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Laparoscopic Non-Obstetric Surgery During Pregnancy

Surgeon: Dr. Samrat Jankar & Dr. Shraddha Galgali

Anesthesiologist: Dr. Dhananjay Sanjekar

A 26-year female presented with 17th week of gestation complained of intermittent abdominal pain. It was diagnosed as a 12X8 cm left-sided heterogenous ovarian cyst, matured dermoid tumour on imaging. Considering a large symptomatic cyst and risk of rupture during pregnancy, the patient was taken for laparoscopic surgery with consent for open conversion and risk of abortion.


With all standard surgical and anaesthesia precautions, Dr Samrat Jankar and the team could complete Salphingo-oophorectomy surgery laparoscopically without any adverse events. The postoperative specimen and fluid sent for cytology were negative. Further, lavage cytology was done, which was also negative for malignancy.

  • Operative time: 90 min
  • Blood loss: 30 ml
  • Hospital stay: 48 hours


Challenges for Laparoscopic Surgery in this Case:

  1. Gravid uterus till infraumbilical position (less space for manipulation).
  2. Large cyst (benign or malignant) need to remove entirely without spillage.
  3. Surgical time has to be as short as possible.

Dr. Samrat Jankar said, “This was the first laparoscopic non-obstetric surgery during pregnancy at SUHRC and also a first-time experience for us. This was possible only because of good teamwork.”


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Laparoscopic Rectopexy

A 70 year old male came with something coming out of anus for last 1 year. It would come out every time during defecation and last for 6 hour and not going back. By clinical examination he was diagnosed to have rectal prolapse.

The prolapse reduced with local anaesthesia. After 1 day of stabilization, he was taken in operation theater.

He underwent laparoscopic rectopexy, whole prolapse fixed inside to pelvic bone.  Postoperation he recovered well and was discharged in 3 days.


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Multiple Gallbladder Stones

A 35 year old female came with a repeated upper abdominal colicky pain for last 6 month.  On USG she was diagnosed to have multiple gallbladder stones. After evaluation a laparoscopic cholecystectomy was planned. She under went day care surgery. Discharged from hospital within 24 hr with comfortably. 


Gallbladder stones can vary in size. Some people develop just one gallstone, while others develop many gallstones at the same time. The stones may stay in the gallbladder and cause no symptoms, or they may irritate the gallbladder wall or block gallbladder ducts, resulting in infection, inflammation and upper abdominal pain. It is possible for the infection to spread to the liver or pancreas. Treatment can range from pain relief to surgery. According to Dr. Samrat Jankar laparoscopic surgeon in Pune, “the excess cholesterol or bile forms crystals, which eventually form stones. The risk of developing gallstones tends to increase with age (especially after age 40 years)”.

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Chronic Diverticulitis

A 43 year old female came with diagnosed case of chronic diverticulitis. She was on medication for last 2 years. Upon examination, abdomen distended with tympanic note all over abdomen. After thorough evaluation she underwent laparoscopic sigmoidectomy with 5 small cuts over abdomen. The operation time was 4 hours with a blood loss of 200 ml. She was hospitalized for 6 days, later discharged with normal life style and tolerating normal food.


Diverticulosis is a condition in which there are small pouches or pockets in the wall or lining of any portion of the digestive tract. These pockets occur when the inner layer of the digestive tract pushes through weak spots in the outer layer. Diverticulitis occurs when the pouches become infected or inflamed. This condition usually produces localized abdominal pain, tenderness to touch and fever. A person with diverticulitis may also experience nausea, vomiting, shaking, chills or constipation. Minor cases of infection are usually treated with oral antibiotics and do not require admission to the hospital. Repeated attacks of diverticulitis may require surgery to remove the affected portion of the colon. 

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Ligation of the intersphincteric fistula tract (LIFT)

52 years male came with a history of perianal discharge from multiple perianal opening, had two prior surgery for the same problem. But recurred.

On MRI fistulotomy diagnosed to have a complex fistula in ano.

He underwent LASER LIFT. 

He recovered very well after surgery, there was no pain, wound completely healed in 3 weeks.

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laparoscopic cholecystectomy Surgery

After though evaluation underwent laparoscopic cholecystectomy, discharged on day 1 after surgery without any pain or other complaints

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laparoscopic cholecystectomy

He underwent complete laparoscopic cholecystectomy, took almost 2hr 30min, only 100ml blood loss, he recovered very well, after 12 hr of surgery was walked in ICU.was discharged 3day after surgery.

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Chronic pancreatitis

Chronic pancreatitis is an inflammatory disease that leads to scarring of the pancreas and irreversible changes. Chronic pancreatitis results in abdominal pain and in some cases result in fatty stools that are large. Calcification is another sign of chronic inflammation. It can develop throughout the pancreas. These calcifications are like stones that are within the tissue itself, or within the pancreatic duct


The 19-year boy had recurrent abdominal pain with radiation to back, multiple hospitalizations, an evaluation found to have chronic calcified pancreatitis after through evasion underwent open lateral pancreaticojejunostomy with head coring. He had an uneventful recovery discharged on day 7.


- Causes :
Chronic pancreatitis alcohol abuse, smoking, abnormalities of the pancreas. Other causes of acute recurrent pancreatitis include high levels of calcium in the blood.
- Symptoms :
Symptoms of chronic pancreatitis include abdominal pain, nausea, vomiting, sometimes weight loss, diarrhea, and diabetes. Abdominal pain is the most common presenting symptom. The abdominal pain is typically epi-gastric and radiating to the back.

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Appendicitis can be one of the most common causes of abdominal pain. Acute perforation of the appendix is one of the complications of appendicitis. It can also be complicated by “rupture”. Hence regarded as a surgical emergency. In such cases, there is a risk of the stool contents within the appendix leaking out into the abdomen. This can result in an inflammatory reaction in our body in an attempt to “contain” the spread, creating abscesses. The resulting inflammation also makes surgical removal difficult as the bowel becomes friable. These abscesses can result in prolonged fevers and pain. Complete cleaning of abdomen and Appendicectomy done laparoscopically. Antibiotics were given. The patient recovered very well, discharged on day 3.

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