Loop duodenal switch is an end-to-side proximal duodeno-ileal bypass with a sleeve gastrectomy. The proximal duodenal stump is anastomosed to an ileal loop, 200 cm from the ileocecal valve. The procedure is a malabsorptive operation with some theoretical advantages: only one anastomosis is performed..., and so the operative time is shorter, and there is no mesenteric opening. It is not a mini-gastric bypass, as the gastric antrum, the pylorus and the first centimeters of the duodenum are preserved. The short term outcome shows a very good weight loss curve with no metabolic disturbances.

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.

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

Scleral fixated IOLs in case of inadequacy of capsular support and scleral sutured capsular tension rings when adequate zonular support is inavailable have been recently used in cataract surgery. In these techniques, polypropylene suture is used and the suture ends over the sclera after the knot ha...s been formed, may erode the conjunctiva and become exposed. Thus, the erosion may lead to the development of endophtalmitis. In order to prevent the aforementioned complication, scleral flaps, otologous cornea, duramater or fascia lata patches have been used to cover the knot and rotation of the knot into the tissues has been described.

Challenges of cataract surgery in the eye with a history of radial keratotomy include IOL power calculation, protection of the cornea and aviodance of capsular complications.

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

Stephen has sharing his experience with the others.

Baby CPR

This video demonstrates how to test for trace amounts of blood in the patients stool. Trace amounts of blood in the stool can be sign of a number of problems, colon cancer being the most worrisome.

At Children's Hospital, Dr. Mary Bedard and the NICU nursing staff save the life of a tiny infant struggling from a serious intestinal infection. ~ Detroit Medical Center

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.

This 25 second video clip demonstrates the effect of "post-tetanic facilitation" in a patient receiving rocuronium (a neuromuscular blocking agent)under general anesthesia

Lecture presented by Dr. Mostafa Yakoot, to the European Multicongress of parasitology Valencia, Spain

In this video Erin K, a tubal reversal patient, explains the symptoms she experienced while suffering from Post Tubal Ligation Syndrome (PTLS). After having tubal reversal surgery her symptoms were relieved. Although numerous women suffer from adverse symptoms after having a tubal ligation, many physicians do not believe PTLS exists. In an ongoing study of over 300 patients reporting Post Tubal Ligation symptoms more than 90% have found relief after tubal reversal at Chapel Hill Tubal Reversal Center.

Causes of declining libido in women

Laparoscopic varicocellectomy Surgery

أ.د/ سمير عبد الغفار في برنامج الصحة و الجمال يتحدث عن الطرق العلاجية المختلفة لعلاج الأورام الليفية في الرحم و خاصة بالطرق التي تتفادى استئصال الرحم.
أ.د/ سمير عبد الغفار هو استشاري العمليات التداخلية بدون جراحة في كلية الطب بجامعة عين شمس

للمزيد من المعلومات عن الأورام الليفية في الرحم:
http://www.Fibroidstoday.com

Associate Professor Dr. Samir Abd Elghaffar spekaing in the famous TV show "Health and Beauty" discussing various non invasive techniques of curing fibroids and leiomyomas stressing on the interventional radiology techniques.

Dr. Samir Abd Elghaffar is the consultant of interventional radiology and non invasive procedures in Ain Shams Faculty of medicine.

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

Prostate Health and Cancer Seminar features nationally renowned physicians and scientists presenting the most current study and practices for the diagnosis and treatment of prostate cancer. This day-long program offers in-depth exploration of prostate issues that range from monitoring PSA counts to cutting-edge research to current treatment trends.

Amyotrophic lateral sclerosis The disorder causes muscle weakness and atrophy throughout the body caused by degeneration of the upper and lower motor neurons. Unable to function, the muscles weaken and atrophy. Affected individuals may ultimately lose the ability to initiate and control all voluntary movement, although bladder and bowel sphincters and the muscles responsible for eye movement are usually, but not always, spared. Cognitive function is generally spared for most patients although some (~5%) also have frontotemporal dementia.A higher proportion of patients (~30-50%) also have more subtle cognitive changes which may go unnoticed but are revealed by detailed neuropsychological testing. Sensory nerves and the autonomic nervous system, which controls functions like sweating, are generally unaffected but may be involved for some patients. The earliest symptoms of ALS are typically obvious weakness and/or muscle atrophy. Other presenting symptoms include muscle fasciculation (twitching), cramping, or stiffness of affected muscles; muscle weakness affecting an arm or a leg; and/or slurred and nasal speech. The parts of the body affected by early symptoms of ALS depend on which motor neurons in the body are damaged first. About 75% of people contracting the disease experience "limb onset" ALS i.e. first symptoms in the arms ("upper limb", not to be confused with "upper motor neuron") or legs ("lower limb", not to be confused with "lower motor neuron"). Patients with the leg onset form may experience awkwardness when walking or running or notice that they are tripping or stumbling, often with a "dropped foot" which drags along the ground. Arm-onset patients may experience difficulty with tasks requiring manual dexterity such as buttoning a shirt, writing, or turning a key in a lock. Occasionally, the symptoms remain confined to one limb for a long period of time or for the whole course of the illness; this is known as monomelic amyotrophy. About 25% of cases are "bulbar onset" ALS. These patients first notice difficulty speaking clearly or swallowing. Speech may become slurred, nasal in character, or quieter. Other symptoms include difficulty swallowing, and loss of tongue mobility. A smaller proportion of patients experience "respiratory onset" ALS where the intercostal muscles that support breathing are affected first. Regardless of the part of the body first affected by the disease, muscle weakness and atrophy spread to other parts of the body as the disease progresses. Patients experience increasing difficulty moving, swallowing (dysphagia), and speaking or forming words (dysarthria). Symptoms of upper motor neuron involvement include tight and stiff muscles (spasticity) and exaggerated reflexes (hyperreflexia) including an overactive gag reflex. An abnormal reflex commonly called Babinski's sign (the big toe extends upward and other toes spread out) also indicates upper motor neuron damage. Symptoms of lower motor neuron degeneration include muscle weakness and atrophy, muscle cramps, and fleeting twitches of muscles that can be seen under the skin (fasciculations). Around 15–45% of patients experience pseudobulbar affect, also known as "emotional lability", which consists of uncontrollable laughter, crying or smiling, attributable to degeneration of bulbar upper motor neurons resulting in exaggeration of motor expressions of emotion.