2/03/2017

Many people ask about our pathology. For a long time, Danny Milner, MD, at Harvard/Brigham and Women's Hospital. performed all our pathology on the specimens I brought home with me. This was a really great situation which, unfortunately, ended when Danny left the Brigham to become the Chief Medical Officer at the American Society for Clinical Pathology. After an appeal on my Blog Site (www.earthwidesurgicalfoundation.blogspot.com), I received many gracious offers for pathology help from around the world. 
 
Fortunately, we met Dr. Chidi Onwuka from the Department of Histopathology at the University of Uyo Teaching Hospital. He graduated from the University of Nigeria, Nsukka and did his pathology training at the National Postgraduate Medical College of Nigeria. His group now does all our pathology work. Chidi is a very pleasant chap and comes every week to pick up our specimens and his turn around time is 1 week!

1/31/2017

FIBROUS DYSPLASIA WITH ECTOPIC TEETH

This 12 year old girl came in with a swollen Cheel. She obviosly had fibrous dysplasia-Fibrous dysplasia is an uncommon bone disorder in which scar-like (fibrous) tissue develops in place of normal bone. This can weaken the affected bone and cause it to deform or fracture. In most cases, fibrous dysplasia affects only a single bone — most commonly the skull or a long bone in the arms or legs. We operated and found massive fibrous tissue requiring a chisel for revoval of the entire maxilla. During removal we found several ectopic teeth-perhaps the stimulus for her problem. 

The orbital floor was gone and the eye drooped down into the sinus when we were done. We used a polypropylene mesh sling to support the eye-which is onlevel with the other eye after surgery. She is healing well.
 


1/29/2017

CONGENTIAL URINARY INCONTINENCE

This 13 year old girl was incontinent of urine from birth. Its a a long story so I won't tell it all. We repaired the problem. She ended up with 3 ureters reimplanted into the bladder. Her pants are dry now.


TRA FLAP FOR FUNGATING BREAST CANCER


This Lady came in with a fungating breast cancer that was constantly bleeding. We felt it ws best to remove the cancer before giving her chem/XRT. We used a TRAM FLAP for reconstruction



1/26/2017


This 18 year old female came with a large left upper quadrant mass which had been growing for 1.5 years. Based on CT results, we thought we were dealing with a giant liver cyst. We were wrong. The patient had a giant retroperitoneal cyst of some type with the stomach, duodenum, pancreas and colon firmly attached to it. With careful dissection, we were able to dissect the cyst free.
Right upper quadrant mass
Apparent liver cyst
Cyst with stomach adherent
Stomach,  duodenum, pancreas, and colon dissected free
Dr. Uche Nkeonye
Ebere Erundo, surgical assistant
Retroperitoneal cyst
Specimen opened



1/24/2017

A PICTURE IS WORTH A THOUSAND WORDS


CHEST WALL RESECTION

Yesterday we operated on a 48 year old lady with a right flank/chest wall mass. The lady has neurofibromatosis which is benign but occasionally becomes malignant. The mass invaded ribs 9-12. Resection would require resection the mass and ribs and reconstruction of the chest wall. 



We resected the mass/ribs, transfered the diaphragm to the 8th rib and reconstructed the resulting defect with mesh. Everything came back together great and the patient did well overnight. We are awaiting her pathology


Resection of mass

Mass prior to removal

Mass removed and chest and abdomen opened with lung to right
Diaphragm reattached with PTFE patch

Defect reconstructed with mesh

Final result