Kal Mehdi MD

ROBOT 🤖 DAY- the ‘DaVinci’ Surgical system has been a widely utilized technology amongst multiple surgical disciplines. {pic #2} It could provide surgeons with better self-sufficiency as well as enhanced visualization & precision. For patients it offers shorter operative time or time under anesthesia, quicker recovery and often same day discharge! Case above involves female in her 40’s suffering from abnormally heavy periods & chronic pelvic pain due to multiple large fibroids for several years. Robotic-assisted laparoscopic hysterectomy (removal of uterus, cervix and the fibroid tumors {pic #4}) was performed with modest blood loss and the pt was discharged home few hours after surgery. 🤖🤖🤖

Follicular Cyst- or the common ‘ovarian cyst’ originates from a normal physiologic process of follicle formation that occurs monthly in women with regular cycles. Occasionally some of those follicles persist after ovulation has occurred and fill up with fluid or blood and could expand to abnormally large cysts. Most common symptom is pelvic pain that tends to be on the side of the existing cyst. Case above is of a young woman in her 20’s with chronic pelvic pain on the right side. On CT imaging a enlarged mass was noted coming off her right o***y; 13.5 cm in diameter and pushing up against her ureter on the right side causing swelling in the outflow tract of the kidney on that side (Hydronephrosis). Diagnostic laparoscopy was performed revealing ovarian cyst on right side (pic #2). The cyst was punctured and fluid completely suctioned leaving redundant wall of now deflated cyst (pic #3) that was then resected and sent to pathology (pic #4). Patient did well post-operatively and went home the same day!

Ovarian Cystadenofibroma- is a relatively rare type of tumors of the o***y that contains a mix of both epithelial & fibrous stromal cells (giving its mixed soft & hard components grossly-pic #4). It is not a malignant (cancerous) tumor; however on diagnostic imaging can usually seen as a ‘complex’ mass containing cystic & solid components and could resemble a malignant tumor. This case includes a 70 year old female with chronic pelvic pain specifically in her right lower quadrant for about 4-6 weeks; symptoms present daily with pain not always responsive to Advil. Ultrasound revealed 4x6x3.5 cm complex mass on her right o***y. Pt taken for surgery: diagnostic laparoscopy & enlarged right o***y with mass noted (pic #2&3). Right o***y & tube were removed and sent to pathology confirming diagnosis. Patient doing well post-operatively and pain significantly improved.