J Vasc Surg. 2009 Jul;50(1):134-9. Celiac artery compression syndrome managed by laparoscopy. Baccari P, Civilini E, Dordoni L, Melissano G, Nicoletti R, Chiesa R. Department of General Surgery, Scientific Institute San Raffaele University Hospital, Milan, Italy. paolo.baccari@hsr.it Abstr...

act OBJECTIVE: Celiac artery compression syndrome (CACS) is an unusual condition caused by abnormally low insertion of the median fibrous arcuate ligament and muscular diaphragmatic fiber resulting in luminal narrowing of the celiac trunk. Surgical treatment is the release of the extrinsic compression by division of the median arcuate ligament overlying the celiac axis and skeletonization of the aorta and celiac trunk. The laparoscopic approach has been recently reported for single cases. Percutaneous transluminal angioplasty (PTA) and stenting of the CA alone, before or after the surgical relief of external compression to the celiac axis, has also been used. We report our 7-year experience with the laparoscopic management of CACS caused by the median arcuate ligament. METHODS: Between July 2001 and May 2008, 16 patients (5 men; mean age, 52 years) were treated. Diagnosis was made by duplex ultrasound scan and angiogram (computed tomography [CT] or magnetic resonance). The mean body mass index of the patients was 21.2 kg/m(2). One patient underwent laparoscopic surgery after failure of PTA and stenting of the CA, and two patients after a stenting attempt failed. RESULTS: All procedural steps were laparoscopically completed, and the celiac trunk was skeletonized. The laparoscopic procedures lasted a mean of 90 minutes. Two cases were converted to open surgery for bleeding at the end of the operation when high energies were used. The postoperative course was uneventful. Mean postoperative hospital stay was 3 days. On follow-up, 14 patients remained asymptomatic, with postoperative CT angiogram showing no residual stenosis of the celiac trunk. One patient had restenosis and underwent aortoceliac artery bypass grafting after 3 months. Another patient had PTA and stenting 2 months after laparoscopic operation. All patients reported complete resolution of symptoms at a mean follow-up of 28.3 months. CONCLUSIONS: The laparoscopic approach to CACS appears to be feasible, safe, and successful, if performed by experienced laparoscopic surgeons. PTA and stenting resulted in a valid complementary procedure only when performed after the release of the extrinsic compression on the CA. Additional patients with longer follow-up are needed.

460-pound Zach lost over 300 pounds, but the extreme weight loss left him with a lot of excess skin.

the technique of insertion of a tube into the pericardial sac to remove fluid or blood, improving cardiac function

Intestino Irritable Tratamiento, Colon Irritable, Tratamiento Para El Colon Irritable--- http://intestino-irritable-tratamiento.plus101.com --- Si usted está sufriendo de Síndrome del Intestino Irritable SII, aquí hay una serie de técnicas y estrategias que se conocen para aliviar grandemente los síntomas a largo y corto plazo. La alimentación es la fuente de energía primordial que tenemos y es por eso que hay que darle una importancia suprema a la hora de querer atacar los síntomas del SII. Se recomienda el consumo de hierbas, tales como: manzanilla, consuelda, aceite de onagra, bálsamo de limón, hinojo, canela, nuez moscada, cúrcuma, todas las especias y enzimas digestivas. Todas ellas producen grandes beneficios para su organismo, dentro de los cuales destacamos: La manzanilla actúa como carminativo, así como calmante y agente tonificante para el tracto digestivo. Los aceites esenciales de manzanilla también han contribuido a aliviar cólicos intestinales e irritación en los animales. La manzanilla se toma normalmente tres veces al día, entre las comidas, en una forma de té. La consuelda tiene un uso como agente tópico para mejorar la cicatrización de heridas, úlceras en la piel, tromboflebitis y torceduras. También se utiliza para las personas con problemas gastrointestinales, como úlceras de estómago y el síndrome del intestino irritable, y para quienes sufren problemas pulmonares. Una combinación de menta, comino y otras dos hierbas carminativas (para aliviar los gases), semillas de hinojo y ajenjo, han resultado ser un tratamiento eficaz para los dolores abdominales. La acacia tiene un alto contenido de fibra y con frecuencia se recomienda para aliviar la irritabilidad intestinal. Las frutas como la papaya, el plátano, el mango, la piña, las fresas y los arándanos son altamente recomendables. Las verduras como las patatas dulces, la calabaza y las zanahorias no pueden dejar de ser parte de su dieta. Tenga cuidado con algunos de los medicamentos recetados para el SII ya que algunos de ellos han sido retirados del mercado debido a que contenían ingredientes tóxicos. Algunos ingredientes contenidos en medicamentos de venta libre para el resfriado también han demostrado efectos negativos en pacientes con SCI. Recomendamos las gotas de zinc como una alternativa durante un resfriado ya que no irrita el estómago y tiene visibles resultados de estímulo inmunológico. Los alimentos que se deben evitar: lácteos, huevos (especialmente la yema debido al alto contenido de grasa), brócoli, maíz, aceites hidrogenados, jarabe de maíz alto en fructosa, manzanas (debido al alto contenido de fructosa), frijoles, chocolate (debido a la cafeína) , café, té con cafeína. Para obtener más información sobre cómo poder controlar y eliminar los síntomas del SII, puede visitar el sitio http://intestino-irritable-tratamiento.plus101.com

Soon enough, a robot will be doing surgeries on you!

Male babies leave their DNA in the mother

A peak flow meter is an inexpensive, portable, handheld device for those with asthma that is used to measure how well air moves out of your lungs. Measuring your peak flow using this meter is an important part of managing your asthma symptoms and preventing an asthma attack.

Bacterial infections are common health issues caused by pathogenic bacteria.

DMC Huron Valley-Sinai Hospital offers hope for severe sinus sufferers through new image-guided surgery that opens up passages, allowing freer breathing and higher quality of life. See two patients who have undergone the procedure and hear about their new lease on life. ~ Detroit Medical Center

kin grafting is a type of graft surgery involving the transplantation of skin. The transplanted tissue is called a skin graft. Skin grafting is often used to treat: Extensive wounding or trauma Burns Areas of extensive skin loss due to infection such as necrotizing fasciitis or purpura fulminans[2] Specific surgeries that may require skin grafts for healing to occur - most commonly removal of skin cancers Skin grafts are often employed after serious injuries when some of the body's skin is damaged. Surgical removal (excision or debridement) of the damaged skin is followed by skin grafting. The grafting serves two purposes: reduce the course of treatment needed (and time in the hospital), and improve the function and appearance of the area of the body which receives the skin graft.

Skin grafting is a type of medical grafting involving the transplantation of skin. The transplanted tissue is called a skin graft. Skin grafting is often used to treat: Extensive wounding or trauma Burns Areas of extensive skin loss due to infection such as necrotizing fasciitis or purpura fulminans Specific surgeries that may require skin grafts for healing to occur – most commonly removal of skin cancers. Skin grafts are often employed after serious injuries when some of the body’s skin is damaged. Surgical removal (excision or debridement) of the damaged skin is followed by skin grafting. The grafting serves two purposes: it can reduce the course of treatment needed (and time in the hospital), and it can improve the function and appearance of the area of the body which receives the skin graft. There are two types of skin grafts, the more common type is where a thin layer is removed from a healthy part of the body (the donor section), like peeling a potato, or a full thickness skin graft, which involves pitching and cutting skin away from the donor section. A full thickness skin graft is more risky, in terms of the body accepting the skin, yet it leaves only a scar line on the donor section, similar to a Cesarean section scar. For full thickness skin grafts, the donor section will often heal much more quickly than the injury and is less painful than a partial thickness skin graft.

The Da Vinci Surgical System Robot has benefits for the patient undergoing mitral valve repair and the surgeon performing the procedure. Cardiothoracic Surgeon Thomas Molloy, MD, of St. Joseph Medical Center in Tacoma, WA explains.

Spinal anesthesia is done in a similar way. But the anesthetic medicine is injected using a much smaller needle, directly into the cerebrospinal fluid that surrounds the spinal cord. The area where the needle will be inserted is first numbed with a local anesthetic. Then the needle is guided into the spinal canal, and the anesthetic is injected. This is usually done without the use of a catheter. Spinal anesthesia numbs the body below and sometimes above the site of the injection. The person may not be able to move his or her legs until the anesthetic wears off.

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Laparostomy is a surgical condition in which the abdomen is left open to contrast a condition named Abdominal Compartment Syndrome

LIZ: The first time the doctor made my tip too narrow and I didnt look like myself. The second time the doctor made my tip too wide, and actually took out (removed) extra bone from the side of my nose. That didnt need to be taken out (removed)

My initial consultation with Dr. Nassif was fantastic! He treated me liker his own daughter, and was very caring and thorough. He went over everything!

DR. NASSIF: Liz came into me for a revision rhinoplasty. She told me that shes had two previous rhinoplasties. She was unhappy with the way her nose appeared on her face. She felt it was asymmetric, the tip was kind of bulbous, or large appearing, especially when she looked up, this view, it was very asymmetric. And so, her whole goal was to make it look better, hopefully make it her LAST surgery, and also to help with her breathing.

One of the things thats very important about revision rhinoplasty that you always have to consider is; What are you going to find in there? Even though you can feel the nose, you can palpate it, you can look at it, and you can guess what the other doctors have performed; your first up-hill battle is to see how much scar tissue youre going to be able to identify with. So when you have to open up the nose, you have to remove the scar tissue, identify it: whats there, whats present, whats been removed. Then after you do that, and you have cartilage now ready for grafting, or fascia, or perichondrium, you have to start rebuilding it. Rebuilding it (cartilage) is the second big stage after weve already carved everything; weve carved the cartilage. In that scenario when Im playing with the nose, in regards to staring at the profile, staring at the front of the nose, I go back and forth and look inside and outside of the nose to make sure its as symmetric as possible. That takes a long time One of Lizs main complaints was that on her profile, that her tip stuck out too far. And so one of the things I had to do in surgery is called a medial cura tuck-up, I had to push the tip back, by pushing the tip back, it can make the tip look a little bit wider. But in this situation, I was able to bring everything in as much as I can. After Im finished with everything, and Im happy, then we go ahead and we start to close the nose. Thats putting every little small stitch in perfectly, so that the scar will be minimally visible.

Ureteral stents are one of the most common devices used by urologists. They are placed with cystoscopic guidance in an operating room setting. Ureteral stents are used to relieve ureteral obstruction, promote ureteral healing following surgery, and to assist with ureteral identification during pelvic surgery. Ureteral stent placement is associated with some degree of morbidity in the majority of patients that ranges from generalized urinary discomfort to urinary tract infection or obstruction. Much of the morbidity is related to the biocompatibility of the materials used to fashion the stent and, to some extent, their design; unfortunately, the ideal stent has yet to be discovered.

The needle should pass through the tissue at a perpendiculaPlace the tips of the left-hand forceps on the underside of the tissue at the point where the needle will enter, and gently push the edge upward. With the right hand, bring the needle into contact with the tissue, and press downward. These movements create eversion. Pass the needle through. Do not grab the tissue with your left hand forceps since it will damage the intima. If needed, you can pick up adventitia or a nearby suture to help with exposure and eversion. r.The needle must pass through the other side at a perpendicular, too. Bring the tip of the needle to the place where you intend to bring it out on the other side. Put the tip of your left-hand forceps on the upper surface of the tissue at the intended exit point. Press down with the left-hand forceps and push up with the needle to give you the correct eversion. The width of the bite should be about three times the thickness of the needle. The bites on both sides must be equal, and the needle should cross exactly in a straight line (not diagonally). Pull the needle through the tissue following the curve of the needle

Heart sounds are the noises generated by the beating heart and the resultant flow of blood through it. Specifically, the sounds reflect the turbulence created when the heart valves snap shut. In cardiac auscultation, an examiner may use a stethoscope to listen for these unique and distinct sounds that provide important auditory data regarding the condition of the heart. In healthy adults, there are two normal heart sounds often described as a lub and a dub (or dup), that occur in sequence with each heartbeat. These are the first heart sound (S1) and second heart sound (S2), produced by the closing of the atrioventricular valves and semilunar valves, respectively. In addition to these normal sounds, a variety of other sounds may be present including heart murmurs, adventitious sounds, and gallop rhythms S3 and S4. Heart murmurs are generated by turbulent flow of blood, which may occur inside or outside the heart. Murmurs may be physiological (benign) or pathological (abnormal). Abnormal murmurs can be caused by stenosis restricting the opening of a heart valve, resulting in turbulence as blood flows through it. Abnormal murmurs may also occur with valvular insufficiency (regurgitation), which allows backflow of blood when the incompetent valve closes with only partial effectiveness. Different murmurs are audible in different parts of the cardiac cycle, depending on the cause of the murmur.

A Lecture Presented by Dr. Mostafa Yakoot to Vascular Surgery Congress. TITLE: SAFETY & EFFICACY OF A NEW HONEY OINTMENT (PEDYPHAR) FOR DIABETIC FOOT ULCERS. Based on the original article in JWC by: Yakoot M, Abdelatif M, Etman M.