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Watch the BBC first on iPlayer 👉 https://bbc.in/iPlayer-Home http://www.bbc.co.uk/human Richard Edwards undergoes a double hand transplant in which his hands are amputated and replaced with hands from a donor. This is the first time this has been done. Three months later the new hands are already changing his life.
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How to perform a parotidectomy gland resection? In this video we take you step by step through the protid gland resection surgical technique. This video is intended for ENT residents and Head and Neck Surgery Surgeons. It is part of the ORL-Information's Head and Neck surgery Masterclass in collaboration with the University Hospital of Nîmes. Surgeons Editors: Pr. Benjamin LALLEMANT, MD, PhD - Dr. Camille GALY, MD Head and and Neck Department, University Hospital of Nîmes, France Official video | www.orl-information.fr
Cette vidéo présentent la technique de la parotidectomie avec dissection du nerf facial. Elle illustre les différents temps de l'intervention notamment le temps de repérage du nerf facial.
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Train with some of the region’s very best pediatric general surgeons — in a two-year, pediatric surgical fellowship training program at Nemours/Alfred I. duPont Hospital for Children. Our hospital’s Division of Pediatric Surgery is offering this program in affiliation with Sidney Kimmel Medical College at Thomas Jefferson University .
The goal of the fellowship is to give individuals who have completed an accredited general surgery residency advanced knowledge and training in the management and surgical treatment of newborns, infants and children.
Our Fellowship Program
This fellowship will help you prepare for certification by the American Board of Surgery, and is accredited by the Accreditation Council for Graduate Medical Education (ACGME).
The Pediatric Surgery Fellowship aims to:
train a well-rounded, empathetic, safe pediatric surgeon who is confident managing all aspects of the surgical care of children.
steward our fellow in quality improvement projects and methodology, and provide research opportunities.
provide a rigorous didactic curriculum for our fellow utilizing 360 degree feedback.
cultivate opportunities for our fellow to educate residents and students.
encourage our fellow to collaborate across specialties.
develop our fellow’s presentation skills during M&M conferences and multi-disciplinary educational meetings.
The program features the full participation of all nine of the pediatric surgical division’s full-time faculty members. Each of these physicians will contribute greatly to your education. Your training will include operating room and outpatient clinic experience, as well as bedside evaluation of children. You’ll also play a role in the organization of formal teaching conferences, held weekly. Formal rotations will be spent on Pediatric Urology, PICU and Neonatology during the first 12 months. The last year will be spent entirely on the Pediatric Surgical Service.
The majority of your inpatient consultative time will take place at Nemours/Alfred I. duPont Hospital for Children, a freestanding children’s hospital in Wilmington, Del. The hospital:
is nationally ranked by U.S. News & World Report in eight pediatric specialties
recently opened expansion with 260 beds
performs more than 2,800 inpatient and 9,300 outpatient surgical procedures each year in our operating rooms
has an on-site delivery center for newborns with complex congenital anomalies
receives more than 50,000 annual visits in our Emergency Department (ED)
is accredited by The American College of Surgeons as a Level One Pediatric Trauma Center
is accredited by the Commission on Accreditation of Rehabilitation Facilities (CARF)
Visit https://www.nemours.org/educat....ion/gme/fellowships/ to learn more.
Function and Anatomy: The hip is a ball and socket type joint, formed by the articulation of the head of the femur with the pelvis. Normal range of motion includes: abduction 45 degrees, adduction 20-30 degrees, flexion 135 degrees, extension 30 degrees, internal and external rotation. Hip pathology can cause symptoms anywhere around the joint, though frequently pain is anterior and radiates to the groin region. Additionally, pathology outside of the hip can be referred to this region. History and exam obviously help in making these distinctions.
Learn Basic Laparoscopic Surgery, the components of a laparoscopic surgical setup, optimal positioning and ergonomics in laparoscopic surgery, and much more. Check out the full course for free here: https://www.incision.care/free-trial
What is Laparoscopic Surgery:
Laparoscopic surgery describes procedures performed using one or multiple small incisions in the abdominal wall in contrast to the larger, normally singular incision of laparotomy. The technique is based around principles of minimally invasive surgery (or minimal access surgery): a large group of modern surgical procedures carried out by entering the body with the smallest possible damage to tissues. In abdominopelvic surgery, minimally invasive surgery is generally treated as synonymous with laparoscopic surgery as are procedures not technically within the peritoneal cavity, such as totally extraperitoneal hernia repair, or extending beyond the abdomen, such as thoraco-laparoscopic esophagectomy. The term laparoscopy is sometimes used interchangeably, although this is often reserved to describe a visual examination of the peritoneal cavity or the purely scopic component of a laparoscopic procedure. The colloquial keyhole surgery is common in non-medical usage.
Surgical Objective of Laparoscopic Surgery:
The objective of a laparoscopic approach is to minimize surgical trauma when operating on abdominal or pelvic structures. When correctly indicated and performed, this can result in smaller scars, reduced postoperative morbidity, shorter inpatient durations, and a faster return to normal activity. For a number of abdominopelvic procedures, a laparoscopic approach is now generally considered to be the gold-standard treatment option.
Definitions
Developments of Laparoscopic Surgery:
Following a number of smaller-scale applications of minimally invasive techniques to abdominopelvic surgery, laparoscopic surgery became a major part of general surgical practice with the introduction of laparoscopic cholecystectomy in the 1980s and the subsequent pioneering of endoscopic camera technology. This led to the widespread adoption of the technique by the early- to mid-1990s. The portfolio of procedures that can be performed laparoscopically has rapidly expanded with improvements in instruments, imaging, techniques and training — forming a central component of modern surgical practice and cross-specialty curricula [2]. Techniques such as laparoscopically assisted surgery and hand-assisted laparoscopic surgery have allowed the application of laparoscopic techniques to a greater variety of pathology. Single-incision laparoscopic surgery, natural orifice transluminal endoscopic surgery, and minilaparoscopy-assisted natural orifice surgery continue to push forward the applications of minimally invasive abdominopelvic techniques; however, the widespread practice and specific indications for these remain to be fully established. More recently, robotic surgery has been able to build on laparoscopic principles through developments in visualization, ergonomics, and instrumentation.
This Basic Laparoscopic Surgery Course Will Teach You:
- Abdominal access techniques and the different ways of establishing a pneumoperitoneum
- Principles of port placement and organization of the operative field
- Key elements of laparoscopic suturing, basic knotting and clip application
Specific attention is paid to the following hazards you may encounter:
- Fire hazard and thermal injury
- Lens fogging
- Contamination of insufflation system
- Complications from trocar introduction
- Limitations of Veress needle technique
- Limitations of open introduction technique
- Complications of the pneumoperitoneum
- Gas embolism
- Mirroring and scaling of instrument movements
- Firing clip applier without a loaded clip
The following tips are designed to improve your understanding and performance:
- Anatomy of a laparoscope
- Checking for optic fiber damage
- "White balance" of camera
- Checking integrity of electrosurgical insulation
- Access at Palmer's point
- Lifting abdominal wall before introduction
- Confirming position of Veress needle
- Umbilical anatomy
- Identification of inferior epigastric vessels under direct vision
- Translumination of superficial epigastric vessels
- Selection of trocar size
- Aiming of trocar
- Working angles in laparoscopic surgery
- Choice of suture material
- Instruments for suturing
- Optimal ergonomics for suturing
- Extracorporeal needle positioning
- Optimal suture lengths
- "Backloading" needle
- Intracorporeal needle positioning
- Hand movements when suturing
- Optimal positioning of scissors
- Extracorporeal knot tying
- Visualization of clip applier around target structure
- Common clip configurations
Shoulder Clinical Examination - Medical School Clinical Skills - Dr Gill
Personally, I find the shoulder examination the most complex examination possibly as there are so many variations and special tests. Some of which overlap and some will relate specifically to a patients presentation.
Often in a medical school syllabus, only select special tests will be used. In this shoulder exam demonstration, we include the Hawkins-Kennedy Test looking for impingement. This is dovetailed with examination for bicipital tendonitis as this is another possible cause of impingement type symptoms.
This shoulder upper limb exam follows the standard "Look, Feel, Move" orthopaedic exam approach, and overall order as set out in MacLeods Clinical Examination
Watch further orthopaedic examinations for your OSCE revision:
The Spine Examination:
https://youtu.be/pJxMHa6SCgU
Knee Examination
https://youtu.be/oyKH4EYfJDM
Hip Joint Clinical Examination
https://youtu.be/JC9GKq5nSdQ
________
Please note that there is no ABSOLUTE way to perform a clinical examination. Different institutions and even clinicians will have differing degrees of variations - the aim is the effectively identify medically relevant signs.
However during OSCE assessments. Different medical schools, nursing colleges, and other health professional courses will have their own preferred approach to a clinical assessment - you should concentrate on THEIR marks schemes for your assessments.
The examination demonstrated here is derived from Macleods Clinical Examination - a recognized standard textbook for clinical skills.
#ShoulderExamination #ClinicalSkills #DrGill
Protopic Vitiligo, Weiße Flecken Am Rücken, Pigmentflecken Im Gesicht Entfernen, Flecken Haut--- http://vitiligo-heilung.info-pro.co --- Weiße Flecken auf der Haut: Vitiligo, Die Entwicklung weißer Flecken auf der Haut ist ist ein Symptom einer Hautstörung, die Vitiligo genannt, im deutschen Sprachgebrauch aber auch häufig als "Weißfleckenkrankheit" bezeichnet wird. Man bringt den Zustand mit der Zerstörung oder Fuktionsstörung der Hautzellen in Verbindung, die für die Herstelleung des Hautpigmentes (Melanin) zuständig sind, welches dem Menschen seine Hautfarbe verleiht. Meistens entwickeln sich die Flecken dabei an Stellen, die oft der Sonne ausgesetzt sind, also z.B. die Hände, Arme, Füße, Beine und das Gesicht. Bisweilen treten die Flecken aber auch in den Achselhöhlen, im Genitalbereich und um den Bauchnabel herum auf. Von Vitiligo betroffene erleben häufig auch ein vorzeitiges Ergrauen der Haare. Es wird geschätzt, dass mindestens 1 % der Bevölkerung der Vereinigten Staaten an Vitiligo leidet; in Europe sind die Zahlen ähnlich. Weltweit leiden gegenwärtig mehr als 100 Millionen Menschen an der Hauterkrankung. Die Ursache von Vitiligo Die genaue Ursache der Erkrankung ist noch immer unbekannt. Eine der populärsten Theorien ist jedoch, dass es sich bei Vitiligo um eine Autoimmunstörung handelt. Sie veranlasst das Immunsystem, die Melanozyten (die Hautpigmente produzierenden Hautzellen) anzugreifen. In der Tat haben Menschen, die an einer anderen Autoimmunstörung, wie adrenocorticaler Unterfunktion or Schilddrüsenüberfunktion leiden, ein weitaus höheres Risiko, auch an Vitiligo zu erkranken. Manche Mediziner sind auch der Auffassung, dass Sonnenbrände, emotionaler Stress und bestimte Medikamente die weißen hautflecken hervorrufen könnten. Es wird außerdem geglaubt, dass Vitiligo is also believed eine genetisch vererbte Erkrankung darstellt. Behandlungsoptionen für Vitiligo Für Vitiligo gibt es unterschiedliche Behandlungsmöglichkeiten. Allerdings sind sie allesamt praktisch wirkungslos und beinhalten dazu noch das Risiko, ernsthafte Nebenwirkungen hervorzurufen. Krankenversicherer übernehmen zudem die vollen Behandlungskosten. Das allein macht eine Vitiligo-Behandlung bereits zu teuer für die meisten Patienten, denn es sind üblichwerweise zwei bis drei Besuche wöchentlich in ener Spezialklinik nötig. Ein Paradebeispiel für eine solche Behandlung ist die sogenannte PUVA-Therapie, die ausgesprochen häufig eingesetzt wird. "Gratis-Präsentation enthüllt einen ziemlich ungewöhnlichen Tipp zur Beseitigung von Vitiligo für alle Zeiten und in nur 45-60 Tagen - Garantiert!" http://vitiligo-heilung.info-pro.co Erfahren Sie mehr darüber, indem Sie diese Webseite besuchen: http://vitiligo-heilung.info-pro.co
A flail chest occurs when a segment of the thoracic cage is separated from the rest of the chest wall. This is usually defined as at least two fractures per rib (producing a free segment), in at least two ribs. A segment of the chest wall that is flail is unable to contribute to lung expansion. Large flail segments will involve a much greater proportion of the chest wall and may extend bilaterally or involve the sternum. In these cases the disruption of normal pulmonary mechanics may be large enough to require mechanical ventilation.
This patient has infectious mononucleosis (IM), a disease caused by the Epstein-Barr virus. IM is a systemic viral infection that is usually seen in children and adolescents. The common presentation is fever with pharyngitis or tonsillitis, cervical adenopathy, splenomegaly, and mild hepatitis.