Examination of Varicose Veins

Good abdominal wall closure is one of the basic surgical skills and is a common feature of almost all modern-day CSF shunt operations. The fact that some patients require multiple abdominal operations highlights the need for a simple and effective technique for peritoneal catheter insertion through the abdominal wall and abdominal wall closure. Although technically simple, abdominal wall closure becomes more complex when combined with the requirement to maintain CSF shunt function in cases in which the shunt catheter passes through the abdominal wall into the peritoneal cavity. In this report, the authors describe a simple technique for passing the peritoneal catheter of a ventriculoperitoneal shunt through the abdominal wall on a pathway separate from the fascial opening. This technique minimizes the risk of abdominal wall-related complications and is especially important in high-risk patients such as those with obesity and/or diabetes and in children.

No - Knife Endovenous Laser

Is your vertigo or dizziness BPPV or autoimmune?

Visit http://www.vipmedicalgroup.com or call us at (877) 739-5306 for more information on minimally invasive pain management treatments. At VIP Centers, we offer pain management services such as treatment for neck pain, back pain, shoulder pain, hip pain, knee pain, or any other joint pain related injury. Our highly skilled team of doctors are Harvard trained and Board Certified. They have a wealth of experience in pain medicine, sports medicine, bone and joint inflammation. The procedures we offer do not require a hospital stay, general anesthesia, or painful surgery. This means you can return to your normal activities immediately after your treatment.

A knee revision, from Pakistan!!

We get excited when people graduate! May it be graduating from physiotherapy or even graduating onto a new progression of an exercise! Today you move onto new challenges as Mike & Tyler demonstrate the final side plank progression. Kitchener Massage Therapy - http://www.strivept.ca/massage-therapy-kitchener.html

Anemia is a medical condition in which the red blood cell count or hemoglobin is less than normal. The normal level of hemoglobin is generally different in males and females. For men, a normal hemoglobin level is typically defined as a level of more than 13.5 gram/100 ml, and in women as hemoglobin of more than 12.0 gram/100 ml. These definitions may vary slightly depending on the source and the laboratory reference used. Continue Reading

They are the leaders of the pack when it comes to minimally invasive surgeries. Laparoscopic and robotic. Different techniques with the same benefits.

"There's significantly less blood loss, it's a quicker procedure, quicker recovery, less scarring, less chance for post operative wound complications or infections," says Dr. Darren Miter, laparoscopic surgeon with Lee Memorial Health System.

In a laparoscopic procedure surgeons operate through a series of poke holes, manually inserting thin cutting tools and a camera to provide magnified vision. It's used in a variety of surgical specialties.

"The vast majority of gallbladder surgeries are performed laparoscopically. A single incision in the belly button, one up under the breastbone and either one or two in the right upper side of the belly. Using long skinny instruments and looking up at a TV monitor, remove the gallbladder that way," says Dr. Miter.

While laparoscopic is a hands-on approach, robotic procedures are surgeon-controlled. Working at a console, surgeons direct the robotic arms, which have super-human capabilities and 3D, hi def vision.

"I mean you have to see it to believe it, that's a great tool to have. You got a very good depth perception. Plus the other thing when you're working with your hands it's more intuitive," says Dr. Nagesh Ravipati, colorectal surgeon with Lee Memorial Health System.

The robotic system performs maneuvers the human hand can't.

"Especially if you have to do any suturing, it is so much simpler with the robots because you can just turn around 360 degrees," says Dr. Ravipati.

Robotic surgery is gaining momentum in precise procedures, including the field of cancer.

"The robot is good when you're going to operate on just one field. For rectal surgery you're in one place, it's docked. It gives you the best 3 dimensional vision," says Dr. Ravipati.

Robotic and laparoscopic. Both cutting edge options, with less cutting.

View More Health Matters video segments at leememorial.org/healthmatters/

Lee Memorial Health System in Fort Myers, FL is the largest network of medical care facilities in Southwest Florida and is highly respected for its expertise, innovation and quality of care. For nearly a century, we've been providing our community with everything from primary care treatment to highly specialized care services and robotic assisted surgeries.

Visit leememorial.org

Let's ask this 12 year old kid which tool he prefers to successfully intubate a difficult airway in less than 20 seconds..."

NC EMS Show - Dad gives permission for us to film his son, after seeing how easy the Vie Scope is to use. And he nailed it!

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LASIK, or "laser-assisted in situ keratomileusis," is the most commonly performed laser eye surgery to treat myopia, hyperopia and astigmatism. The goal of the treatment is to reshape the cornea to correct the refractive error of the eye.
The cornea is the transparent dome-shaped structure in front of the eye. The cornea refracts light and accounts for about two-thirds of the eye's total optical power. Altering the curvature of the cornea changes the way light rays enter the eye. As a result, the light rays can be focused properly onto the retina for clearer vision.
For nearsighted people, the laser is used to flatten the cornea. For farsighted people, the cornea is made steeper. For patients with astigmatism, the laser is used to smooth the irregularly-shaped cornea into a more regular shape.
The outer layer of the cornea - the epithelium – is capable of replacing itself within a few days after being damaged or removed. The deeper layer of the cornea – the stroma, on the contrary, is a permanent corneal tissue with very limited regenerative capacity. The stroma, if reshaped by a laser, will remain that way permanently.
In this procedure, a thin, circular "FLAP" is created in the surface of the cornea to gain access to the permanent corneal tissue. This can be done with a mechanical cutting tool called a microkeratome, OR, for a blade-free experience, by a femtosecond laser. An excimer laser is then used to remove some corneal tissue to reshape the cornea. Excimer laser uses cool ultraviolet light beams to vaporize microscopic amounts of tissue in a precise manner to accurately reshape the cornea. The excimer laser is computer-controlled and is programmed based on the patient’s refractive error. The flap is then laid back in place and is allowed to heal.
LASIK eye surgery is mostly painless and can be completed within minutes. Improved vision can usually be seen overnight.

PRK, or photorefractive keratectomy, was the first type of laser eye surgery for vision correction and is the predecessor to the popular LASIK procedure. In PRK, NO flap is created. Rather, the epithelial cells on the eye surface are simply removed. An excimer laser is then used to reshape the cornea just like it does in LASIK.
The vision correction outcomes of PRK surgery are comparable to those of LASIK, but the recovery period is longer. This is because the epithelium is completely removed in PRK and it takes a few days to regenerate. PRK patients also have more discomfort and haziness of vision in the first few days after the surgery. Improved vision also takes longer to achieve.
PRK does, however, offer certain advantages. Because PRK does not involve creation of a flap, which contains both epithelial and deeper stromal tissue, the entire thickness of the stroma is available for treatment. The treatment range is therefore higher. This is particularly useful for patients with high levels of myopia or for those whose cornea is too thin for LASIK. PRK is also free of flap-related complication risks.

Coarctation of the aorta (CoA[1][2] or CoAo), also called aortic narrowing, is a congenital condition whereby the aorta is narrow, usually in the area where the ductus arteriosus (ligamentum arteriosum after regression) inserts. The word “coarctation” means narrowing. Coarctations are most common in the aortic arch. The arch may be small in babies with coarctations. Other heart defects may also occur when coarctation is present, typically occurring on the left side of the heart. When a patient has a coarctation, the left ventricle has to work harder. Since the aorta is narrowed, the left ventricle must generate a much higher pressure than normal in order to force enough blood through the aorta to deliver blood to the lower part of the body. If the narrowing is severe enough, the left ventricle may not be strong enough to push blood through the coarctation, thus resulting in lack of blood to the lower half of the body. Physiologically its complete form is manifested as interrupted aortic arch

Any independent vertical movement of the transducer or the patient will affect the hydrostatic column of this fluid-filled system and thus alter the pressure measurements. At some time before or after PAC insertion, the system must therefore be zeroed to ambient air pressure. The reference point for this is the midpoint of the left atrium (LA), estimated as the fourth intercostal space in the midaxillary line with the patient in the supine position. With the transducer at this height, the membrane is exposed to atmospheric pressure, and the monitor is then adjusted to zero. Calibration Once zeroed, the monitoring system must be calibrated for accuracy. Currently, most monitors perform an automated electronic calibration. Two methods are used to manually calibrate and check the system. If the catheter has not been inserted, the distal tip of the PAC is raised to a specified height above the LA. For example, raising the tip 20 cm above the LA should produce a reading of approximately 15 mm Hg if the system is working properly (1 mm Hg equals 1.36 cm H 2 O). Alternatively, pressure can be applied externally to the transducer and adjusted to a known level using a mercury or aneroid manometer. The monitor then is adjusted to read this pressure, and the system is calibrated. Dynamic tuning Central pressures are dynamic waveforms (ie, they vary from systole to diastole) and thus have a periodic frequency. To monitor these pressures accurately, the system requires an appropriate frequency response. A poorly responsive system produces inaccurate pressure readings, and differentiating waveforms (eg, PA from pulmonary capillary wedge pressure [PCWP]) can become difficult. When signal energy is lost, the pressure waveform is dampened. Common causes of this are air bubbles (which are compressible), long or compliant tubing, vessel wall impingement, intracatheter debris, transducer malfunction, and loose connections in the tubing. A qualitative test of the frequency response is performed by flicking the catheter and observing a brisk high-frequency response in the waveform. After insertion, the system can be checked by using the rapid flush test. When flushed, an appropriately responsive system shows an initial horizontal straight line with a high-pressure reading. Once the flushing is terminated, the pressure drops immediately, which is represented by a vertical line that plunges below the baseline. A brief and well-defined oscillation occurs, followed by return of the PA waveform. A dampened system will not overshoot or oscillate, and causes a delay in returning to the PA waveform.

Retinoblastoma is an eye cancer that begins in the retina — the sensitive lining on the inside of your eye. Retinoblastoma most commonly affects young children, but can rarely occur in adults. Your retina is made up of nerve tissue that senses light as it comes through the front of your eye. The retina sends signals through your optic nerve to your brain, where these signals are interpreted as images. A rare form of eye cancer, retinoblastoma is the most common form of cancer affecting the eye in children. Retinoblastoma may occur in one or both eyes.

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This cosmetic plastic surgery graphically shows breast implants being removed in an operating room in an actual surgery.

Adult stem cells are cells from your own body that can renew themselves and turn into other cells (differentiate). They live inside all of us in various tissues, poised to leap into action to repair damage as it occurs. As we age or have big injuries, we may not be able to recruit enough of these cells to the site to fully repair the area. Regenexx Stem Cell Procedures help overcome this problem by extracting stem cells from an area of high volume, then concentrating the cells and reinjecting them into the damaged area to help the body heal naturally.