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Today, the most common approach for open-heart surgery is a sternotomy, which requires a 12-14-inch incision through the breastbone. But in the hands of experienced minimally invasive surgeons, many cardiac procedures can be performed through smaller 2- to 3-inch incisions between the ribs without the need to cut through the breastbone. Learn more in this medical animation from Sarasota Memorial's Minimally Invasive Cardiac Surgery Team and medical director Jonathan Hoffberger, DO. For information or referrals, visit smhheart.com.
Dilation and curettage (D&C) is a procedure to remove tissue from inside your uterus. Doctors perform dilation and curettage to diagnose and treat certain uterine conditions — such as heavy bleeding — or to clear the uterine lining after a miscarriage or abortion.
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.
An inguinal hernia occurs when tissue, such as part of the intestine, protrudes through a weak spot in the abdominal muscles. The resulting bulge can be painful, especially when you cough, bend over or lift a heavy object. However, many hernias do not cause pain.
An inguinal hernia isn't necessarily dangerous. It doesn't improve on its own, however, and can lead to life-threatening complications. Your doctor is likely to recommend surgery to fix an inguinal hernia that's painful or enlarging. Inguinal hernia repair is a common surgical procedure.
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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
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Dressing Changes- Wet to Dry (Nursing Skills)
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Dressing Changes- Wet to Dry (Nursing Skills):
In this video we’re going to look at how to do a wet to dry dressing change. Wound care and dressing changes should be performed at least daily or more often depending on orders. Dressing changes should be sterile to avoid introducing any new bacteria to the wound and to promote wound healing.
Bookmarks:
0:05 Introduction
0:10 Wound Assessment link above
0:24 Dressing Change Prep
1:24 Wet vs Dry Gauze
1:37 Soaking Gauze
2:00 Gauze Ring Out
2:25 Packing the wound
3:00 Covering the wound bed
3:37 Dry gauze barrier
4:00 ABD pad application
4:46 Documentation
4:54 Outro
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NCLEX®, NCLEX-RN® are registered trademarks of the National Council of State Boards of Nursing, INC. and hold no affiliation with NURSING.com.
With ECT, electrodes are placed on the patient's scalp and a finely controlled electric current is applied while the patient is under general anesthesia. The current causes a brief seizure in the brain. ECT is one of the fastest ways to relieve symptoms in severely depressed or suicidal patients.
A bone-anchored hearing aid (BAHA) or bone-anchored hearing device,is a type of hearing aid based on bone conduction. It is primarily suited for people who have conductive hearing losses, unilateral hearing loss, single-sided deafness and people with mixed hearing losses who cannot otherwise wear 'in the ear' or 'behind the ear' hearing aids. They are more expensive than conventional hearing aids, and their placement involves invasive surgery which carries a risk of complications, although when complications do occur, they are usually minor. Two of the causes of hearing loss are lack of function in the inner ear(cochlea) and when the sound has problems in reaching the nerve cells of the inner ear. Example of the first include age-related hearing loss and hearing loss due to noise exposure. A patient born without external ear canals is an example of the latter for which a conventional hearing aid with a mould in the ear canal opening would not be effective. Some with this condition have normal inner ear function, as the external ear canal and the inner ear are developed at different stages during pregnancy. With normal inner anatomy, sound conducted by the skull bone improves hearing.
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History, Examination and Management of Hernia
Mentor: Dr. Nishanth, Consultant Surgeon, Bengaluru.
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Histological features and cellular biology of exocrine glands. This video is a part of our Histology Video Course (https://youtube.com/playlist?l....ist=PLnr1l7WuQdDynxT
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Computed tomography (CT)-guided transthoracic needle biopsy is a well-established, minimally invasive diagnostic tool for pulmonary lesions. Few large studies have been conducted on the diagnostic performance and adequacy for molecular testing of transthoracic core needle biopsy (TCNB) for small pulmonary lesions.
Uterine polyps, also called endometrial polyps, are usually small, bulb-shaped masses of endometrial tissue attached to the uterus by a stalk. They are soft, as opposed to uterine fibroids, which can grow much bigger and are made of hard muscle.
Vatche, Minassian, MD, MPH, Chief of Urogynecology, and Sarah Cohen, MD, MPH, Director of the Minimally Invasive Gynecologic Surgery Fellowship Program at Brigham and Women’s Hospital, perform a laparoscopic burch colposuspension, a procedure used to correct stress urinary incontinence.
Stress urinary incontinence is one of the most common types of incontinence and is characterized by urinary leakage during physical activities including coughing, sneezing, exercising, lifting, and laughing. As the condition progresses, it can become severe enough to happen with simple acts such as bending and walking. This condition is due to an anatomic weakness of the bladder neck which typically maintains the seal of urine during activity. Stress incontinence can result from a variety of conditions including vaginal childbirth, aging, menopause and obesity. As this is an anatomic condition, primary treatment may involve pelvic floor exercises and/or minimally invasive surgery.
Learn more about treatment for stress urinary incontinence:
Division of Urogynecology: http://www.brighamandwomens.or....g/Departments_and_Se
Division of Minimally Invasive Gynecologic Surgery: http://www.brighamandwomens.or....g/Departments_and_Se