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External cephalic version, or version, is a procedure used to turn a fetus from a breech position or side-lying (transverse) position into a head-down (vertex) position before labor begins. When successful, version makes it possible for you to try a vaginal birth.
Mini-Laparoscopic Cholecystectomy with Intraoperative Cholangiogram for Symptomatic Cholelithiasis (Gallstones) - Extended
Authors: Brunt LM1, Singh R1, Yee A2
Published: September 26, 2017
AUTHOR INFORMATION
1 Department of Surgery, Washington University, St. Louis, Missouri
2 Division of Plastic and Reconstructive Surgery, Washington University, St. Louis, Missouri
DISCLOSURE
No authors have a financial interest in any of the products, devices, or drugs mentioned in this production or publication.
ABSTRACT
Minimal invasive laparoscopic cholecystectomy is the typical surgical treatment for cholelithiasis (gallstones), where patients present with a history of upper abdominal pain and episodes of biliary colic. The classic technique for minimal invasive laparoscopic cholecystectomy involves four ports: one umbilicus port, two subcostal ports, and a single epigastric port. The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) has instituted a six-step strategy to foster a universal culture of safety for cholecystectomy and minimize risk of bile duct injury. The technical steps are documented within the context of the surgical video for (1) achieving a critical view of safety for identification of the cystic duct and artery, (2) intraoperative time-out prior to management of the ductal structures, (3) recognizing the zone of significant risk of injury, and (4) routine intraoperative cholangiography for imaging of the biliary tree. In this case, the patient presented with symptomatic biliary colic due to a gallstone seen on the ultrasound in the gallbladder. The patient was managed a mini-laparoscopic cholecystectomy using 3mm ports for the epigastric and subcostal port sites with intraoperative fluoroscopic cholangiogram. Specifically, the senior author encountered a tight cystic duct preventing the insertion of the cholangiocatheter and the surgical video describes how the author managed the cystic duct for achieving a cholangiogram, in addition to the entire technical details of laparoscopic cholecystectomy.
It used to be when a woman needed a hysterectomy she could expect full abdominal surgery with a long recovery time. Dr. Melissa Lee uses less invasive methods that can cut the patients downtime in half.
"We were trained in more laparoscopic and minimally invasive cases so of course that's what I'm more comfortable with doing right now."
She sees a new generation of patients opting for laparoscopic surgery.
"Laparoscopy is the use of small cameras with small incisions and instruments that are guided by the hand, and you're able to see directly into the abdomen without actually fully opening the abdomen," says Dr. Lee, an obstetrician-gynecologist with Lee Memorial Health System.
Nowadays, even a large mass or uterus can be removed using the slender tools.
"There are multiple different laparoscopic instruments that you can use. Whether they're blunt dissections or just dissectors that hold and retract back or actual scissors or cutting instruments, there are multiple different options," says Dr. Lee.
While a standard abdominal hysterectomy requires a four to eight inch incision, the laparoscope needs only a quarter to half inch. It's enough to make a big difference in terms of recovery.
"They're able to get up and move around faster. They're able to recover faster, their pain level and their need for pain medicine is much lower," says Dr. Lee.
The laparoscopic procedure also cuts down on scarring and more importantly, shortens the hospital stay. The trend now is home within 24 hours.
"Where the patient is done early in the morning, they're doing well they're tolerating oral intake they're able to getup and move around. And those patients a lot of times will feel comfortable to go home that same nigh after a major surgery," says Dr. Lee.
New studies show women who've had a laparoscopic hysterectomy viewed their quality of life as better than those who had an open abdominal procedure, making this a good option for the right patient.
View More Health Matters video segments at leememorial.org/healthmatters/
Lee Memorial Health System in Fort Myers, FL is the largest network of medical care facilities in Southwest Florida and is highly respected for its expertise, innovation and quality of care. For nearly a century, we've been providing our community with everything from primary care treatment to highly specialized care services and robotic assisted surgeries.
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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.
Soft tissue biopsy from osteolytic lesions is a challenge for the interventionist. The Spirotome Bone is conceived for this intervention. The procedure is straigthforward and produces tissue specimens of high quality in sufficient amounts to allow quantitative molecular biology.
ThermiVa is a non-surgical vaginal tightening treatment for women who want to reclaim what childbirth or aging may have taken away. Using the same technology that’s used in ThermiTight and ThermiSmooth, radiofrequency energy is sent to the desired area (internally or externally), heating the tissue and stimulating the body’s own collagen. ThermiVa is performed in three treatments over the course of three months.
Are most spiders poisonous? The majority of the 3,000 spiders in the United States aren’t poisonous. Even if most spiders did bite, their fangs are too small or weak to puncture human skin. Their bites may leave itchy, red wounds that heal within a week or so. The spiders that do manage to bite through our skin and insert toxic venom can cause serious health complications. Read on to learn what spider bites look like, what spider varieties leave certain bites, and how to treat spider bites. What do spider bites look like? Identifying a spider bite is easier if you saw the spider that bit you, but it’s possible that you won’t notice the wound until hours later. Look for things like: swelling a red welt skin damage any troubling symptoms that accompany the bite Other possible symptoms that may accompany a spider bite include: itching or rash pain around the area of the bite muscle pain or cramping blister that’s red or purple in color sweating difficulty breathing headache nausea and vomiting fever chills anxiety or restlessness rashes swollen lymph glands high blood pressure Spider bites often take longer to heal than other insect bites, and they may affect skin tissues. It’s important to keep the bite clean to reduce the risk of infection. How to treat a spider bite at home In some cases, you can treat spider bites at home. For nonvenomous spider bites, follow these steps: Apply an ice pack on and off the bite for 10 minutes at a time. Elevate the area to reduce swelling. Take an antihistamine, such as diphenhydramine (Benadryl), to help with itching. Clean the area with soap and water to prevent infection. Apply antibiotic ointment to the area if blisters develop. Seek medical attention if you’re showing symptoms of a spider bite or if the symptoms don’t go away over time. Always seek medical attention if you suspect you’ve been bitten by one of the following species: brown recluse black widow hobo spider tarantula Brazilian wandering spider
Pediatric surgeons at Texas Children’s Hospital West Campus perform general surgical procedures such as circumcisions, removal of foreign objects, hernia repair, and suturing of minor lacerations. While more complex surgeries take place at the Texas Children’s Main Campus, pre-operative and follow-up outpatient care for those procedures is available at the West Campus.
Everything about Texas Children’s Hospital West Campus is dedicated to the health and wellness of children. As greater Houston's first suburban hospital designed exclusively for children, we offer the expert care you've come to trust from Texas Children's Hospital coupled with a location that's convenient and accessible for area families. Our facility is located just off the westbound feeder road of the Katy Freeway (at I-10 and Barker Cypress).
For more information about Texas Children's Hospital West Campus, visit http://www.texaschildrens.org/....Locate/In-the-Commun
Meet Dr. Allen Milewicz, chief of community surgery at Texas Children's West Campus
https://www.youtube.com/watch?v=uMoCdipuKfA&index=16&list=PLiN68C9rloPBD-E9ChWhVy73h7V3SEMlm
A cervical biopsy is a procedure that is sometimes done on women during an exam called a colposcopy to remove cervical tissue for examination. It is also called a punch biopsy. It is usually performed when a Pap smear result is either inconclusive or abnormal and a doctor wants to screen further for any cervical dysplasia or cervical cancer.
Peripheral arterial disease (P.A.D.) occurs when plaque (plak) builds up in the arteries that carry blood to your head, organs, and limbs. Plaque is made up of fat, cholesterol, calcium, fibrous tissue, and other substances in the blood. When plaque builds up in arteries, the condition is called atherosclerosis (ATH-er-o-skler-O-sis). Over time, plaque can harden and narrow the arteries. This limits the flow of oxygen-rich blood to your organs and other parts of your body. P.A.D. usually affects the legs, but also can affect the arteries that carry blood from your heart to your head, arms, kidneys, and stomach. This article focuses on P.A.D. that affects blood flow to the legs.