Patient information from Sunnybrook's Holland Musculoskeletal Program. For more, visit: http://sunnybrook.ca/holland

Gastric bypass, also called Roux-en-Y gastric bypass surgery, is considered a “metabolic” procedure because it changes how your body absorbs fat, calories and nutrients. This metabolic change occurs because your gastrointestinal tract is altered when your gastric bypass surgeon attaches the smaller section of your stomach directly to your small intestine. As a result, your appetite changes and you feel full faster.

Mini-Laparoscopic Cholecystectomy with Intraoperative Cholangiogram for Symptomatic Cholelithiasis (Gallstones) - Standard
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.

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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A video showing Two port laparoscopic Cholecystectomy

Peripheral vascular disease, also called PVD, refers to any disease or disorder of the circulatory system outside of the brain and heart. The term can include any disorder that affects any blood vessels. It is, though, often used as a synonym for peripheral artery disease. PVD is the most common disease of the arteries. The build-up of fatty material inside the vessels, a condition called atherosclerosis or hardening of the arteries, is what causes it. The build up is a gradual process. Over time, the artery becomes blocked, narrowed, or weakened.

Examination of the hip

A very bad lasik eye surgery duringwhich the surgeon messed everything

A great video showing Total Abdominal Hysterectomy

Cannula are often introduced into blood vessels in 80% of patients in the hospital for treatment. This can be a daunting experience to patients and stressful to doctors as multiple attempts are used. This may result in introducing spreading MRSA, E Coli & Chlostredium living on your skin into blood and results in Invasive MRSA infection.

Skin is often not adequatly cleaned during subsequent atempts as doctors/nurses do not wait for 1 min after applying cleaning solution on the skin before they puncture your skin.

Multiple punctured sites allow CA-MRSA to enter blood stream resulting in bacteremia and death.

Our mission is to reduce spreading invasive CA-MRSA in the hospitals by developing alternative technique to introduce cannulae.

Medifix was created by doctors with a mission to reduce the threat of spreading antibiotic resustant bacteria to mankind.

Endoscopic Treatment of Allergic Fungal Maxillary Sinusitis

Laparoscopic Roux-en-Y Gastric Bypass with Hand-Sutured Anastomosis. Dr. Dennis Smith, Advanced Obesity Surgery, Marietta, GA

Meningeal Irritation Signs from the USMLE collection

Rest
Ice
Compression
Elevation

A dermatologist explains how this skin condition is recognised and treated and the challenging effects it can have on an individual.

Gynecomastia means enlargement of male breast to resample female breast that is a common problem between males and causes many psychological problem
Dr. Mohamed El-Rouby
Consltant of Plastic surgery - Faculty of Medicine - Ain Shams University

Shoulder Exam
I think that the most daunting aspect of the shoulder exam is appreciating the functional anatomy of this incredibly mobile joint. The primary benefit of the ball and socket arrangement is that it allows the hand to be positioned precisely in space, maximizing our ability to function. In terms of functionality, the shoulder might be best described as having a golf ball-on-a-tee design.
Location Of The Muscle Groups Is Approximated In The Pictures Above.

Start by looking at the normal (or more normal) side. Note any scars, obvious asymmetry, discoloration, swelling, or muscle asymmetry.

Palpation
Gently palpate around the shoulder, touching each of the landmarks noted above. Make note of pain.

How to insert Endotracheal tube in children

Flexor compartment synovectomy in a patient with rheumatoid arthritis presenting with loss of finger movement and local pain due to synovitis. Performed at the Queen Victoria Hospital, East Grinstead.

Surgical Knot