Hemophagocytic lymphohistiocytosis is a rare but life threatening condition characterised by activation of macrophages which result in phagocytosis of RBCs and cytokine mediated tissue damage. This presentation aims to discuss the genetic basis, clinical features, diagnostic criteria and management options in this serious condition. The management options in HLH include Etoposide, Dexamethasone, Cyclosorine, Tacrolimus, Alemtuzumab and stem cell transplant.

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Dr. Joseph McGinn explains minimally invasive bypass, the procedure he pioneered as an alternative to open heart surgery.

A video describing the procedure of colonoscopy or flexible fibre-optic examination of the colon.

Children are special patients, and their medical needs are unique, including their surgical needs. At UNC Hospitals, an expert and experienced team of physicians treat children in a kid-friendly and family-centered environment. UNC Pediatric Surgeon Dr. Timothy Weiner explains

Breast masses are broadly classified as benign or malignant. Common causes of a benign breast mass include fibrocystic disease, fibroadenoma (see the image below), intraductal papilloma, and abscess.

It is very important to instruct your patients about how to self exam their breasts for any abnormalities or masses for early detection of any changes

Patient Glenn Williams had a hernia measuring 20cm x 30cm. Consultant Graham Offer has performed ground breaking surgery to help Glenn.

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?

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Hemorrhoidectomy Ligasure

A video showing the repair of episiotomy

A surgical video showing Femoro-Popliteal Bypass with a Saphenous Vein Graft

this video about identifying a hernia vs a cyst

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This condition is seen in imperforate hymen or transverse vaginal septum. Pt presents with primary amenorrhea. Dr Hemant Damle Prof Dept of OBGYN SKNMC Pune India

Possible complications could include: Difficulty healing. Infection. Stump pain (severe pain in the remaining tissue) Phantom limb pain (a painful sensation that the foot or toe is still there) Continued spread of gangrene, requiring amputation of more areas of your foot, toes or leg. Bleeding. Nerve damage.

Penile implant surgery for dysfunctional erection of the penis

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