Do you think you have a hernia?
What are hernias?
The hernias we address in this http://DoctorsExpressHartsdale.com Medical Minute are inguinal, or groin, hernias. More common in men than women, an inguinal hernia can occur when part of the small intestine protrudes through a weakness or tear in the area between your abdomen and your thigh- or your groin. It's possible for anyone to get an inguinal hernia, but it is more commonly found in males.

Hernias form a bulge and can be accompanied by pain. Men have an approximate 26% lifetime risk of having hernia at some point in their life, where as women have a much lower chance of one- only about 3% of women will experience a hernia at some point in their life. There are other types of hernias, such as abdominal, or "hiatal" hernias but groin hernias outnumber abdominal hernias by about 3 to 1.

What causes a hernia?
The cause of a hernia is not always known, but hernias are often the result of weak spots in the abdominal wall. Weaknesses can be due to congenital defects (present at birth) or formed later in life. Some risk factors for inguinal hernia include:
• fluid or pressure in the abdomen
• heavy lifting
• straining during urination or bowel movements
• obesity
• chronic cough
• pregnancy

Hernias often form in people with weakened abdominal muscles or in those who do a lot of heavy lifting or straining, which is why we see it quite often in young men. Physiology plays a part: men have testicles and scrotum which descend through the inguinal canal-much larger in men than in women. That is part of the reason men tend to be more susceptible to hernias than women.

Symptoms of hernia

Symptoms of inguinal hernia usually include a bulge in the groin area and pain, pressure, or aching at the bulge—especially when lifting, bending, or coughing. These symptoms usually subside during rest periods. Men may also experience swelling around the testicles.


Screening and Diagnosis of Hernias
If you are having abdominal pain or pelvic bulge and pain, you want to see physician, and he or she will do an exam. They will use their finger, to see if you have a bulge in your scrotum or on your groin and they'll see if its reducible or not. If the exam doesn't give them the answer, they can then perform an ultrasound, an inexpensive test that can tell you the same day whether a hernia is present.


What to do if you think you have a hernia
Most of the time hernias do not cause problems. People often live with hernias their entire life without them becoming aggravated or painful. When they do cause pain though, there is concern that complications may have arisen. Most common hernias are what we call reducible; you can take your finger or you can lie down in bed and due to the effects of gravity, the bulge in the groin will actually disappear, which means the intestinal contents actually go back into the abdominal cavity or to the correct location. If it's not reducible by lying down or using a finger or having a physician trying to reduce it, then there are concerns about complications such as strangulation, or incarceration occurring. If those concerns are there, then you need to see a surgeon, and there may be a need for surgery.

How to Treat a Hernia
As stated earlier, hernias can often be watched for years without being treated. If however, they are causing pain, we generally refer you to a surgeon who can do a very simple laparoscopic surgery.

If you suspect a hernia, but have not been diagnosed, you should see your doctor, and of course, we are happy to see you here at Doctors Express

The anatomy of the direct and indirect inguinal hernia.


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Lembert Suture for the intestine

For more information about Mohs surgery, please visit https://cle.clinic/3x7CRTy

Mohs surgery is a highly effective skin cancer removal procedure that takes just a few hours. It is most often used to treat basal cell and squamous cell carcinomas, the two most common skin cancers.

Chapters:
0:00 How effective is Mohs Surgery?
0:23 When is Mohs Surgery used?
0:50 How does Mohs Surgery work?
1:55 Does Mohs Surgery cure skin cancer?
2:06 How long is the recovery period after Mohs Surgery?

Resources:
Skins Cancer: https://cle.clinic/3G2MMM8
How Skin Cancer Is Found and Removed — At the Same Appointment: https://cle.clinic/3r9Wzu6
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The information in this video was accurate as of 4.8.2022 and is for information purposes only. Consult your local medical authority or your healthcare practitioner for advice.

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How To Get Pregnant, Ways To Get Pregnant, Best Days To Get Pregnant, Easiest Way To Get Pregnant.

http://how-to-get-pregnant.info-pro.co

Signs Of Infertility

What Exactly Is Infertility?

The problems with either conceiving a child, or with carrying out the pregnancy to its eventual fruitful end, fall under the definition of infertility. Infertility is the incapability of an individual to become pregnant, in case of females, or the incapability to induce pregnancy, in case of the males.

The inability of an individual to carry out a pregnancy to its full term is also dubbed infertility. How does one recognize infertility? What are the signs of infertility?

Signs of infertility in women:
Children At Age 43 After Years Of "Trying".
You Can Too! Here's How...": http://how-to-get-pregnant.info-pro.co

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There are a few different kinds of emergency contraception. The best kind for you depends on a few factors — when you had sex, your weight, whether you’re breastfeeding, and what kind is easiest for you to get. Here’s what you need to know.

The clinician performing the procedure should be familiar with the anatomy of the specific joint and cognizant of the relevant landmarks in order to avoid puncture of tendons, blood vessels, and nerves (see the images below).

If you look at someone’s back, you’ll see that the spine runs straight down the middle. When a person has scoliosis, their backbone curves to the side. The angle of the curve may be small, large or somewhere in between. But anything that measures more than 10 degrees is considered scoliosis. Doctors may use the letters “C” and “S” to describe the curve of the backbone. You probably don’t look directly at too many spines, but what you might notice about someone with scoliosis is the way they stand. They may lean a little or have shoulders or hips that look uneven. What Causes Scoliosis? In as many as 80% of cases, doctors don’t find the exact reason for a curved spine. Scoliosis without a known cause is what doctors call “idiopathic.” Some kinds of scoliosis do have clear causes. Doctors divide those curves into two types -- structural and nonstructural. In nonstructural scoliosis, the spine works normally, but looks curved. Why does this happen? There are a number of reasons, such as one leg’s being longer than the other, muscle spasms, and inflammations like appendicitis. When these problems are treated, this type of scoliosis often goes away. In structural scoliosis, the curve of the spine is rigid and can’t be reversed

If a fetal lung lesion is causing heart failure, fetal surgery may be performed to remove the CCAM before birth. http://fetalsurgery.chop.edu

N. Scott Adzick, MD, Mark Johnson, MD, and Holly Hedrick, MD, experts from the Center for Fetal Diagnosis and Treatment at Children’s Hospital of Philadelphia, explain when fetal intervention for CCAM is recommended, the various approaches that may be used to treat the most complex fetal lung lesions before birth, and how these procedures are performed.

One concern with fetal lung lesions is that they take up space in the chest. If the lung mass grows and pushes the heart and other organs out of place, it can lead to complications such as fetal hydrops (heart failure in the fetus). If this happens, a fetal surgery procedure may be performed to remove the CCAM before birth.
In other cases, an EXIT procedure may be performed to partially deliver the baby, so the team can remove the mass before the baby is fully delivered.

In this video series, parents, nurses and doctors from Children’s Hospital of Philadelphia’s Center for Fetal Diagnosis and Treatment talk about the different types of fetal lung lesions like congenital cystic adenomatoid malformation (CCAM) and bronchopulmonary sequestration (BPS), the importance of accurate diagnosis and monitoring, and the most advanced treatment options currently available. They also discuss follow-up care and long-term outcomes for babies diagnosed with fetal lung lesions.

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]

This video is for reference only. The video may not be otherwise used, reproduced nor modified. For more information to purchase a copy or permission to use this animation on your next case, project, website or TV, contact us at [a]www.trialex.com[/a] or 800-591-1123.
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A hystroscopy showing a case of 2 intramural fibroids

This Basic Laparoscopic Surgery: Abdominal Access and Trocar Introduction course will teach you the steps of Laparoscopic Surgery. View the full course for free by signing up on our website: https://www.incision.care/

What is Laparoscopic Surgery:
Laparoscopic surgery describes procedures performed using one or multiple small incisions in the abdominal wall in contrast to the larger, normally singular incision of laparotomy. The technique is based around principles of minimally invasive surgery (or minimal access surgery): a large group of modern surgical procedures carried out by entering the body with the smallest possible damage to tissues. In abdominopelvic surgery, minimally invasive surgery is generally treated as synonymous with laparoscopic surgery as are procedures not technically within the peritoneal cavity, such as totally extraperitoneal hernia repair, or extending beyond the abdomen, such as thoraco-laparoscopic esophagectomy. The term laparoscopy is sometimes used interchangeably, although this is often reserved to describe a visual examination of the peritoneal cavity or the purely scopic component of a laparoscopic procedure. The colloquial keyhole surgery is common in non-medical usage.

Surgical Objective of Laparoscopic Surgery:
The objective of a laparoscopic approach is to minimize surgical trauma when operating on abdominal or pelvic structures. When correctly indicated and performed, this can result in smaller scars, reduced postoperative morbidity, shorter inpatient durations, and a faster return to normal activity. For a number of abdominopelvic procedures, a laparoscopic approach is now generally considered to be the gold-standard treatment option.
Definitions

Developments of Laparoscopic Surgery:
Following a number of smaller-scale applications of minimally invasive techniques to abdominopelvic surgery, laparoscopic surgery became a major part of general surgical practice with the introduction of laparoscopic cholecystectomy in the 1980s and the subsequent pioneering of endoscopic camera technology. This led to the widespread adoption of the technique by the early- to mid-1990s. The portfolio of procedures that can be performed laparoscopically has rapidly expanded with improvements in instruments, imaging, techniques and training — forming a central component of modern surgical practice and cross-specialty curricula [2]. Techniques such as laparoscopically assisted surgery and hand-assisted laparoscopic surgery have allowed the application of laparoscopic techniques to a greater variety of pathology. Single-incision laparoscopic surgery, natural orifice transluminal endoscopic surgery, and minilaparoscopy-assisted natural orifice surgery continue to push forward the applications of minimally invasive abdominopelvic techniques; however, the widespread practice and specific indications for these remain to be fully established. More recently, robotic surgery has been able to build on laparoscopic principles through developments in visualization, ergonomics, and instrumentation.

This Basic Laparoscopic Surgery: Abdominal Access and Trocar Introduction course will teach you:
- How to access the abdomen using an open, closed, and direct optical-entry technique
- Principles underlying safe abdominal insufflation
- The vascular anatomy of the abdominal wall and its implications for trocar placement
- How to introduce trocars into the peritoneal cavity
- The principle of triangulation and how this can be applied to organizing a laparoscopic surgical field

Specific attention is given to these hazards you may encounter:
- Intravascular, intraluminal, or extraperitoneal needle position
- Limitations of a closed introduction technique
- Abdominal surgical history
- Limitations of an open introduction technique
- Optical trocar entry in thin individuals
- Visualization of non-midline structures
- Limitations of direct optical-entry techniques
- Limitations of clinical examination to confirm intraperitoneal insufflation
- Leakage of insufflation gas

These tips are designed to help you improve your understanding and performance:
- Alternative left upper quadrant approach
- Testing Veress needle before use
- Lifting the abdominal wall for Veress needle introduction
- "Hanging-drop test"
- Palmer's test
- Confirming intra-abdominal insufflation
- Subcutaneous tissue retraction
- Anatomy of the umbilicus
- Retraction of abdominal wall fascia
- Finger sweep of anterior abdominal wall
- Lifting the abdominal wall for optical trocar introduction
- Identification of venous bleeding at the end of a procedure
- Identification of inferior epigastric vessels by direct vision
- Peritoneal folds of the anterior abdominal wall
- Transillumination of superficial epigastric vessels
- Infiltration of local anesthetic at port sites
- Aiming of trocars
- Selection of trocar size
- Maintaining direct vision

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

NURSING VIDEO ACTUAL CATHETERIZATION PROCEDURE OF MALE. FULL LENGTH VERSION Clear quality photography. This video provides an excellant clinical view of the entire procedure.

some knowledge

antaomy of small intestine

At Nationwide Children’s, our Department of General Pediatric Surgery provides comprehensive surgical care for infants, children and adolescents with congenital and acquired conditions, including major congenital anomalies, traumatic and thermal injuries, and tumors. As the second largest pediatric treatment center in the United States our surgeons perform more than 4,000 operative procedures every year. We are dedicated to clinical excellence, generation of new knowledge through research and the training of the next generation of leaders in children’s surgery. Under the umbrella of a unified program, 11 surgical departments share a common mission, philosophy and approach to patient care.

Pediatric Surgery Program: https://bit.ly/3t4QZef
Pediatric Surgery Fellowship and Residency: https://bit.ly/3qWAWwd
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Commentary:

0:24
He may not look like he’s in good condition but you can guesst that his somewhere in nirvana at this point
0:44
After the operation, this patient loses more than just color in his skin but apparently he loses his nipples as well
1:43
This sedated patient is equipped with his own hand-gun. No pun intended
2:17
His anesthesia dose came with the usual side effects of crazy talk with a dash of attitude and sarcasm
3:17
The only thing crazier than love is being sedated during an endometriosis surgery
4:36
This may come as a surprise to some but penguins don’t actually reside in Alaska. In case you didn’t know that well now you do
5:09
If the doctor advises you against something you can’t resist doing, how many of us would still listen to him?
6:35
When them meds start kicking in , it’s time to frame this experience as an excuse to divulge some of your secret fantasies
7:05
There’s a time and place dirty jokes but anesthesia told this guy any times the right time
7:24
Her 16 year old son talks about the last thing he remembers right after surgery and this is what he says
8:35
She’s definitely not in the mood at all. I wouldn’t wanna tick her off during this time if I were you
8:44
A feeling of relief after your operation may be followed by some emotional changes such as mood swings and over sensitivity
9:44
Even if you do say something you wouldn't normally say while you are under sedation, according to some doctors, “it's always kept within the operating room”
10:38
The beeping sounds of the medical equipments tip this patient over the edge. so she tries to drown out the noise with her own voice
11:08
Anyone who's received anesthesia can attest to feeling pretty loopy. Although many won't remember it's fairly common to say some wacky things after waking up
11:53
It's typical for people to feel sad or vulnerable after surgery. Kind of like how this girl is feeling right now
12:04
If she wasn’t under the influence in the hospital right now , it would be pretty hard to justify this type of behavior
12:17
Imagine working as an anesthesiologist. You might become numb to a lot of strange behaviors and everything unusual becomes the new norm for you

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How did Mr Bean get himself into pretending to be a doctor?

Thyroid nodules increase with age and are present in almost 10% of the adult population. Autopsy studies reveal the presence of thyroid nodules in 50% of the population, so they are fairly common. 95% of solitary thyroid nodules are benign, and therefore, only 5% of thyroid nodules are malignant.