Obstetrics & Laparoscopy
Case Report #OG-2026-04
Laparoscopic Myomectomy & Fertility Restoration in Large Intramural Fibroid (8.5 cm)
Lead Surgeon: Dr. P. Shankari (MBBS, MD OG, DRM Kiel Germany, FMAS)
Patient History: A 31-year-old nulliparous woman presented with severe menorrhagia, secondary dysmenorrhea, and primary infertility of 3 years duration. Ultrasound and MRI revealed a large 8.5 cm FIGO Type 3 intramural fibroid distorting the posterior uterine wall and endometrial cavity.
Surgical Approach: Under laparoscopic guidance (FMAS protocol), a posterior vertical hysterotomy was performed using vasopressin hydrodissection. The fibroid was enucleated intact without entering the endometrial cavity. Multi-layer barbed suture uterine reconstruction was completed to ensure myometrial integrity for future pregnancy.
Clinical Outcome: Operative time 65 mins, blood loss <50 ml. Patient discharged within 24 hours. At 6-month follow-up, menstrual cycles normalized, cavity distortion resolved completely, and successful spontaneous conception occurred at 8 months post-op.
Orthopedics & Spine
Case Report #OR-2026-02
L4-L5 Micro-Decompression & Sciatica Recovery Without Spinal Fusion
Lead Surgeon: Dr. N. Rajkumar (MBBS, MS Ortho, DNB, MNAMS)
Patient History: A 44-year-old male presented with severe right L5 radiculopathy, foot drop threat, and intense buttock-to-toe shooting pain (VAS score 9/10) persistent for 8 weeks despite conservative physical therapy. MRI confirmed a large extruded paracentral disc herniation compressing the right L5 nerve root.
Surgical Approach: Targeted right-sided L4-L5 micro-laminotomy and discectomy were executed. Nerve root decompression was verified under high-magnification loupe magnification with minimal muscular disruption, avoiding rigid hardware spinal fusion.
Clinical Outcome: Immediate postoperative resolution of radicular leg pain. Patient mobilized on Day 1 without neuro deficit and resumed light sedentary work within 2 weeks.
High-Risk Obstetrics
Case Report #OG-2026-09
Management of Severe Preeclampsia with Twin Gestation at 34 Weeks (HRP A+++ Protocol)
Lead Obstetrician: Dr. P. Shankari (Coordinator HRP A+++ Assessment)
Patient History: A 29-year-old primigravida with diamniotic dichorionic (DADC) twin pregnancy presented at 33+4 weeks gestation with sudden-onset headache, visual scotoma, blood pressure 170/110 mmHg, and 3+ proteinuria.
Clinical Management: Emergency admission under Coordinator HRP A+++ Assessment protocols. Intravenous Labetalol titration and Magnesium Sulfate seizure prophylaxis were instituted alongside continuous electronic fetal monitoring and corticosteroid administration for fetal lung maturation.
Clinical Outcome: Elective emergency Caesarean delivery at 34+2 weeks yielded healthy Twin 1 (2.1 kg) and Twin 2 (1.95 kg) with APGAR 8/9 and 9/10. Maternal blood pressure stabilized post-partum with complete resolution of proteinuria by Day 5.
Orthopedics & Trauma
Case Report #OR-2026-07
Biological Open Reduction & Internal Fixation of Complex Comminuted Femoral Shaft Fracture
Lead Surgeon: Dr. N. Rajkumar (MBBS, MS Ortho, DNB, MNAMS)
Patient History: A 26-year-old male victim of a road traffic accident sustained a closed Winquist Type III comminuted mid-shaft left femur fracture.
Surgical Approach: Closed intermedullary interlocking reamed nailing was executed under fluoroscopic control (C-arm) preserving fracture hematoma and periosteal blood supply.
Clinical Outcome: Partial weight-bearing walking achieved at 3 weeks with crutches. Full cortical bridging callus observed at 12 weeks with 100% limb length equality and full knee extension.