
during 1st surgery where a little stump
is left as safeguard to major morbidity
or mortality . And if any tumour
develops over time , do understand,
it is more likely misfortune of patient
rather than ignorance of previous
doctors.

A 50 plus male who supposedly had Appendectomy by open conventional ...
method 25 years back.Presented with recurrent abdominal pain forlast 6yr.
Pain was typically RIF to start and then
entireabdomen.Had one episode of
Acute pancreatitis diagnosed and
treated in past.Since then had multiple admissions and treatment at local
tertiary care centers and Hyderabad
and other centers of excellence.
And was being treated in lines of
Pancreatitis without obvious CT findings
although everytime CT suggested a
tubular Swelling just adjacent to
Caecum and some suspected
Appendicular stump problem .Was
operated again locally by a senior
surgeon who supposedly had operated adhesions and other findings ( details
not available )Patients pain persisted for
2 years with multiple more admissions.
Finally was referred to us . We found all
CT including present one showing the
same finding . We did Laparoscopic exploration and found a 1.2 cm lump
almost embedded into part of colon
( caecum ) and almost invisible and inseparable. We finally were able to
dissect it out and did realise , it is an
appendix stump with probably a tumor
( high possibility of Carcinoid ie neuroendocrine tumors , found after
opening specimen later ). Ot time was
only 1 hr Blood loss almost none .
Hopefully the patient will now be able
to stop multiple visits and admissions
after some more time for final treatment
( if at all ) . PS - Gallbladder and
Appendix stump or residue may dilate
over time to cause recurrent symptoms . It is not always fault of previous surgery but probably difficult situation on table
during 1st surgery where a little stump
is left as safeguard to major morbidity
or mortality . And if any tumour
develops over time , do understand,
it is more likely misfortune of patient
rather than ignorance of previous
doctors.

Invited lecture on gastrointestinal and Hepatobiliary pancreatic surgery and ... Oncosurgery at Annual conference of Family Practitioners Association

Invited Lecture on Gastrointestinal and Hepatobiliary pancreatic surgery and ...Oncosurgery at Indian medical
Association Kolkata .

Invited speaker

Felicitation of Dr Sen

Invited lecture as National faculty to Association of Surgeons of India,
Manipur state (2)

Felicitation at Indian medical
Association Annual conference

Invited lecture as National faculty to Association of Surgeons of India,
Manipur state

Invited lecture on gastrointestinal and Hepatobiliary pancreatic surgery and Oncosurgery at Bihar .

Mass connect for gastrointestinal and Hepatobiliary pancreatic surgery and Oncosurgery at Amri Dhakuria hospital .

National Faculty at IHPBA 2020

Rarest of Rare case survivor

Clinic at Bihar

Faculty from Kolkata at International Hepatobiliary pancreatic Association
Annual Conference

Gratitude by a patient

Chronic Pancreatitis and Pancreatic
Stones surgery

Difficult laparoscopic Gallbladder
surgery

Laparoscopic colorectal cancer surgery

Laparoscopic colorectal non cancer
surgery . Massive prolapse long
standing .

Laparoscopic ELAPE surgery for Very
Low rectal cancer.

Major long standing Colorectal Prolapse

Same patient of massive colorectal
prolapse after surgery and reconstruction.

70 year man with 3 times ERCP stented
for 18 Bilirubin jaundice due to lower ...
CBD cholangiocarcinoma with multiple comorbidity . Had local involvement of
Portal vein of less than 180° . We did Whipples with sleeve / partial portal
vein resection reconstruction by portal
vein recon plus pancreatojejunostomy hepaticojejunostomy and jejuno
-jejunostomy . Blood loss minimal .
No transfusion given. Operating time
total 3hrs ( skin cut to final skin stitch) .
We do Whipples quite frequently but
usually portal vein resection recons
take more time .

70 year man with 3 times ERCP stented
for 18 Bilirubin jaundice due to lower ...
CBD cholangiocarcinoma with multiple comorbidity . Had local involvement of
Portal vein of less than 180° . We did Whipples with sleeve / partial portal
vein resection reconstruction by portal
vein recon plus pancreatojejunostomy hepaticojejunostomy and jejuno
-jejunostomy . Blood loss minimal .
No transfusion given. Operating time
total 3hrs ( skin cut to final skin stitch) .
We do Whipples quite frequently but
usually portal vein resection recons
take more time .

93 + year old male presented with
acute pain abdomen with vomiting and ...constipation. Diagnosed as recurrent
sigmoid volvulus ( where the redundant
or excess left part colon gets dilated
twists on it's on axis and causes
obstruction to stool flow and gradually
lacks blood supply and goes into
gangrene and perforates ie ruptures
and patient can even die of severe
sepsis due to presence of old infected
stool volumes in abdomen).
He had similar episode and
open operation in past .
So re do operation in already disfigured abdomen would be more challenging especially considering age , poor health , comorbidity and already delayed presentation of the case beyond the golden period of cure .
However we operated and did a colectomy for the hugely dilated segment because untwisting wasn't possible due to not only bands but severe anastomosis stricture ie narrowing of the twist area and then we had to do stoma and distal mucus fistula ( bring both cut ends of remaining colon and rectum out on the abdomen so that stoo

24 year old female with polyposis coli presented with low rectal and right colonic ... proved cancers . Received CT + RT followed by Pan proctocolectomy ( after CT MRI Pet CT all suggested operable disease )
The biopsy report suggests as below
All POLYPS ARE CANCERS and IT IS NOT FAP !
There are 100s of CANCERS/ LUMINAL METS in this case

Middle aged lady underwent laparos
-copic cholecystectomy ( gallbladder
removal ) but... unfortunately had major
bile duct excision injury where common
bile duct ( CBD ) and Common hepatic
duct (CHD )was cut off leading to biliary
fistula and peritonitis ( spread of bile
into abdomen and severe sepsis ).She
was re operated to have controlled
fistula ( ie all bile draining out of abdo
-men by drains ie tubes ) ( any body
fluid as long as it comes of body with
-out accumulating inside abdomen
cavity has higher chances of survival
due to lower chances of infection ) .
She works with Senior Doctor . Was
referred to us at 4th month of Biliary
fistula . MRCP revealed TYPE 4 injury
which is one the most severe grade
and complex . The right and left
( 2 main ducts from each side of liver)
were cut and separated and retracted
little inside liver . We finally conducted
a complex Hepatobiliary bypass surgery
by ROUX en Y bypass of RHD and LHD
after limited hepatotomy ( dissect liver
to take the ducts out ) and obliquely

Middle aged lady underwent laparos
-copic cholecystectomy ( gallbladder
removal ) but ...unfortunately had major
bile duct excision injury where common
bile duct ( CBD ) and Common hepatic
duct (CHD )was cut off leading to biliary
fistula and peritonitis ( spread of bile
into abdomen and severe sepsis ).She
was re operated to have controlled
fistula ( ie all bile draining out of abdo
-men by drains ie tubes ) ( any body
fluid as long as it comes of body with
-out accumulating inside abdomen
cavity has higher chances of survival
due to lower chances of infection ) .
She works with Senior Doctor . Was
referred to us at 4th month of Biliary
fistula . MRCP revealed TYPE 4 injury
which is one the most severe grade
and complex . The right and left
( 2 main ducts from each side of liver)
were cut and separated and retracted
little inside liver . We finally conducted
a complex Hepatobiliary bypass surgery
by ROUX en Y bypass of RHD and LHD
after limited hepatotomy ( dissect liver
to take the ducts out ) and obliquely

AMRI Dhakuria today.
Celebration for succesful stapler piles
surgery as per stapler company mile
-stone on 20000 stapler procedures .
Glad to be part of it for years

24 year female presented with polyposis
coli with low rectal cancer with intestinal obstruction to a... Tertiary care hospital
2 years back at Bangalore. She underwent loop Sigmoid colostomy with Chemotherapy and Radiotherapy . She didnt accept surgery for APR ie removal of rectum and anus with permanent end colostomy ( ie stool in bag over abdomen ) at that time . Presently she presented to us with proven cancer right colon , right colic flexure and operable low rectal cancer near anorectal junction .

D2 gastrectomy for stomach cancer.

D2 gastrectomy for stomach cancer.

Gallbladder Cancer

Laparoscopic ELAPE surgery for very low rectal cancer..

Laparoscopic ELAPE surgery for very low rectal cancer

Laparoscopic Gallbladder surgery

Neuroendocrine tumour duodenum ie Carcinoid.

Neuroendocrine tumour duodenum ie Carcinoid.

Open ventral hernia surgery.

Open ventral hernia surgery.

Partial malrotation of gut in elderly
Male with internal hernia.

Partial malrotation of gut in elderly
Male with internal hernia.

Re do left extended liver resection for
biliary cystadenoma.

Re do left extended liver resection for
biliary cystadenoma.

Re do left extended liver resection for
biliary cystadenoma.

Re do left extended liver resection for
biliary cystadenoma.

Universal precautions in serology
positive cases

Wilkies Superior mesenteric artery
syndrome.Young female with weight
loss and intestinal obstruction and
vomiting

Lay people have idea that Appendix
and Gallbladder operations are walk
in a park easy. ... NO they can be as
treacherous or even more , compared
to a major critical cancer surgery. Here
is 1 of many such intriguing cases we
do. Nearly 80 year male with 2 abdo
-minal operations in same region with multiple associated ailments ( comor
-bidities ) coming with severe pain with
fever with sepsis with acute intestinal obstruction . Surgery revealed feco
-purulent peritonitis ( stool and pus in abdomen ) with ruptured gangrenous appendicitis with caecal ( the part of
right colon ) gangrene with perfor
-ation ( ie a hole through which faecal
matter ie stool escapes freely inside
abdomen causing severe deadly
sepsis ) . Entire gangrenous structures removed . Buttress caecal base repair
done . Patient discharged on day 6.

Lay people have idea that Appendix and Gallbladder operations are walk in a park easy. ... NO they can be as treacherous or even more , compared to a major critical cancer surgery . Here is 1 of many such intriguing cases we do . Nearly 80 year male with 2 abdominal operations in same region with multiple associated ailments ( comorbidities ) coming with severe pain with fever with sepsis with acute intestinal obstruction . Surgery revealed fecopurulent peritonitis ( stool and pus in abdomen ) with ruptured gangrenous appendicitis with caecal ( the part of right colon ) gangrene with perforation ( ie a hole through which faecal matter ie stool escapes freely inside abdomen causing severe deadly sepsis ) . Entire gangrenous structures removed . Buttress caecal base repair done . Patient discharged on day 6.

Lay people have idea that Appendix
and Gallbladder operations are walk
in a park easy.... NO they can be as
treacherous or even more , compared
to a major critical cancer surgery. Here
is 1 of many such intriguing cases we
do. Nearly 80 year male with 2 abdo
-minal operations in same region with multiple associated ailments ( comor
-bidities ) coming with severe pain with
fever with sepsis with acute intestinal obstruction . Surgery revealed feco
-purulent peritonitis ( stool and pus in abdomen ) with ruptured gangrenous appendicitis with caecal ( the part of
right colon ) gangrene with perfor
-ation ( ie a hole through which faecal
matter ie stool escapes freely inside
abdomen causing severe deadly
sepsis ) . Entire gangrenous structures removed . Buttress caecal base repair
done . Patient discharged on day 6.

Cirrhotic liver with acute cholecystitis
( ie acute infection of Gallbladder due
to stones ) . We have... done plenty so
far by laparoscopy but contrary to
belief that they need sub total ie partial gallbladder removal , in most our cases ,
we have removed entire Gallbladder
without bleed or complications . The
ones with severe dilated vessels in and
around Gallbladders are the ones that
need cautious movements and various modifications of techniques to instru
-ments to skills to peri operative care .

Cirrhotic liver with acute cholecystitis
( ie acute infection of Gallbladder due
to stones ) . We have... done plenty so
far by laparoscopy but contrary to
belief that they need sub total ie partial gallbladder removal , in most our cases ,
we have removed entire Gallbladder
without bleed or complications . The
ones with severe dilated vessels in and
around Gallbladders are the ones that
need cautious movements and various modifications of techniques to instru
-ments to skills to peri operative care.

A known and most dreadful complica
-tion of Laparoscopic Gallbladder sur
-gery is bile ... duct injury. The worst of
that is the transection and segment
loss injuries . Even worse when bilioma
ie collection of bile now spreads inside abdomen causing biliary peritonitis
called Waltman Walter's syndrome
where septic shock and other organ dysfunction can cause high chance
of death. A young lady suffered some
-where in the periphery and brought
to us with percutaneous drains all
blocked and patient in very critical
shape with severe septic shock and
multi organ dysfunction . We re ope
-rated today ( we have done quite few
in past as well ) by laparoscopy . There
was 5.3 litres of bile approximately . All cleared drained . Abdomen washed vigorously and thoroughly with 6 litres
warm Normal Saline . And widest bore
drains put in HRP and Pelvis. ( purpose
is to have controlled biliary fistula ie all
bile leaks out of abdomen in bags and prevents further sepsis ) and later do
biliary bypass reconstructive surgery.

A known and most dreadful compli
-cation of Laparoscopic Gallbladder
surgery is bile ...duct injury.The worst
of that is the transection and seg
-ment loss injuries.Even worse
when bilioma ie collection of bile
now spreads inside abdomen cau
-sing biliary peritonitis called Wal
-tman Walter's syndrome where
septic shock and other organ
dysfunction can cause high chance
of death. A young lady suffered
somewhere in the periphery and
brought to us with percutaneous
drains all blocked and patient in
very critical shape with severe
septic shock and multi organ
dysfunction . We re operated
today ( we have done quite few
in past as well ) by laparoscopy.
There was 5.3 litres of bile approx
-imately.All cleared drained.Abdo
-men washed vigorously and thorou
-ghly with 6 litres warm Normal Saline.
And widest bore drains put in HRP
and Pelvis . ( purpose is to have
controlled biliary fistula ie all bile
leaks out of abdomen in bags
and prevents further sepsis ) and
later do biliary bypass recon
-structive surgery.

Middle aged Male with Situs inversus
of stomach with chronic pancreatitis
and cholecystitis...with infected walled
off pancreatic necrosis causing pan
-creatic tail splenic hilum region
abscess with severe adhesions
and fibrosis esp

He did a major task of Splenectomy
where the spleen was occupying
almost entire ...abdomen . It's size was
29cm × 16 × 12 cm ( so almost a foot
long instead of normal 7 to 14cm )
and was weighing 1980 gm ( so nearly
2 KG instead of 150 gms) . Operation
was done complete in 1hr 15 mins
with minimal blood loss of around
30 to 40 ml.

A complex infected pilonidal sinus.
( it is a sinus tract formed on back
over sacral... region and sacrum bone
ie a last fused 5 vertebral bone just
above tail bone coccyx. ) These sinuses
are formed due to hairs mostly and has
a small opening and a big cavity down
below right upto bones . These are dangerously prone to recurrence . Besides cutting them out completely leaves a big gap upto bone which is difficult to close and won't heal in midline . So needs a large flap for adequate coverage and to avoid a midline scar . We have done quite mane without recurrence or complications . Not at all a small or easy surgery though it looks small sinus from outside.

70 year frail male with gallbladder
stone along with neuroendocrine
tumor of... pancreas done laparo
-scopic surgery successfully and
discharged in few days . Awaiting
reports . Apparently carcinoid based
on tests and severe fibrosis inside
abdomen . Recently a famous
Bollywood star was in news for a neuroendocrine tumor.These
are indolent growing nerve
hormone secreting cell tumor
which maybe benign or malignant.
But has a potential for cure . By Drsuddhasattwa Sen and team
at AMRI DHAKURIA HOSPITALS,
KOLKATA.

Elderly patient with acute abdomen
due to perforated gangrenous
appendix... with caecal base with periappendicular and Psoas abscess.
In a case of ? Crohns ( inflammatory
bowel disease ) disease. Look at typical
fat wrapping.

Laparoscopic Surgery for Complex
ruptured giant Amoebic Liver Abscess

VIPoma, a very rare Neuroendocrine
tumour of pancreas resected by wedge resection pancreas.

Giant Hydatid Cyst of Right lobe
liver. Operated Laparoscopically

Giant Hydatid Cyst of Right lobe liver. Operated Laparoscopically

Giant Hydatid Cyst of Right lobe liver. Operated Laparoscopically

Laparoscopic Oesophagus Surgery

Liver Resection Surgery for Liver
Tumor

Portal Hypertension Surgery for liver
cirrhosis and other causes of portal Hypertension

Pancreatic cancer Suegery.Whipples
with portal vein and Gastroduodenal
artery trifurcation resection recon
-struction

Billiary Stricture and Jaundice following
bile duct cut injury afterlapariscopic Gallbladder surgery

Billiary bypass surgery for Jaundice
and bile duct stone

Billiary bypass for bile duct narrowing
and billiary stricture

Meckels diverticulum gangrene surgery

Largest Pancreatic GIST tumor surgery

Bloodless,non transfusions surgery for pancreatic resection .Distal pan
-createctomy or pancreas removal
part

Giant Pancreatic tumor with Distal pancreatosplenectomyradical surgery

Gallbladder Cancer

Laparoscopic Liver resection,Laparo
-scopic radical Cholecystectomy for Gallbladder Cancer

Largest Liver Cancer

A giant Liver cancer locally advanced

A very large tumor liver resection
surgery

Hydatid cyst liver resection surgery

Gallbladder sarcoma cancer surgery

Small intestine tumor surgery

Large Piles Haemorrhoids

Post stapler piles surgery.Immediate result

Liver tumor surgery

Stomach cancer surgery

Stomach cancer specimen after major stomach removal. Major gastrectomy.

Stoma surgery.

Stomal prolapse and stomal hetnia
surgery.

Small intestinal surgery.

Laparoscopic appendectomyfor acute purulent appendicitis.

Largest neck tumor.

Neck tumor removal reconstruction.

Largest neck tumor.

Laparoscopic Liver resection surgery.

Gallbladder gangrene surgery.

Bile leak bile peritonitis laparoscopic
surgery.

Liver metastasis.Cancer spread surgery.

Ventral Incisional hernia surgery.

Pancreatic stone, chronic pancreatitis surgery.

Ventral hernia.

Laparoscopic ventral hernia mesh
repair surgery.

Difficult gallbladder with abscess with perforation surgery laparoscopic.

Endolaparoscopic bile duct stone surgery.