At one time, women who had delivered by cesarean section in the past would usually have another cesarean section for any future pregnancies. The rationale was that if allowed to labor, many of these women with a scar in their uterus would rupture the uterus along the weakness of the old scar. Over time, a number of observations have become apparent: Most women with a previous cesarean section can labor and deliver vaginally without rupturing their uterus. Some women who try this will, in fact, rupture their uterus. When the uterus ruptures, the rupture may have consequences ranging from near trivial to disastrous. It can be very difficult to diagnose a uterine rupture prior to observing fetal effects (eg, bradycardia). Once fetal effects are demonstrated, even a very fast reaction and nearly immediate delivery may not lead to a good outcome. The more cesarean sections the patient has, the greater the risk of subsequent rupture during labor. The greatest risk occurs following a “classical” cesarean section (in which the uterine incision extends up into the fundus.) The least risk of rupture is among women who had a low cervical transverse incision. Low vertical incisions probably increase the risk of rupture some, but usually not as much as a classical incision. Many studies have found the use of oxytocin to be associated with an increased risk of rupture, either because of the oxytocin itself, or perhaps because of the clinical circumstances under which it would be contemplated. Pain medication, including epidural anesthetic, has not resulted greater adverse outcome because of the theoretical risk of decreasing the attendant’s ability to detect rupture early. The greatest risk of rupture occurs during labor, but some of the ruptures occur prior to the onset of labor. This is particularly true of the classical incisions. Overall successful vaginal delivery rates following previous cesarean section are in the neighborhood of 70 This means that about 30of women undergoing a vaginal trial of labor will end up requiring a cesarean section. Those who undergo cesarean section (failed VBAC) after a lengthy labor will frequently have a longer recovery and greater risk of infection than had they undergone a scheduled cesarean section without labor. Women whose first cesarean was for failure to progress in labor are only somewhat less likely to be succesful in their quest for a VBAC than those with presumably non-recurring reasons for cesarean section. For these reasons, women with a prior cesarean section are counseled about their options for delivery with a subsequent pregnancy: Repeat Cesarean Section, or Vaginal Trial of Labor. They are usually advised of the approximate 70successful VBAC rate (modified for individual risk factors). They are counseled about the risk of uterine rupture (approximately 1in most series), and that while the majority of those ruptures do not lead to bad outcome, some of them do, including fetal brain damage and death, and maternal loss of future childbearing. They are advised of the usual surgical risks of infection, bleeding, anesthesia complications and surgical injury to adjacent structures. After counseling, many obstetricians leave the decision for a repeat cesarean or VBAC to the patient. Both approaches have risks and benefits, but they are different risks and different benefits. Fortunately, most repeat cesarean sections and most vaginal trials of labor go well, without any serious complications. For those choosing a trial of labor, close monitoring of mother and baby, with early detection of labor abnormalities and preparation for

Brain port surgery is a minimally invasive surgical technique performed through a specially designed tube about the size of a dime. Using neuronavigation GPS-like guidance, the brain port is inserted into the brain with millimeter accuracy and is used as a channel to guide the surgeon and his/her instruments to various regions of the brain. Colloid cysts, metastatic tumors, and a variety of tumors within the ventricles are often candidates for this approach.

Diastasis recti often occurs during pregnancy and can persist after pregnancy. It affects core strength and the appearance of the abdominal muscles.

Dr. Erick Sanchez repairs the abdominal muscles with every tummy tuck. This short video shows the muscle repair portion of the surgery with a bonus after photo at the end!

To request a consultation with Dr. Sanchez, visit sanchezplasticsurgery.com and click Request a Consultation. Fill out the form and someone will get in touch with you to answer all your questions.

Expected cost can be found at the bottom of each procedure page on our website.

he inflatable penile prosthesis consists of two attached cylinders -- a reservoir and a pump -- which are placed surgically in the body. The two cylinders are inserted in the penis and connected by tubing to a separate reservoir of saline. The reservoir is implanted under the rectus muscles in the lower abdomen.

Vaginoplasty is any surgical procedure that results in the construction or reconstruction of the vagina. It is a type of genitoplasty. Pelvic organ prolapse is often treated with one or more surgeries to repair the vagina.

Watch that Female Foley Catheter Insertion Procedure

A wet mount is the suspension of a small amount of vaginal discharge in a liquid medium. Two liquids are commonly used, normal saline and potassium hydroxide. Each has it's own unique properties that make it useful in this setting

Care must be taken to prevent stenosis at the anastomotic site. If the diameter of the anastomosis is less than 2 cm, the anastomosis should be taken down and resected. A classic end-to-end anastomosis should be performed to ensure adequate diameter to the intestine. If the posterior wall of the colon has been preserved, care should be taken to close the colostomy prior to opening the peritoneal cavity. This will reduce intraperitoneal contamination from the stoma site. Copious irrigation of the wound should be made prior to primary closure. If gross contamination has occurred, delayed closure of the wound should be considered.

Butt implants are a popular plastic surgery procedure among those who wish to enhance the appearance, shape, and size of their rear ends. Buttock augmentation involves the surgical insertion of artificial body implants into a patient’s buttocks to create a larger, shapelier, and more sensuous rear end. Patients who have underdeveloped buttocks can achieve a more proportionate figure with butt implants. Women who wish to achieve an “hour glass” figure or are unhappy with the size of their buttocks can benefit from female butt implants. Men with flat or poorly developed buttocks can enhance the shape of the area to their liking with male butt implants. Many buttock augmentation patients say that their clothes fit better, they feel more attractive, and their confidence levels have improved.

Watch that video to know How To Firm And Lift Your Sagging Breasts Naturally

Watch that video of Pathway and Ejaculation of Sperm

Peripheral Vascular Examination OSCE - Clinical Skills - Dr Gill

In the cardiovascular examination, particularly in the case of an OSCE station, we conclude the examination often by stating that the examiner would want to perform:
- An ECG
- Check full blood count
- and "do a peripheral vascular examination

In this video, we demonstrate that oft-talked about, but comparatively less common examination.

Starting off, with the examination of the hands, the radial, brachial and carotid pulses. before moving down to assess for a AAA, checking the femoral and popliteal pulses, before wrapping up around the ankle with the posterior tibial and dorsalis pedis pulses

For completeness, the cardiovascular examination is demonstrated here
https://www.youtube.com/watch?v=ECs9O5zl6XQ&t=2s

#PeripheralVascular #ClinicalSkills #DrGill

Testicular Self Exam

This video demonstrate Bilateral Salpingectomy for a patient suffering from hematosalpinx of one side and Hydrosalpinx other side in which one IVF has failed. Laparoscopic salpingectomy. In this less-invasive procedure, the surgeon makes 1-3 small incisions in the lower abdomen, and inserts a laparoscope into the pelvis through one of the incisions. The camera at the end of the laparoscope guides the surgeon through the procedure. The fallopian tube tissue is then removed. For more information https://www.laparoscopyhospital.com/

For more information please contact:
World Laparoscopy Hospital
Cyber City, Gurugram, NCR DELHI
INDIA 122002
Phone & WhatsApp: +919811416838, + 91 9999677788

28 years old gentleman presented with huge liver abscess in the right lobe, with repeated attempts of percutaneous aspirations in the past. He was evaluated and subjected to Laparoscopic drainage. This video depicts feasibility of laparoscopy in deep seated liver abscesses. Video created by: Dr. Juneed M. Lanker Fellow Minimal Access Surgery Apollo Hospitals Chennai.

OB_A_1013
3D animation depicting the operating room and initial procedure preparing the patient for a laparoscopic hysterectomy. The patient is prepped and draped in the usual fashion and surrounded by the surgeon and surgical assistants. The skin is elevated, an infraumbilical incision is made, a trocar port is inserted through the incision and the abdomen is insufflated. Finally, a laparoscope is inserted into the port to allow for direct visualization of the uterus and the surgery can begin.

To view more animations and exhibits, visit our medical library: https://www.trialexhibitsinc.c....om/library/multimedi

Contact us on your next case for consulting, trial graphics, animations, medical illustrations or presentation services. 800-591-1123 [a]www.trialex.com[/a]

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Watch that video to know the Types of Female Genital discharge

As a pediatric surgeon at NewYork-Presbyterian/Weill Cornell Medical Center, Dr. Nitsana Spigland treats newborns, children, teens, and young adults requiring surgical interventions. She specializes in antenatal counseling and newborn congenital malformations.

Learn more about Dr. Spigland at: https://www.nyp.org/physician/nspigland.