Pilomatricoma is a rare and mostly benign tumour arising from the hair follicles, generally located in the head and neck region and less frequently on the trunk. It may be clinically confused with rather commonly occurring pathologies like sebaceous cyst, pyogenic granuloma or even malignancy. Thus, the first and foremost step towards its management is to arrive at a convincing diagnosis, and the next is to aim at its complete excision to prevent local recurrence. In this paper, we present an unusual case of an ulcerated pilomatricoma of the chest wall in an adult male. Although its gross appearance deceptively pointed towards a malignant cause, to our surprise, it ultimately proved to be benign on histological examination. Therefore, the crux of this report is to encourage the present-day surgeon to consider pilomatricoma as an important differential before undertaking any "step-of-no-return" like an avoidable radical excision and its attending morbidity. To our knowledge, such a case has not been reported in the available literature.
Cooperative laparoscopic endoscopic intra-gastric surgery, with its ability to acquire advantages of both these technologies, is a recent development in the field of minimally invasive surgery. However, the pre-requisition of its multi-disciplinary approach together with several technical constraints have, plausibly, limited its widespread acceptance. The ever-increasing number of modifications being reported in today's literature largely underscores the inability of any one to be the best. We illustrate a novel, simple-to-learn, rapid and potentially cost-effective technique of intra-gastric surgery using just the routine laparoscopic instruments, and name it the 'Jategaonkar technique'. We have practised it in seven consecutive patients without any complications; and hence, recommend it for regular application. Such a method is yet to be described in the literature.
An unambiguous identification of anterior rectus sheath (ARS) is a crucial initial step required for precise umbilical porting in order to achieve successful execution of laparoscopic totally extra-peritoneal (TEP) hernioplasty. However, it is scarcely discussed in the present-day literature. Backed with the experience of 1100 cases, we present an easy and rapid technique of exposing the anterior rectus sheath with the aim to save operative time without compromising the safety. Such a method is yet to be described in the literature.
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