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An abscess is an infectious process characterized by a collection of pus surrounded by inflamed tissue. [1, 2] Abscesses can form anywhere in the body, from a superficial skin (subcutaneous) abscess to deep abscesses in muscle, organs, or body cavities. Patients with subcutaneous skin abscesses present clinically as a firm, localized, painful, erythematous swelling that becomes fluctuant (see the image below).
For a full Surgical Airway Techniques resource: https://bit.ly/2rb9Nud
Video courtesy of Gauri Mankekar, MBBS, MS, PhD
Dr. Ailawadi, M.D., the Chair of Cardiac Surgery at Michigan Medicine, specializes in minimally invasive valve surgery as well as complex cardiac operations. This video shows step by step footage of a Coronary Artery Bypass Graft (CABG) in a complex patient. In this case, CABG was performed through a sternotomy (through the breast bone) using the internal thoracic artery and saphenous leg veins to bypass obstructed coronary arteries. In this video, Dr. Ailawadi will perform a triple vessel bypass (CABG) which has been shown to minimize the risk of future heart attack and help patients live longer in the setting of complex coronary artery disease.
To learn more about cardiac surgery at Michigan Medicine, visit: https://medicine.umich.edu/dept/cardiac-surgery
To learn more about Frankel Cardiovascular Center, visit: https://www.umcvc.org/
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Chapters
0:00 Introduction
1:04 Why do doctors perform laparoscopy?
2:11 How is laparoscopy performed?
3:22 Result
3:47 Risk of laparoscopy
Laparoscopy (from Ancient Greek λαπάρα (lapára) 'flank, side', and σκοπέω (skopéō) 'to see') is an operation performed in the abdomen or pelvis using small incisions (usually 0.5–1.5 cm) with the aid of a camera. The laparoscope aids diagnosis or therapeutic interventions with a few small cuts in the abdomen.[1]
Laparoscopic surgery, also called minimally invasive procedure, bandaid surgery, or keyhole surgery, is a modern surgical technique. There are a number of advantages to the patient with laparoscopic surgery versus an exploratory laparotomy. These include reduced pain due to smaller incisions, reduced hemorrhaging, and shorter recovery time. The key element is the use of a laparoscope, a long fiber optic cable system that allows viewing of the affected area by snaking the cable from a more distant, but more easily accessible location.
Laparoscopic surgery includes operations within the abdominal or pelvic cavities, whereas keyhole surgery performed on the thoracic or chest cavity is called thoracoscopic surgery. Specific surgical instruments used in laparoscopic surgery include obstetrical forceps, scissors, probes, dissectors, hooks, and retractors. Laparoscopic and thoracoscopic surgery belong to the broader field of endoscopy. The first laparoscopic procedure was performed by German surgeon Georg Kelling in 1901. There are two types of laparoscope:[2]
A telescopic rod lens system, usually connected to a video camera (single-chip or three-chip)
A digital laparoscope where a miniature digital video camera is placed at the end of the laparoscope, eliminating the rod lens system
The mechanism mentioned in the second type is mainly used to improve the image quality of flexible endoscopes, replacing conventional fiberscopes. Nevertheless, laparoscopes are rigid endoscopes. Rigidity is required in clinical practice. The rod-lens-based laparoscopes dominate overwhelmingly in practice, due to their fine optical resolution (50 µm typically, dependent on the aperture size used in the objective lens), and the image quality can be better than that of the digital camera if necessary. The second type of laparoscope is very rare in the laparoscope market and in hospitals.[citation needed]
Also attached is a fiber optic cable system connected to a "cold" light source (halogen or xenon) to illuminate the operative field, which is inserted through a 5 mm or 10 mm cannula or trocar. The abdomen is usually insufflated with carbon dioxide gas. This elevates the abdominal wall above the internal organs to create a working and viewing space. CO2 is used because it is common to the human body and can be absorbed by tissue and removed by the respiratory system. It is also non-flammable, which is important because electrosurgical devices are commonly used in laparoscopic procedures.[3]
Procedures
Surgeons perform laparoscopic stomach surgery.
Patient position
During the laparoscopic procedure, the position of the patient is either in Trendelenburg position or in reverse Trendelenburg. These positions have an effect on cardiopulmonary function. In Trendelenburg's position, there is an increased preload due to an increase in the venous return from lower extremities. This position results in cephalic shifting of the viscera, which accentuates the pressure on the diaphragm. In the case of reverse Trendelenburg position, pulmonary function tends to improve as there is a caudal shifting of viscera, which improves tidal volume by a decrease in the pressure on the diaphragm. This position also decreases the preload on the heart and causes a decrease in the venous return leading to hypotension. The pooling of blood in the lower extremities increases the stasis and predisposes the patient to develop deep vein thrombosis (DVT).[4]
Gallbladder
Rather than a minimum 20 cm incision as in traditional (open) cholecystectomy, four incisions of 0.5–1.0 cm, or more recently, a single incision of 1.5–2.0 cm,[5] will be sufficient to perform a laparoscopic removal of a gallbladder. Since the gallbladder is similar to a small balloon that stores and releases bile, it can usually be removed from the abdomen by suctioning out the bile and then removing the deflated gallbladder through the 1 cm incision at the patient's navel. The length of postoperative stay in the hospital is minimal, and same-day discharges are possible in cases of early morning procedures.[citation needed]
Colon and kidney
This video provides a guide peforming a respiratory examination in an OSCE station, including real-time auscultation sounds of common pathology such as coarse crackles, fine crackles, wheeze and stridor.
You can access our step-by-step OSCE guide to accompany this video here: https://geekymedics.com/respiratory-examination-2/
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Chapters:
- Introduction 00:00
- General inspection 00:40
- Inspection of the hands 00:50
- Schamroth's window test 01:09
- Heart rate and respiratory rate 01:50
- Jugular venous pressure 02:02
- Face, eyes and mouth 02:13
- Anterior chest inspection 02:36
- Trachea and cricosternal distance 03:01
- Palpation of apex beat 03:16
- Chest expansion 03:28
- Lung percussion 03:50
- Auscultation of lungs 04:21
- Vocal resonance 05:03
- Lymph node palpation 05:32
- Inspection of posterior chest 06:04
- Posterior chest expansion 06:10
- Percussion of posterior chest 06:32
- Auscultation of posterior chest 06:55
- Sacral and pedal oedema 08:04
- Summary of findings 08:39
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Always adhere to your medical school/local hospital guidelines when performing examinations or clinical procedures. DO NOT perform any examination or procedure on patients based purely upon the content of these videos. Geeky Medics accepts no liability for loss of any kind incurred as a result of reliance upon the information provided in this video.
Some people have found this video useful for ASMR purposes.
Special thanks to www.easyauscultation.com and Andy Howes for providing some of the respiratory sounds.
http://www.highimpact.com - This brain surgery animation was used to demonstrate a young girl's craniotomy, cranioplasty, and reconstructive skull surgery after her vehicle was struck by a tractor-trailer. The procedures included the evacuation of a large epidural hematoma, the draining of the epidural space, and the reassembly of bone fragments to repair the skull.
More Brain Surgery Animations: https://tinyurl.com/y6m4lkdf
WHAT HAPPENED
A teenage girl was riding home with her parents and boyfriend from a Wednesday night church service when a tractor-trailer struck the back driver’s side of their car as they were traveling through an intersection. The impact sent the car spinning into oncoming traffic where it struck another vehicle. When paramedics arrived, the 17-year-old was unresponsive with bleeding from her left ear and a laceration from behind her left ear.
She was rushed to the hospital where she underwent a series of CT scans that showed a severely comminuted open skull fracture with an underlying 1.1 cm subdural hematoma. She was taken to the operating room where an emergency craniotomy was performed to evacuate the hematoma and reassemble the skull fragments. The patient gradually began to wake up and was discharged six days later, after she showed she could maneuver up and down the hallway.
The biggest challenge in a traumatic brain injury case like this - where most of the damages are deeply underlying and undetectable on the surface - is that the only visual evidence is in the form of 2D black-and-white radiographic films. This can look ambiguous to the typical juror because it’s often difficult to discern where these snapshots are located inside the person’s skull. Tony Seaton, Esq., and Robert Bates, Esq., needed to reinforce this 2D radiographic evidence with maximum 3D context.
We equipped them with a custom Diagnostic Slice Chooser: an interactive presentation that presents radiographic slides within a three-dimensional model of the patient’s head. We also designed the model accurately to the patient’s likeness and colorized the films to highlight key areas of damage. The attorneys could show the complete depth and magnitude of his client’s injuries at every level both before and after the surgery. After establishing the full extent of damages, we also created an animation to walk viewers through the surgical experience the patient would undergo as a result of her injuries.
The visual presentation helped jurors understand the destructive impact this collision had on this young teenager’s life, and Mr. Seaton and Mr. Bates, Esq., were able to acquire a $4.5M settlement for his client.
Read the Full Case Study: https://tinyurl.com/yy4v2dyh
Tuberous breast deformity is a congenital breast anomaly that becomes manifest at the time of puberty and breast development. The three components of tubular deformity usually include, pseudoherniation of breast tissue into the nipple areolar complex, poorly defined inframammary fold and flattening of the lower pole of the breast which leads to a conical tubular shape. Stuart Linder M.D. 9675 BRIGHTON WAY, SUITE 420 BEVERLY HILLS CA 90210 (310) 275-4513
To license this video for patient education or content marketing, visit: http://www.nucleushealth.com/?utm_source=youtube&utm_medium=video-description&utm_campaign=tephernia-030615
An inguinal hernia is a bulging of the intestine through a defect or weak spot in the wall of the lower abdomen. This video shows how inguinal hernias form and how they are treated.
#TotalExtraperitonealLaparoscopicInguinalHerniaRepair #TEP #laparoscopy
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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.