Top videos

Sigmoid Colostomy
Sigmoid Colostomy Mohamed 20,261 Views • 3 years ago

Sigmoid Colostomy

Defecography showing Enterocele
Defecography showing Enterocele Mohamed 14,154 Views • 3 years ago

Defecography showing Enterocele

Endoscopic Transgastric Pancreatic Necrosectomy using a Forward Viewing Echoendoscope
Endoscopic Transgastric Pancreatic Necrosectomy using a Forward Viewing Echoendoscope DrHouse 17,334 Views • 3 years ago

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.

Minimal invasive anterior preperitoneal inguinal hernia repair
Minimal invasive anterior preperitoneal inguinal hernia repair DrHouse 21,788 Views • 3 years ago

Surgical technique: A 3cm skin incision under spinal or general anesthesia, depending on the patients’ preference, starts half way the line between the superior anterior iliac spine towards the midline in a 30° angle to the pubic tubercle. Scarpa’s fascia is opened as well as the external obliq...ue aponeurosis. By using this skin line incision the internal ring will be immediately visualized. Although it is important to look for both direct and indirect hernias evaluating the groin, we do not taper the cord and directly evaluate the ring for indirect hernias. In case of an indirect hernia the sac is reduced or resected according to the preference of the surgeon and the preperitoneal space is entered bluntly through the dilated internal ring. In case of a direct hernia the approach slightly differs. One could prefer to open the transversalis fascia through the internal ring over a few centimeters or you can open the fascia more medially, at the site of the direct hernia. As primary point of concern the epigastric vessels should be identified and retracted softly upwards. Then a gauze can be introduced into the preperitoneal space and by doing so most of the space needed medially will be created. Then one can already palpate Cooper’s ligament and the pubic bone. Laterally to the internal ring more digital dissection is needed to create just the appropriate space for the mesh. By placing the mesh it is important not to introduce the mesh too medially. Laterally of the internal ring an adequate overlap of the mesh is necessary, especially in indirect hernias. No splitting of the mesh seems necessary. The patient will be asked to strain and push on the ring to control its place and to check adequate spreading of the mesh to cover the whole myopectineum of Fruchaud. One single stitch of vicryl 3/0 is placed taking both the fascia transversalis and the mesh.

Draw Blood Sample Venepuncture
Draw Blood Sample Venepuncture Mohamed 27,759 Views • 3 years ago

This video shows how to draw a blood sample which is medically known as venepuncture

Intestinal Obstruction Operation
Intestinal Obstruction Operation DrHouse 17,563 Views • 3 years ago

The operation was done by cut opening the abdomen for resection anastamoses of intestine. You can see all intestines. The patient unfortunately died of sepsis. He was just 15 yrs old

Restored Flexibility: Treating Spinal Fusion
Restored Flexibility: Treating Spinal Fusion Emery King 9,888 Views • 3 years ago

After a bad fall, a patient suffering from spinal fusion seeks help from a DMC Neurosurgery specialist.
~ Detroit Medical Center

Symptoms of H1N1 (Swine Flu)
Symptoms of H1N1 (Swine Flu) Doctor 11,969 Views • 3 years ago

In this video, Dr. Joe Bresee, with CDC's Influenza Division, describes the symptoms of H1N1 (swine flu) and warning signs to look for that indicate the need for urgent medical attention.

Understanding Heartburn
Understanding Heartburn Doctor 7,486 Views • 3 years ago

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

Pediatric Abdomen Radiology
Pediatric Abdomen Radiology Doctor 13,081 Views • 3 years ago

Pediatric Abdomen - Radiology & Imaging Powerpoint Video Lecture presentation with interesting case collection

Sarcoidosis Deformity
Sarcoidosis Deformity academyo 12,113 Views • 3 years ago

Third video about sarcoidosis. Please see my website for disclaimer.

How to properly apply a tourniquet
How to properly apply a tourniquet Mohamed 25,899 Views • 3 years ago

How to properly apply a tourniquet

Oxyhemoglobin dissociation curve
Oxyhemoglobin dissociation curve academyo 11,201 Views • 3 years ago

the video will describe oxyhemoglobin dissociation curve. please see my website for disclaimer.

Virus Multiplication
Virus Multiplication RAJESH PATEL 19,902 Views • 3 years ago

Showing how viruses multiply in general

Causes of declining libido in women
Causes of declining libido in women Doctor 14,796 Views • 3 years ago

Causes of declining libido in women

Embospheres Microspheres as a choice in Embolization
Embospheres Microspheres as a choice in Embolization Doctor Samir Abdelghaffar 15,366 Views • 3 years ago

Embospheres Microspheres are round particles which give them some extra advantages when they are used in embolization. This video gives a full idea about their advantages and use

Robotic surgery to remove a kidney tumor
Robotic surgery to remove a kidney tumor Mohamed 21,057 Views • 3 years ago

New robotic surgery procedure pioneered at Washington University School of Medicine in St. Louis to remove tumors from kidneys in a minimally invasive way

GYNECOMASTIA  IN QATAR
GYNECOMASTIA IN QATAR mohamed al emadi 10,872 Views • 3 years ago

GYNECOMASTIA IN QATAR video

Endoscopic Ventilation Tube Insertion
Endoscopic Ventilation Tube Insertion Mohammed Wahba 8,289 Views • 3 years ago

This clip shows the basic steps of inserting V.T> tubes. This surgery is performed for the treatment of OME resistent to medical TTT.

HE Hematoxylin and Eosin stain
HE Hematoxylin and Eosin stain Doctor 15,179 Views • 3 years ago

H&E stain is a popular staining method in histology. Its a combination of two dyes: the basic dye (hematoxylin) and the alcohol-based dye (eosin). In an H&E stain you will usually see both eosinophilia and basophilia: the nuclei of cells basophilic (blue), while eosinophilia is typical of cytoplasmic constituents (pink). Xylene, alcohols, distilled water are also required.

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