This is the CT of a 43 year old male patiënt with infected necrotizing pancreatitis that will undergo a VARD procedure; Videoscopic Assisted Retroperitoneal Debridment. Two weeks before this procedure two large bore percutaneous drains were placed in the peripancreatic collection. The patient i...s placed in supine position with the left side 30 degrees elevated. A 5-7 cm subcostal incision is made in the left flank. With help of CT images and by following the percutaneous drain, the subcutaneous tissue and the fascia are dissected and we enter the retroperitoneal peripancreatic collection. First, with a regular suction device any pus encountered is removed. Two long sympathectomy hooks are inserted in order to keep in the incision open. We than insert the zero degree laparoscope. The first necrosis encountered is removed under direct sight with the use of long grasping forceps. Following the percutaneous drain deeper into the cavity, parts of loosely adherent necrotic material are removed. Gently pulling we remove the necrotic tissue. The suction device is helpful in removing any fluid obstructing the view. Complete necrosectomy is not the ultimate aim of this procedure. Only loosely adherent pieces of necrosis are removed thereby keeping the risk of tearing underlying blood vessels to a minimum. In the rare case of extensive bleeding, the retroperitoneal cavity can be easily packed, either awaiting the bleeding to definitely stop or to act as a bridge to angiographic coiling. This patient is now 6 weeks after onset of disease. We always try to postpone surgical intervention, if possible up to 30 days. On the left side of the collection is the percutaneous drain. In this patient the drain had worked well for 2 weeks. When the patient deteriorated again it was decided to perform the VARD procedure. Large pieces of necrotic pancreas can be removed with VARD. This is a big advantage ov VARD over pure endosopic or percutaneous techniques. When all the necrotic tissue is removed we clean the cavity. Two drains are left in situ as a postoperative lavage system. The VARD procedure is performed via a 6 cm incision, which is closed and continuous postoperative lavage started immediately.

Liver Metastasis Resection. A Technique That Makes It Easier. Authors: de Santibañes E, Sánchez Clariá R, Palavecino M, Beskow A, Pekolj J. Background: Liver resection is the only therapeutic option that achieves long-term survival for patients with hepatic metastases. We propose a tech...nique that causes traction and counter traction on the resection area, thus easily exposing the structures to be ligated. Since the parenchyma protrudes like a cork from a bottle we named this procedure “Corkscrew Technique”. Objective: To describe an original surgical technique to resect liver metastases. Technique: We delimite the resection area at 2 cm from the tumor. We place separated stitches, in a radiate way. The needle diameter must allow passing far from the deepest margin of the tumor. The stitches must be tractioned all together to separate the tumor from the normal parenchyma. Material and Methods: Between years 1983 and 2006, we perform 1270 liver resection. We used the corkscrew technique like only procedure in 612 patients whereas in 129 patients we associated it to an anatomic resection. Results: Mortality was 1%. Morbidity was 16% with a reoperation rate of 3%. Conclusions: The Corkscrew Technique is simple and safe, it spares surgical time, avoids blood loss, ensures free tumor margins and it is easy to perform.

Scalpel Blade Handling

Pomeroy Tubal Ligation during a C-Sections

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How amblyopia develops in children. Basically, if one eye doesn't see well from an early age, the wiring never forms correctly back to the occipital cortex.

This video demonstrates pelvic adhesions found in a patient with endometriosis during laparoscopic surgery.

Romberg Test

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Nurses often prime IV lines with the hopes that there are no air bubbles. In this video, I will share a couple of tips to help reduce the risk or frequency of air bubbles during line priming. I will also talk about how to troubleshoot the air bubbles when they appear during an infusion

Providing patient care and influencing safe patient outcomes requires that registered nurses and licensed practice nurses maintain air free IV lines. Learn the strategies and tips to decrease the risk of air bubbles appearing in your primary or secondary medication line as well as troubleshooting tips to remove those alarming bubbles. Your patients will thank you!

Whether you are providing normal saline, a medication, or a combination, ensure that all fluids are compatible.

Supplies used in this video include the Alaris Primary Infusion line, alcohol swabs and a sterile 10 cc syringe ... and a nail in the wall :)

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❤️ ~ You may also be interested in watching ~ ❤️

PICC line assessment https://youtu.be/tnKClpU-J1g
How To Access a PICC line https://youtu.be/SCF6bmk8KWc
Putting on Sterile Gloves https://youtu.be/xNwkKLqDJn4
Organizational Plans for Nursing https://youtu.be/_NATxwPwHzc
Medication Conversions https://youtu.be/TCPBXg2TYCs

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The importance of being fully informed about serious heart conditions like atrial fibrillation

Take a trip around the world while ensuring healthy eye habits and optimal vision

Part 2: from Loyola Medical School, Chicago showing clinical examination of the neurological system.

Examination of the upper limb by Loyola medical school, Chicago Part 2

Median Sternotomy

Among the many health benefits of sex are: Improved Immunity. People who have sex frequently (one or two times a week) have significantly higher levels of immunoglobulin A (IgA). ... Heart Health. ... Lower Blood Pressure. ... It's a Form of Exercise. ... Pain Relief. ... May Help Reduce Risk of Prostate Cancer. ... Improve Sleep. ... Stress Relief.

http://www.landging.com/digestive-system-animation-colon.html
This digestive system animation demonstrates the procedure of colon cleansing.

Vaginal Hysterectomy utilizing the PlasmaSeal Open Forceps presented by Kristi Keil, MD.

Why chiropractic us crucial to your health

The video is about the evolution of the anatomic UCLA laparoscopic technique over 1325 cases and demonstrates the key steps of our operation to improve patient safety and outcomes.

Learn more at http://urology.ucla.edu