Dr Tayyab Riaz Ch

05/02/2026

𝗥𝗲𝘀𝘂𝗹𝘁𝘀 𝗼𝗳 𝗶𝗻𝗷𝗲𝗰𝘁𝗶𝗼𝗻 𝗡𝗮𝗹𝗯𝘂𝗽𝗵𝗶𝗻𝗲 𝗔𝗱𝗱𝗶𝗰𝘁𝗶𝗼𝗻
This patient came to me in OPD with bilateral forearm and lower-leg ulcers with surrounding skin discoloration, scarring, and depigmented patches. He is injecting inj Nalbuphine at these sites from last 15-20 years leading to this picture. It is very typical of chronic injectable drug abuse–related skin and vascular damage. In patients addicted to injectable Nalbuphine, several mechanisms can lead to this appearance including.
1) Repeated local tissue injury and scarring
2) Chemical irritation and adulterants
3) Infection
4) Vascular damage and thrombosis
5) Malnutrition and poor immunity

05/02/2026

Simple and Easy cases dont fascinate me any more 😁

01/02/2026

Nephrecyomy for Huge non-Functioning left kidney along with removal of previously placed DJ stent. It was having massive hydro-pyonephrosis.

29/01/2026

Sebaceous Cyst Excision from Back ✔️💯

27/01/2026

𝗕𝗮𝘀𝗮𝗹 𝗖𝗲𝗹𝗹 𝗖𝗮𝗿𝗰𝗶𝗻𝗼𝗺𝗮 𝗘𝘅𝗰𝗶𝘀𝗶𝗼𝗻 𝗮𝗻𝗱 𝗥𝗵𝗼𝗺𝗯𝗼𝗶𝗱 𝗙𝗹𝗮𝗽 𝗥𝗲𝗰𝗼𝗻𝘀𝘁𝗿𝘂𝗰𝘁𝗶𝗼𝗻 in 60y old male
He was having left infraorbital BCC from a few years.
Rhomboid flap provides excellent cosmatic outcomes for large BCC on face with desired oncological clearance.
For nodular BCC 3-5mm tumor free margin is acceptable followed by adjuvant radiotherapy after discussion with oncologist.

26/01/2026

𝗖𝗮𝗹𝗹𝘂𝘀
This patient has Congenital Deformity of Left Foot and has developed a Second Heel over time in result of weight and pressure bearing at that area.
Its Called Callus which is buildup of thickened, dead skin caused by excessive pressure and friction over time.

24/01/2026

𝗣𝗿𝗶𝗻𝗰𝗶𝗽𝗹𝗲𝘀 𝗼𝗳 𝗚𝘂𝘁 𝗔𝗻𝗮𝘀𝘁𝗼𝗺𝗼𝘀𝗶𝘀
1- There should be Bleeding Resection Margins.
2- Anastomosis should be Tension Free.
3- Remove Gut Caliber Discrepancy between two ends to make it Negotiable.
4- Take Stay Sutures at Mesenteric and Anti-Mesenteric Borders
5- Start suturing from mesenteric border.
6- Suturing Pattern should be Extramucosal Seromuscular.
7- Thread should be absorbale (Vicryl 2-0 Or 3-0 is preferable
8- Needle entry and exit at 90° to gut surface.
9- Needle Entry & Exit distance 0.5cm from margin. 10- Inter-sitch distance 0.5cm.
11- When completed do Patency and Leakage tests. 12- Close any Mesenteric rent to prevent internal herniation.

Both interrupted or continuous Suturing is acceptable in adults as far as all mentioned principles are followed
In children avoid continuous suturing because gut is growing and can lead to potential stricture formation in future

According to recent guidelines NO Gut preparation or per-op mechanical lavage is needed for colon except for rectosigmoid surgeries

𝗣𝗼𝘀𝘁 𝗢𝗣 𝗖𝗮𝗿𝗲
Follow the ERAS protocol for Successful early healing
ERAS is Enhanced Recovery after surgery and includes
NO NG tube
NO Drains or early removal of drains
Early Mobilization in Evening
Manage Nausea and vomiting
Non op**te analgesics
Start oral sips in the Evening or 8 hours after recovery and start semisolids 48-72 hours post-op or after bowel sounds are audible

Watch complete video for detailed understanding 👉🏻

This is a detailed video about principles of Large Gut anastomosis. there is detail in each step of end to end colon anastomosis along with tips and tricks s...

19/01/2026

The Way to a WOMAN'S heart is also a GROIN access!!. Though Other "WAYS" also exist ❤️

18/01/2026

𝗥𝗮𝗿𝗲 𝗰𝗮𝘀𝗲 𝗼𝗳 𝗩𝗶𝘁𝗲𝗹𝗹𝗼𝗶𝗻𝘁𝗲𝘀𝘁𝗶𝗻𝗮𝗹 𝗗𝘂𝗰𝘁 𝗔𝗻𝗼𝗺𝗮𝗹𝗶𝗲𝘀 𝗶𝗻 𝟭𝟱𝘆 𝗼𝗹𝗱 𝗴𝗶𝗿𝗹
She presented with complaint of umbilical discharge from 2 weeks. USG showed a well-defined tract along umbilicus ending into an ovoid cystic lesion/collection. Diagnostic laparoscopy planned and there was found Vitelline Cyst and Meckel's diverticulum attached to cyst via a fibroud band. Small 5cm elliptical incision given around umbilicus, omphalectomy and cyst excised, meckel delivered out and resection + end to end anastomosis done. Its been 1 month post-op and she is doing totally fine.
This was a very rare case with co-existence of multiple VID anomalies including Umbilical papilloma, umbilical sinus, umbilical cyst and Meckel’s diverticulum.

Complete case video 👉🏻 https://youtu.be/8cF5Rn9pIw4

This video discusses Interesting case of Vitellointestinal Duct Anomalies including Meckel’s diverticulum, umbilical sinus, and umbilical cyst. The content i...

17/01/2026

Sofa cm OT Table 😁
Explore this Configuration in your table Remotes and have some rest ✔️💯

12/01/2026

Fluctuation means free fluid inside a closed cavity.
Tapping one side causes a wave-like movement or ripple effect felt on the opposite side. There are different methods to check fluctuation depending on the size of the swelling. Fluid can be free serous fluid, pus, blood or effusion depending on cause and location. Treatment varies from needle aspiration to incision and drainage.

09/01/2026

𝗦𝗰𝗮𝗹𝗽𝗲𝗹-𝗵𝗼𝗹𝗱𝗶𝗻𝗴 𝗽𝗼𝘀𝗶𝘁𝗶𝗼𝗻𝘀
A. Dinner knife position
-Provides strong grip,control and power
-Used for lengthy, firm incisions (e.g. midline laparotomy, fascia)
-No 20/21 blade

B. Pen holding position/ Written position:
-Used for precise and superficial incisions,over vessels/ nerves/ tumour
- Widely use in head neck surgery.
-Common in plastic and delicate surgeries like skin flap
-No 15/20 blade

C. Fiddle bow position
-To make incisions with less pressure on delicate structures.
-Less pressure, fine dissection is done with firm grip.
-Used in fine dissection and near vital structures
-No 15/20 blade

D. Stab position
-Used for puncture incisions (e.g. abscess drainage, trocar entry)
-No 11 blade is usually use.