Care must be taken to prevent stenosis at the anastomotic site. If the diameter of the anastomosis is less than 2 cm, the anastomosis should be taken down and resected. A classic end-to-end anastomosis should be performed to ensure adequate diameter to the intestine. If the posterior wall of the colon has been preserved, care should be taken to close the colostomy prior to opening the peritoneal cavity. This will reduce intraperitoneal contamination from the stoma site. Copious irrigation of the wound should be made prior to primary closure. If gross contamination has occurred, delayed closure of the wound should be considered.

Bartter syndrome is a rare inherited defect in the thick ascending limb of the loop of Henle. It is characterized by low potassium levels (hypokalemia), increased blood pH (alkalosis), and normal to low blood pressure. There are two types of Bartter syndrome: neonatal and classic

Amniotomy is the official term for artificially breaking the bag of waters during labor. It is believed that breaking the bag of waters will help to speed up an otherwise slow labor. Amniotomy is part of the Active Management of Labor practiced in some hospitals. Amniotomy is performed by a midwife or doctor. A long, thin instrument with a hook on the end is inserted into the vagina and through the cervix so it can catch and rip the bag of waters. To perform an amniotomy, the cervix must be dilated enough to allow the instrument through the cervix, generally at least a two. Why choose Amniotomy? Unlike other medical methods of starting labor, amniotomy does not add synthetic hormones to your labor. Instead it seems to stimulate your body’s own labor process. Amniotomy allows the use of an internal electronic fetal monitor. How effective is Amniotomy? Amniotomy alone is unpredictable, it may take hours for labor to start with amniotomy. Because amniotomy increases the risk for infection, most caregivers use amniotomy in combination with synthetic oxytocin. Birth does happen faster when amniotomy is combined with synthetic oxytocin than when amniotomy is used alone. Risks of Amniotomy Risks for Mother Increases the risk for infection. This risk is increased with length of time the waters are broken and with vaginal exams. Because of the infection risk, a time limit is given by which the mother must give birth. As the time limit approaches attempts to progress labor will become more aggressive. The fore waters equalize pressure on the cervix so it will open uniformly. When they are broken, the mother increases her chances of having uneven dilation. Risks for Baby Increases the risk of umbilical cord compression. The fore waters equalize pressure on the baby’s head as it presses against the cervix. When they are broken, the pressure on the baby’s head may be uneven causing swelling in some parts.

Dr. Debbie Song at Gillette Children's describes in detail selective rhizotomy surgery.

A selective dorsal rhizotomy is an operation performed to treat spasticity. It is thought that high tone and spasticity arise from abnormal signals that are transmitted through sensory or dorsal nerve roots to the spinal cord. In a selective dorsal rhizotomy we identify and cut portions of the dorsal nerve roots that carry abnormal signals thereby disrupting the mechanisms that lead to spasticity. Potential patients go through a rigorous assessment that includes an in-depth gait and motion analysis as well as a physical therapy evaluation.

They are evaluated by a multidisciplinary team that includes a pediatric rehabilitation doctor, a neurosurgeon, and an orthopedist, Appropriate patient selection is vital. Ideal candidates for selective dorsal rhizotomy are children who are between four and ten years of age, have a history of being born prematurely, and have a diagnosis of diplegia cerebral palsy. These patients usually walk independently or with the assistance of crutches or a walker. They typically function at a level one, two, or three in the gross motor function classification system or gmfcs. A selective dorsal rhizotomy involves the coordinated efforts of the neurosurgery, physiatry, anesthesia and nursing teams. The operation entails making an incision in the lower back that is approximately six to eight inches long. We perform what we call a laminoplasty in which we remove the back part of the spinal elements from the lumbar one or l1 to l5 levels. At the end of the procedure the bone is put back on. We identify and open up the Dural sac that contain the spinal fluid spinal cord and nerve roots. Once the Dural sac is opened ,we expose the lumbar and upper sacral nerve roots that transmit information to and from the muscles of the lower extremities.

At each level we isolate the dorsal nerve root, which in turn is separated into as many as 30 smaller thread light fruitlets.

Each rootlet is then electrically stimulated. Specialized members of the physiatry team look for abnormal responses in the muscles of the legs as each rootless is being stimulated. If an abnormal response is observed then the rootlet is cut.

If a normal response is observed, then the rootlet is not cut. We usually end up cutting approximately 20 to 40 percent of the rootlets. The Dural sac is sutured closed and the l1 through l5 spinal elements are put back into anatomic position, thus restoring normal spinal alignment. The overlying tissues and skin are then closed and the patient is awoken from surgery. The entire operation takes between four and five hours. A crucial component to the success of our rhizotomy program is the extensive rehabilitation course following surgery. With their tone significantly reduced after a rhizotomy, patients relearn how to use their muscles to walk more efficiently through stretching, strengthening, and gait training. Approximately one to two years after a rhizotomy patients undergo repeat gait and motion analysis. The orthopedic surgeons assess the need for interventions to correct bone deformities, muscle contractures, poor motor control, impaired balance, or other problems related to cerebral palsy.

At Gillette we work closely with patients and families to ensure that our selective dorsal rhizotomy program meets their goals for enhancing their function and improving their quality of life.

VISIT https://www.gillettechildrens.org/ to learn more

0:00 Why choose selective dorsal rhizotomy?
0:56 Who is a good candidate for selective dorsal rhizotomy?
1:31 What does a selective dorsal rhizotomy entail?
3:26 What is recovery from selective dorsal rhizotomy like?

Ganglion cysts are noncancerous lumps that most commonly develop along the tendons or joints of your wrists or hands. They also may occur in the ankles and feet. Ganglion cysts are typically round or oval and are filled with a jellylike fluid. Small ganglion cysts can be pea-sized, while larger ones can be around an inch (2.5 centimeters) in diameter. Ganglion cysts can be painful if they press on a nearby nerve. Their location can sometimes interfere with joint movement. If your ganglion cyst is causing you problems, your doctor may suggest trying to drain the cyst with a needle. Removing the cyst surgically also is an option. But if you have no symptoms, no treatment is necessary. In many cases, the cysts go away on their own.

Tears Of Abortion - Story of an aborted baby,

Many over-the-counter medications can help relieve heartburn. The options include: Antacids, which help neutralize stomach acid. Antacids may provide quick relief. But they can't heal an esophagus damaged by stomach acid. H-2-receptor antagonists (H2RAs), which can reduce stomach acid. H2RAs don't act as quickly as antacids, but may provide longer relief. Proton pump inhibitors, such as lansoprazole (Prevacid 24HR) and omeprazole (Prilosec OTC), which also can reduce stomach acid.

Thought a snake in your boot was bad? That old 19th-century idiom is nothing compared to one in your ear.

Shocking footage captured the alleged moment that a “surgeon” tried to remove a live snake that infiltrated a woman’s ear. Video of the herpetological surgery has racked up more than 125,000 views as viewers speculate whether or not the squirm-inducing footage is authentic.

“The snake has gone in the ear,” reads the caption to the bizarre Facebook clip, which was posted Sept. 1 by an India-based social media star named Chandan Singh to his 20,126 followers. However, it’s unclear where, when or how this unfortunate event transpired, local outlet the Economic Times reported.

In the nearly four-minute clip, an alleged medical practitioner can be seen using tweezers in a desperate attempt to extract a black and yellow serpent that’s peeking its head out from a female patient’s ear.

Twin Childbirth Video

Bimanual Hip Examination of the Female genitalia

If you're pregnant, you're likely paying extra close attention to your body. If you happen to feel a cramp you may worry that it is a sign of a miscarriage. While the first trimester is the most common time for miscarriages, there are other reasons for cramps. Whether it signals a miscarriage depends on when it occurs, the severity of the cramping, and whether you're experiencing other symptoms alongside it.

A video showing the steps of cesarean section surgery

A video showing the repair of episiotomy

Professional breast exam

All you need to know about the Types of Female Genital Discharge

Bone cancer symptoms. Possible symptoms of bone cancer include: Bone pain: Pain is the most common sign of bone cancer, and may become more noticeable as the tumor grows. Bone pain can cause a dull or deep ache in a bone or bone region (e.g., back, pelvis, legs, ribs, arms).

A hernia occurs when an organ or fatty tissue squeezes through a weak spot in a surrounding muscle or connective tissue called fascia. The most common types of hernia are inguinal (inner groin), incisional (resulting from an incision), femoral (outer groin), umbilical (belly button), and hiatal (upper stomach).

An abdominal hysterectomy is a surgical procedure that removes your uterus through an incision in your lower abdomen. Your uterus — or womb — is where a baby grows if you're pregnant. A partial hysterectomy removes just the uterus, leaving the cervix intact. A total hysterectomy removes the uterus and the cervix. Sometimes a hysterectomy includes removal of one or both ovaries and fallopian tubes, a procedure called a total hysterectomy with salpingo-oophorectomy (sal-ping-go-o-of-uh-REK-tuh-me). A hysterectomy can also be performed through an incision in the vagina (vaginal hysterectomy) or by a laparoscopic or robotic surgical approach — which uses long, thin instruments passed through small abdominal incisions.

A quick look at an early stage stomach abnormality.

(cryptorchidism) is a testicle that hasn't moved into its proper position in the bag of skin hanging below the penis (scrotum) before birth. Usually just one testicle is affected, but about 10 percent of the time both testicles are undescended. An undescended testicle is uncommon in general, but common among baby boys born prematurely. The vast majority of the time, the undescended testicle moves into the proper position on its own, within the first few months of life. If your son has an undescended testicle that doesn't correct itself, surgery can relocate the testicle into the scrotum.