Dr. Kumar Sonal

01/02/2025

Gallstone ileus is an important, though infrequent, cause of mechanical bowel obstruction. It is caused by impaction of a gallstone in the ileum after being passed through a biliary-enteric fistula. The diagnosis is often delayed since symptoms may be intermittent and investigations fail to identify the cause of the obstruction. The mainstay of treatment is removal of the obstructing stone after resuscitating the patient. Gallstone ileus continues to be associated with relatively high rates of morbidity and mortality.

Sharing an edited operative video of Gallstone Ileus that was managed Laparoscopically.

This is an edited video of laparoscopic management of gallstone ileus. Gallstone ileus is a not so common complication of gallstone disease. ...

21/07/2024

What Is An Inguinal Hernia, and Its Symptoms Guided by A Hernia Specialist.

A hernia happens when part of an organ pushes through an abnormal opening or weak spot. An inguinal hernia, specifically, occurs in the abdomen near the groin. This type of hernia develops when fatty or intestinal tissues push through a weak spot in the abdominal wall near the inguinal canal at the base of the abdomen. When a hernia forms in this area, it can create a noticeable bulge and may cause pain, especially during movement.

Inguinal hernias are more common in men, with about one in six men experiencing this condition at some point in their lives. Many people might not seek treatment if the hernia is small or doesn’t cause symptoms. However, addressing early with a hernia specialist can prevent worsening and reduce discomfort.

e.T.E.P. is a newer way to treat Groin hernias. Sharing an edited video of a Bilateral e.T.E.P. Inguinal mesh hernioplasty.

https://youtu.be/6DaPezDgXMM?si=_Nq0JAkN_Vp8zOaC

Patient had bilateral groin hernia. This is an edited video of Bilateral E.T.E.P. Inguinal mesh hernioplasty.

25/05/2024

22/05/2024

Joining the robotic bandwagon. Happy to have done the first robotic surgery in the state of Bihar and Jharkhand! Robotic surgery is a boon to the patient.
https://www.linkedin.com/posts/ssinnovationsgroup_ssinnovations-ssimantra-ssimaya-activity-7196073198881316864-7moo?utm_source=share&utm_medium=member_desktop

04/02/2024

ETEP-RS for ventral hernia done on 27-01-2024. Patient was discharged the next day. Sharing a few pics of the same today.

ETEP-RS is a newer technique in the armamentarium of a surgeon for the management of Ventral hernias, which has many distinct advantages -- this is more physiologically sound compared to conventional Lap IPOM, it just replicates the open surgery where the mesh is in sublay (retro re**us) position, we can deal with lateral and lumbar hernias that cannot be dealt by Lap IPOM, places the mesh outside the peritoneal cavity- so no worry about bowel adhesions, Diverification of recti can be addressed as well, has the added advantage of mesh integration on both the sides vs only one side in Lap IPOM, minimal post-operative pain compared to IPOMs, almost no SAIO, early discharge from hospital and earlier return to work, does not needs costly meshes and tackers (patient pays for the surgeons expertise than for costly implants and consumables), and is basically Anterior Abdominal Wall reconstruction...... Downsides are-- technically very challenging to do, very steep learning curve, longer operative times (atleast 2x) but this is compensated by lesser total hospital stay, meticulous Laparoscopic suturing skills needed, very detailed knowledge of abdominal wall anatomy required, PRS or Linea Alba disruption can be very difficult to deal with if one is not careful.

15/12/2023

** APPENDICEAL MUCINOUS NEOPLASM **
Appendiceal mucinous neoplasm can mimic Acute Appendicitis. Radiologists play an important role in the pre-operative assessment of these lesions to help us plan the surgery better and have good outcomes for the patients. Sharing one such case here. Avoiding rupture of the tumor during surgery, including mesoappendix, retrieval in endobag, microscopic negative margin -- means a good outcome. The final biopsy report was Low-Grade Appendiceal Mucinous Neoplasm, Well Differentiated. Completion colectomy was not required here.