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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.

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German Video showing examination of the urinary bladder

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Specific treatment for menorrhagia is based on a number of factors, including: Your overall health and medical history The cause and severity of the condition Your tolerance for specific medications, procedures or therapies The likelihood that your periods will become less heavy soon Your future childbearing plans Effects of the condition on your lifestyle Your opinion or personal preference Drug therapy for menorrhagia may include: Iron supplements. If you also have anemia, your doctor may recommend that you take iron supplements regularly. If your iron levels are low but you're not yet anemic, you may be started on iron supplements rather than waiting until you become anemic. Nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs, such as ibuprofen (Advil, Motrin IB, others) or naproxen (Aleve), help reduce menstrual blood loss. NSAIDs have the added benefit of relieving painful menstrual cramps (dysmenorrhea). Tranexamic acid. Tranexamic acid (Lysteda) helps reduce menstrual blood loss and only needs to be taken at the time of the bleeding. Oral contraceptives. Aside from providing birth control, oral contraceptives can help regulate menstrual cycles and reduce episodes of excessive or prolonged menstrual bleeding. Oral progesterone. When taken for 10 or more days of each menstrual cycle, the hormone progesterone can help correct hormone imbalance and reduce menorrhagia. The hormonal IUD (Mirena). This intrauterine device releases a type of progestin called levonorgestrel, which makes the uterine lining thin and decreases menstrual blood flow and cramping. If you have menorrhagia from taking hormone medication, you and your doctor may be able to treat the condition by changing or stopping your medication.

Rheumatic fever is an inflammatory disease that can develop as a complication of inadequately treated strep throat or scarlet fever. Strep throat and scarlet fever are caused by an infection with streptococcus bacteria. Rheumatic fever is most common in 5- to 15-year-old children, though it can develop in younger children and adults. Although strep throat is common, rheumatic fever is rare in the United States and other developed countries. However, rheumatic fever remains common in many developing nations. Rheumatic fever can cause permanent damage to the heart, including damaged heart valves and heart failure. Treatments can reduce damage from inflammation, lessen pain and other symptoms, and prevent the recurrence of rheumatic fever.

ACTUAL CATHETERIZATION A clinical view of insertion into the male urethra. A 14 french coude cath was used.

Graves' disease is an immune system disorder that results in the overproduction of thyroid hormones (hyperthyroidism). Although a number of disorders may result in hyperthyroidism, Graves' disease is a common cause. Because thyroid hormones affect a number of different body systems, signs and symptoms associated with Graves' disease can be wide ranging and significantly influence your overall well-being. Although Graves' disease may affect anyone, it's more common among women and before the age of 40. The primary treatment goals are to inhibit the overproduction of thyroid hormones and lessen the severity of symptoms.

Patient Glenn Williams had a hernia measuring 20cm x 30cm. Consultant Graham Offer has performed ground breaking surgery to help Glenn.

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Harper University Hospital has been accredited as a Bariatric Center of Excellence by the American Society of Bariatric Surgeons. By employing laparoscopy, this bariatric procedure is minimally invasive and results in quicker recovery time, as well as less scarring. ~ Detroit Medical Center

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In this video “How To Do An IM (Intramuscular) Injection” you will learn about:
►the steps in the administration of intramuscular medications
►the angle to position the syringe while administering an intramuscular injection
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Tracheotomy and tracheostomy are surgical procedures that create an opening in the trachea (windpipe) to help patients breathe when they have difficulty doing so through the nose or mouth. Though they are similar in purpose, there are some key differences between them.

Tracheotomy is a temporary procedure that involves creating a small incision in the trachea to insert a breathing tube. The tube is typically removed once the patient no longer requires it, and the incision heals on its own. Tracheostomy, on the other hand, is a more permanent solution that involves creating a hole in the trachea and inserting a tracheostomy tube, which remains in place for an extended period.

Indications for these procedures include:

Airway obstruction due to trauma, tumors, or infection
Severe respiratory distress or failure
Prolonged mechanical ventilation
Inability to protect the airway due to neurological disorders or impaired consciousness
Steps for performing a tracheotomy and tracheostomy:

Preparation: The patient is positioned, and the neck area is cleaned and draped. Local anesthesia is often administered, although general anesthesia may be used in some cases.
Incision: A small incision is made in the neck, and the muscles and tissues are carefully separated to expose the trachea.
Tracheal opening: A small opening is made in the trachea, typically between the second and third tracheal rings.
Tube insertion: A tracheotomy tube is inserted through the incision and into the trachea for a tracheotomy, while a tracheostomy tube is inserted for a tracheostomy. Both tubes are secured in place.
Confirmation: Proper placement of the tube is confirmed by listening for breath sounds and checking for adequate ventilation.
Pre-operative care typically involves a thorough assessment of the patient's medical history, as well as any necessary imaging studies or lab tests to ensure the procedure is appropriate and safe. Informed consent should be obtained from the patient or their legal representative.

Post-operative care includes monitoring the patient's vital signs, ensuring the tube remains secure and patent, and managing any pain or discomfort. For tracheostomy patients, regular cleaning and maintenance of the stoma (the opening in the trachea) and the tracheostomy tube are essential to prevent infection and other complications. Long-term care may involve speech therapy, respiratory therapy, and support from a multidisciplinary team to address any ongoing needs.

It's crucial to remember that these procedures should only be performed by trained medical professionals in a clinical setting.



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The patient has spasticity in the lower extremities greater than the upper extremities. The hips and knees are flexed and adducted with the ankles extended and internally rotated. When the patient walks both lower extremities are circumducted and the upper extremities are held in a mid or low guard position. This type of gait is usually seen with bilateral periventricular lesions. The legs are more affected than the arms because the corticospinal tract axons that are going to the legs are closest to the ventricles.

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Hemorrhoidectomy Operation Video

It may be reassuring to know spotting or bleeding after sex is common and can come from the vagina, cervix, or urinary tract. It occurs most commonly in women 20 to 40 years old. Cervical Cancer: A very rare cause of spotting. ... Vaginal Dryness: Often caused by inadequate foreplay or vaginal lubrication.