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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This is how Paraumbilical hernia looks like and how it is examined although it looks very simple but in exam it can be very difficult to perform all steps in small amount of time. This can be short case or even long of #cpsp #fcps #mbbs #medicalstudent #mbbsexams #plab2 #plab #plab1 and MS #genernalknowledge #surgery exams

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LIS Closed done at 5 O clock position, using Scalpel blade 15. After feeling the groove between internal and external anal sphincter, the blade is passed in and the lower 1/2 of Internal anal sphincter is cut. Remain below dentate line. If anal mucosa is accidently cut suture with 4-0 rapid vicryl. In event of bleeding, pinchcock for 5 minutes.

A spermatocelectomy is surgery to remove a spermatocele. A spermatocele is a cyst (sac of fluid) that contains sperm. It forms inside your scrotum on the outside of your testicle. The cyst is most often attached to your epididymis. The epididymis is a tube that stores sperm.

This video demonstrate Bilateral Salpingectomy for a patient suffering from hematosalpinx of one side and Hydrosalpinx other side in which one IVF has failed. Laparoscopic salpingectomy. In this less-invasive procedure, the surgeon makes 1-3 small incisions in the lower abdomen, and inserts a laparoscope into the pelvis through one of the incisions. The camera at the end of the laparoscope guides the surgeon through the procedure. The fallopian tube tissue is then removed. For more information https://www.laparoscopyhospital.com/

For more information please contact:
World Laparoscopy Hospital
Cyber City, Gurugram, NCR DELHI
INDIA 122002
Phone & WhatsApp: +919811416838, + 91 9999677788

VirtaMed's new laparoscopy simulator starts with patient safety.

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For benign colorectal diseases, totally laparoscopic left-sided colectomy was already reported on some papers. Nowadays, there is increasingly demanded minimally invasive surgerys on malignant bowel diseases including colorectal cancers and so we developed the new techniques in that specimen is del...ivered through the open rectal stump, especially, using Sani Sleeve(TM). In this operation video, you can see that an anvil was fixed to proximal colonic stump with intracorporeal purse-string suture using Endo-stitch(TM). (SETA : Specimen Extraction Through Anus)

Robotic-assisted endoscopic thyroid surgery using the daVinci® Surgical System can safely and effectively offer those needing thyroid surgery relief without neck incisions. Dr. Ron Kuppersmith and Dr. Andrew deJong are now performing this procedure at the College Station Medical Center in Texas.

Giant cell tumour is a locally aggressive primary bone tumour, located eccentrically in the metaphysis and epiphysis of a long bone. It commonly affects distal end of Femur, proximal end of Tibia and distal end of Radius. It is occasionally reported in small bones of hand and foot[1], spine[2] and pelvis[3]. Though it occurs in 20 - 35 year old individuals commonly, it can also be seen in children as young as 2 years[4] and also in older individuals

Amazing animation: General Dentistry in 3D

Infected Hernia Mesh Repair Surgery Video

Surgery. A procedure to remove an epididymal cyst is carried out under general anaesthetic and involves removing the cysts through a small incision in your scrotum that is sealed with dissolvable stitches.

The fetal circulation is the circulatory system of a human fetus, often encompassing the entire fetoplacental circulation that also includes the umbilical cord and the blood vessels within the placenta that carry fetal blood.

The fetal circulation works differently from that of born humans, mainly because the lungs are not in use: the fetus obtains oxygen and nutrients from the mother through the placenta and the umbilical cord.

This video depicts how a stent is placed in the coronary artieries. We first place a guiding wire in the heart artery through a catheter, usually from the groin. Then the stent is inflated by a balloon in the artery, which is then removed. The stent remains permanently. Blood thinners, aspirin and plavix, are both required after a stent is placed in your heart artery.

The most common symptoms of infection from animal bites are redness, pain, swelling, and inflammation at the site of the bite. You should seek immediate medical treatment if any of these symptoms continue for more than 24 hours. Other symptoms of infection include: pus or fluid oozing from the wound

Hepatitis A is a highly contagious liver infection caused by the hepatitis A virus. The virus is one of several types of hepatitis viruses that cause inflammation and affect your liver's ability to function. You're most likely to contract hepatitis A from contaminated food or water or from close contact with someone who's infected. Mild cases of hepatitis A don't require treatment, and most people who are infected recover completely with no permanent liver damage. Practicing good hygiene, including washing hands frequently, is one of the best ways to protect against hepatitis A. Vaccines are available for people most at risk.

#ComprehensiveClinicalClass
History, Examination and Management of Hernia
Mentor: Dr. Nishanth, Consultant Surgeon, Bengaluru.

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