Scleral Buckling: Slinging Muscles & Marking Breaks VR1 Basic Techniques

Background: The number of patients demanding endoscopic neck surgery is rising. The access trauma of the axillary, breast and chest approaches is bigger than in open or video assisted surgery. We tested the feasibility of he sublingual transoral access which is in our opinion the only real minimally...-invasive extracollar endoscopic access to the thyroid gland Methods: We performed an experimental investigation in a porcine model. In 10 pigs we made 10 endoscopic transoral thyroidectomys with a modified axilloscope with the help of ultrasonic scissors and a neuro-monitoring system for identification of the recurrent laryngeal nerve. Results: The average operation time from the introduction to the removal of the obturator just above the larynx was 57 seconds. The mean operation time was 43 minutes. With the help of the neuro-monitoring system we proved in all cases the function of the recurrent laryngeal nerve on both sides. The pigs were observed for another two hours after operation. During and after the operation no complications appeared. Conclusions: We could show that the endoscopic transoral thyroid resection in pigs is possible and save. Our results might be useful for using this access for endoscopic thyroid resection in humans.

Pancreatic pseudocyst drainage was the first therapeutic application of EUS. The cyst is punctured under ultrasound guidance, contrast injected, and a guidewire inserted. Initial dilation to 8mm is performed over the wire The EUS scope is then exchanged over the wire for a forward viewing endoscope.... A second dilation to 18mm is performed. This enables entry of the endoscope into the cyst perform cystoscopy, debridement if necessary, and insertion of multiple large bore double pigtail stents. The curved linear array-or CLA—echoendoscope has oblique viewing optics located proximal to an oblique scanning transducer. The accessory exits from the shaft of the echoendoscope at an ablique angle, adjustable between 15 and 30 degrees. There are several technical limitations using this echoendoscope. The oblique angle of exit results in a weekend transfer of force when advancing the accessory, difficult deployment of larger bore accessories, and in instrument tunneling effect relative to the bowel wall. There is the potential loss of access during endoscope exchange. A novel CLA echoendoscope was developed by the Olympus Corporation that shifts the orientation of endoscopic and ultrasound views from oblique to forward viewing. The channel is therapeutic at 3.7mm Note that the working channel is located adjacent to the ultrasound transducer at the endoscope tip. The accessory exits the working channel in the axis of the shaft. Shown here are balloon inflation and deployment of a Dormia basket. We report on the use of the prototype forward viewing echoendoscope in six consecutive patients who were referred for pancreatic cyst drainage. Here you see endoscopic view-indistinguisable from that of a gastroscope-showing a bulge where the cyst impinges against the posterior gastric wall. Power Doppler is switched on and highlights multiple vessels interposed in the wall This allows selection of a safe vessel-free window for a cyst puncture A 19 G needle is advanced into the cyst lumen. A sample of contents is aspirated for fluid analysis. A guidewire under ultrasound guidance into the cyst. An 18mm balloon is coaxially thread over the wire and advanced across the cyst wall, Note that resistance is encountered, but the forward transfer of force overcome this. The dilation is performed under forward viewing endoscopuc and ultrasound guidance. As the balloon is maximally inflated we see the cystgastrostomy open up. The balloon is then deflated while simultaneously advancing the scope into the cyst cavity. Cystoscopy isnow performed showing the cyst contents to be filled with pasty wall-adherent necroses. Pulsed power Doppler is switched on we can see and hear arterial flow vessels within the wall of the cyst. This identifies sensitive areas at bleeding risk when performing debridement In this case vigorous water jet irrigation is performed through an accessory water irrigation channel built into the echoendoscope. This issued to clear nonadherent debris. Our experience has shown that it is not necessary to actively remove wall-adherent debris using extraction tools as such Dormia or Roth net basket to achieve cyst resolution. Three large bore 10 Fr double pigtail stents are now inserted into the cyst under direct endoscopic guidance. The first stent is delivered over a guide catheter. The second stent. And the third stent All three stents are deployed. Finally, a nasocystic catheter is inserted for maintenance irrigation. In another patient we used the Cook Cystome to perform cystgastrostomy. We have found the Cystotome easy to delivery through the forward viewing echoendoscope. As shown, we advance the Cystotome into the cyst while applying diathermy. This is performed under and endoscopic guidance, entering the cyst at a near perpendicular orientation. After entry, the Cystotome is removed and cyst fluid gushes from the cystagastrotomy site.

To present a new device for fixating the fibro-optic probe during phacoemulsification

parotidectomy has always been considered to be a daunting aesthetic surgical exercise reuiring extreme care to safeguard the facial nerve. most surgeons master the skill with experience and effort and develop thier own tips and tricks for safe conduct of the procedure. details of the procedure along... with practical tips are illustrated in the video for the benefit of head neck surgeons

Periodontal diseases increases the risks of:
-Coronary Heart Disease
-Stoke
-Infective Endocarditis

Right indirect (Gilbert II)inguinal hernia has been repared using PHSe prosthetic device

Allergies, what causes them? This animated video reviews the pathophysiology of allergies, what causes them and why the symptoms occur. Food allergies, seasonal allergies and allergies to pollen all occur through a similar mechanism.

Needle Insertion Transversus Abdominus Block

Retrograde Laparoscopic Appendectomy: Subhepatic Appendix

Calcified Brain Abscess complete removal

Proximal Hypospadias repaired by Tube Onaly Urethroplasty

occur in this infant because of hypocalcemia

Intercostal Tube Insertion in case of pneumothorax

Cosmetic surgery-mammoplasty-breast surgery-tummy

"Targeted" radiation therapy goes right to the problem, not throughout your system. Moreover, discomfort is minimal. ~ Detroit Medical Center

A DMC Neurologist and Neurosurgeon install a nerve stimulator in a young patient to try and control his epileptic seizures. ~ Detroit Medical Center

Video shows how fast patient recovers after inguinal hernia repair without mesh by Dr.Desarda technique. Patient normally can drive car and go to office within 3-4 days.No recurrence, no pain.
A STORY OF MR. DAVID FROM USA LOS ANGELES IS WORTH LISTENING:
Mr. David said that he did not wish to insert a foreign body like mesh in his body for hernia repair. He had heard from his friends and well wishers and also read and learnt from the internet about complications of a foreign body or mesh and the chances of recurrences after mesh repair. He made an immense research on the internet for any available technique of hernia repair that does not use mesh. He found to his amazement that there are only two centers all over the world which specialize in pure tissue repair of hernia. One is ‘Shouldice center’ in Canada and another is ‘Desarda Center’ in India. This is how he came to know about ‘Desarda’s Repair’ while searching on internet and liked it because it is without mesh or any foreign body and virtually free from recurrences thereafter.
David Williamson, a 37 years patient from Los Angeles, USA came to Pune to Dr. Desarda for getting operated for his groin hernia. Mr. David flew from USA and reached Mumbai and then Pune at 4AM in the morning on 7.10.2007. He was operated at 11 AM in Poona Hospital on the same day and was allowed to move out of bed and go to bathroom within 4-5 hours after surgery. He was permitted to move freely all around as and when he wanted. There were no restrictions. He was freely moving all around the ward on second day. He came down the staircase on third day with his hand bag luggage, took auto-rickshaw and went on his own to ATM centre to withdraw the money. On 4th day he went to Rajneesh Oschio Ashram and spent whole day there to attend there various course activities. A local patient is discharged from the hospital on the same day or next day morning and he is advised to attend all his routine work without any restrictions thereafter.
The story of Mr. Ted and Mr. Ron who also came to India for their hernia surgery is also similar to this story. If American surgeons had adopted this technique in their practice, many patients like David who wish to have no foreign body inserted for hernia repair could get easily operated there and could avoid this long distance journey and other hassles of going to some other country for such operation.
“Complete cure from groin hernia is now possible with Dr.Desarda's repair technique.......”
Mesh is a foreign body. Therefore, its use in hernia repairs is known to cause all sorts of complications like pain, recurrence, infection etc. We have developed an innovative new technique of inguinal hernia repair without mesh. It uses your own body muscle for repair and gives virtually complete cure from inguinal hernia problem. An undetached strip of the external oblique aponeurosis is stitched on the weak area between the muscle arch and the inguinal ligament to form a new, strong and physiologically dynamic posterior wall that gives protection and prevents re-herniation. Normally patient goes home in a day after surgery and can drive car and go to office in 3-4 days time. This "Dr.Desarda's hernia repair" is now followed in many countries all over the world. We are surprised to see the enquiries from many patients in the developed countries asking for this repair in their country. This is because this operation does not use any foreign body like mesh for repair and therefore there are no complications that are seen in mesh repairs. A visit to Topix or other hernia forums show thousands of posts showing sufferings of many patients due to mesh repairs. But still why surgeons from developed countries are interested in mesh repairs is a big question for us.
Please visit our website for more details: http://herniasurgery.tripod.com Our cell number: +91 9373322178

Intercostal Chest Tube Insertion

Over 60 million Americans suffer from chronic heartburn. Get the basics on acid reflux