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Nasal catheter YAMIK - is a new drug delivery sistem for topical treatment for sinusitis. The introduction of a large volume of the #drugsolution directly into all the paranasal #sinuses - provides new opportunities in the #treatment of #sinusitis! #YamikprocedureNasal catheter YAMIK is a new device for topical sinonasal delivery of medication during rhinosinusitis treatment. Administration of therapeutic solution with YAMIK catheter is called YAMIK procedure. The following features differs YAMIK procedure from all other topical sinonasal delivery techniques: - Medication is delivered into the all paranasal sinuses at one side of nose regardless of their involvement in the inflammatory disease. -Specific position of patient’s head. Patient should lay on the side of of the sinuses, into which solution will be administered. This position is physiological and comfortable for patients, including children and elders. The LHL position was suggested to be the most favorable position for patients to adopt - Therapeutic solutions reliably penetrates into without previous sinus surgery sinuses with natural ostia size. - Paranasal sinuses are filling with medicinal solution by gravity. To accelerate process, it is used small pressure gradient, which created by motion of syringe plunger with amplitude 1 - 2 ml during administration of solution. - It is provided contact of the whole sino-nasal mucosa with medication. - Prolonged time of the contact of sino-nasal mucosa with medicine provides administration of the therapeutically significant dose. Therapeutic solution administered into paranasal sinuses is considered as a STORE. Thanks to affect mucociliary clearance, therapeutic solution is gradually evacuated from sinuses through ostia. Thereby, prolonged nasal irrigation is performed. - Due to extended contact with saline (NaCl 0,9%), viscous colloidal pathological substance filling paranasal sinuses is dissolved. As a result, its viscosity decreases, and substance is removing by mucociliary clearance. Thereby, drainage function of the ostia are returned some time after finish YAMIK method procedure. -The procedure is performing under local anesthesia. - There is no need in active involvement of the patient. Blowing, pronouncing any sounds like “cuckoo”, holding any things and so on is unnecessary. If is performed by a qualified medical professional the procedure is more effective. - Medication contacts only with nasal passages and paranasal sinuses. Thus, it is provided topical drug therapy. - YAMIK procedure is call sinonasal delivery techniques of a therapeutic solution. It differs from nasal techniques, because medicinal solution contacts not only with nasal mucosa, but with mucous membrane of paranasal sinuses. - The only used drug formulation is a solution. - It is possible non-invasive sample extraction from mucosa of paranasal sinuses (for bacteriological, immunological, cytological and a number of others investigation methods).
Laparoscopic surgery is now commonly used as a type of minimally invasive surgery, but what is it and why is it used?
Interested in learning more about minimally invasive techniques, or having surgery planned? Visit https://www.topdoctors.co.uk/doctor/charles-imber
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Mr Brian MacCormack talking about Paediatric Surgery Emergencies. This talk is part of the Paediatric Emergencies 2022 event. To get your CME certificate for watching the video please visit https://www.paediatricemergenc....ies.com/conference/p
#PaediatricEmergencies #PaediatricEmergencies2022 #PaediatricSurgery
Laparoscopic cholecystectomy is a very safe operation. The overall complication rate is less than 2%. The complication rate for laparoscopic gallbladder surgery is similar to the complication rate for traditional open gallbladder surgery when performed by a properly trained surgeon.
This is the biggest known operation ever.The Whipple procedure(pancreatoduodenectomy) is the most common operation performed for pancreatic cancer and may be used to treat other cancers such as small bowel cancer. Surgeons remove the head of the pancreas, most of the duodenum (a part of the small intestine), a portion of the bile duct and sometimes a portion of the stomach. After the pancreatoduodenectomy, the surgeon reconstructs the digestive tract. At Mayo Clinic, surgeons perform more than 100 Whipple procedures annually. Patients leave the hospital in an average of 14 days.
ENDOSCOPIC (NON-SURGICAL) REMOVAL OF MULTIPLE LARGE TUMORS FROM STOMACH IN A PATIENT WITH PEUTZ-JEGHERS SYNDROME
PEUTZ-JEGHERS SYNDROME: Peutz-Jeghers syndrome (PJS) is a familial syndrome consisting of mucocutaneous pigmentation, gastrointestinal polyposis and cancers of gut & other sites like breast, ovary, and testes. PJS has an autosomal dominant inheritance with variable and incomplete penetrance. Germline mutations of STK11/LKB1 gene on 19p cause this syndrome. Mucocutaneous pigmentation may be noted in early infancy. These deposits of melanin are most commonly found around the mouth, nose, lips, buccal mucosa, hands, and feet, and may also be present in perianal and genital areas. PJS polyps may be found in stomach, small intestine, or colon, but they tend to be prominent in the small intestine. These polyps may increase in size and cause small intestinal obstruction or intussusceptions that may occur in early infancy. Acute upper gastrointestinal bleeding and chronic faecal blood may complicate the disease.
PATIENT: The patient was a 25 yr male who had mucocutaneous pigmentation and multiple polyps in the stomach and duodenum. He presented with bleeding from gastric polyps. As the polyps in stomach were numerous, (more than 20 in number) and were large in size (some equal to small egg size), he had been advised to undergo surgery. Surgery planned was total gastrectomy.
PROCEDURE: The patient underwent video-endoscopy of the esophagus, stomach and duodenum. All polyps were examined for size and presence or absence of stalk. A plan to remove all the gastric polyps at endoscopy was made in the same sitting. He received light conscious sedation. Flat polyps were raised form the gastric wall by injection of saline in to polyp base to let these lesions have a stalk. This was done by needle injector. Each polyp was engaged in a snare and the polyp stalk was cut by coagulation cutting current. The cuts were clean without any bleeding. All polyps were recovered for histology. The histology revealed all polyps to be hamartomous lesions. None of the polyps were cancerous. Patient has been followed up for over one year and is doing fine without any further bleeding or pain.
Video shows the procedure of videoendoscpy and endoscopic removal of polyps.
Whether you're a medical student, a resident, a primary care physician or you practice in an emergency department, you can improve your suture skills with this detailed instruction. As you practice towards a cosmetically perfect technique, your confidence will increase, especially when dealing with complex wounds. Areas of study include: methods of closure, closure materials, anesthetics, suture removal, infection, prophylaxis, when to call in a plastic surgeon, recapping techniques and more
This endoscopy shows a patient with cancer of the larynx, Laryngeal cancer is the most common cancer of the upper respiratory tract. The incidence of laryngeal tumors is closely correlated with smoking, as head and neck tumors occur 6 times more often among cigarette smokers than among nonsmokers. The age-standardized risk of mortality from laryngeal cancer appears to have a linear relationship with increasing cigarette consumption. Death from laryngeal cancer is 20 times more likely for the heaviest smokers than for nonsmokers. It should be suspected in any patient with hoarseness of the voice for three weeks or longer until proven otherwise.
The colonoscope is slowly withdrawn during this screening colonoscopy down from the transverse colon, back around the splenic flexure, and down the descending colon, and reveals this finding a colonic diverticula. Diverticulosis is a common, acquired, age-related occurrence affecting over 50% of the... western adult population over the age of 50. It is seen rarely in Africa and Asia where the dietary fiber content is traditionally higher. Thus most investigators feel that low fiber diets are related to the development of this condition. Ironically, colonic diverticula are not true diverticula but rather pseudodiverticula in that the sac includes layers of the mucosa and submucosa that push through rather than include the outer muscular layer. As with the small bowel the colon has an inner circular muscular layer, but the outer longitudinal layer is composed of three bands of muscle that run the length of the colon known as teniae. Diverticula occur in rows between the mesenteric and two antimesenteric teniae where the colonic wall is further weakened by the defect caused by the perforating vasa recti artery which supplies the colonic mucosa. Occasionally, the anatomic propensity of diverticula to form in rows is quite apparent as seen when this clip is replayed in slow motion. Most often, however, the arrangement of the diverticula appears random due to the angulation of the bowel and thickening of the semi lunar folds. The conditions that cause these pulsion diverticula are not know with certainty but may include high intrahaustral pressures, muscular hypertrophy, and age related alterations in collagen cross linking. Diverticula can bleed or can abscess and perforate. The incidence of diverticulitis or diverticular bleeding is in the range of 1:1,000 patients with diverticulosis.