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.

Total laparoscopic hysterectomy using staples to secure major blood vessels. Vaginal colpotomy and mobilization of bladder performed initally with suture line at junction of vagina and cervix visualized laparoscopically.

After the diagnosis of primary melanoma of pectoral region had been established, the patient was referred to lymphoscintigraphy with gamma camera (techencium; nanno colloid). Two hours after the administration of the contrast medium, the operation commenced. During the operation the primary tumor wa...s excised, and the sentinel node was detected with the use of gamma probe and also excised.

This task requires cutting a circle from a rubber glove streched over 16 nails in a wooden board. Penalties are calculated when the cutting deviated from the drawn line. Score = time (seconds) + surface of glove in mgs deviated from circle. Performance standard: Score = 189 sec

Removal of 5 Releasable sutures from the Eye

The Pulsed Electron Avalanche Knife, a new electrosurgical knife for “cold” and traction-less cutting, was successfully used for a variety of surgical maneuvers commonly encountered in patients undergoing ocular surgery.

How pregnancy can affect gingivitis

A LASAG Yag laser is in thermal mode, 1.5 Joules/pulse to treat the trabecular meshwork between the cornea and iris for glaucoma. The view is of the inside anterior eyeball.

Splenectomy for a giant spleen

Endoscopic finding in a patient with a typical rectal cancer (adenocarcinoma)

Most corneal transplants performed in the U.S. involve replacing the entire thickness of the diseased cornea with a healthy donor cornea (called penetrating keratoplasty or PK). In partial-thickness corneal transplants (LK), only the anterior (surface) layers of the cornea are removed. The donor cornea is then attached to the host corneal bed, containing only posterior (deeper) layers. LK is less risky, but tends to result in somewhat inferior vision vs. PK and cannot be performed if the disease process (e.g. scar) involves the deeper layers of the cornea.

Using a common laser for treatment of eye cancer may benefit some patients by preserving site.

Animated video on otitis media, infection of the middle ear, which is common in children.

Ingrown Toenail

Adult CPR Video Demonstration

Dr. David Rivadeneira from Stony Brook University in Stony Brook, NY will host a panel discussion on how to obtain improved outcomes during open surgery through the application of advanced techniques and technologies, including the new LigaSure Impact™ instrument. "It provides excellent and reliable hemostasis on major blood vessels, but the big advancement is that it is faster than traditional techniques and leaves no foreign material behind."

The program will begin with a brief introduction of the topic, followed by video presentation of two procedures, a right hemicolectomy and a sigmoid colectomy. Dr. Rivadeneira will discuss the techniques that he uses. "You'll be able to see the impact of applying multifunctional energy-based instruments to enable rapid and reliable dissection of the mesentery and ligation of colonic blood supply. This is particularly evident on tough diverticular cases, where it works very well with complicated tissue." Joining Dr. Rivadeneira, to review and discuss the cases, will be Dr. Sang Lee from Weill Cornell Medical College, NY.

Mesenteric artery illuminated with luciferase

Combined Spinal-Epidural Obstetric Anesthesia

Dr.Vijay C. Bose from Apollo Speciality Hospital chennai perform Birmingham Hip Resurfacing Surgery procedure for a case of Avascular necrosis.The NCP ( Neck Capsule Preserving) approach is being used. Total hip replacement, hip resurfacing simply shaves and caps a few centimeters of bone within the joint. The bone-conserving approach of the Birmingham Hip Resurfacing System.

Carotid Endartrectomy, large atheroma removed completely, patient well after surgery.