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Johns Hopkins orthopaedic hip and knee surgeon, Savyasachi "Savya" Thakkar, explains how to prepare for knee replacement surgery, and what to expect before and after surgery. To learn more about our hip and knee replacement division, visit https://www.hopkinsmedicine.org/ortho. #KneeReplacement #JohnsHopkins
Q&A's
0:15 What causes someone to need a knee replacement?
0:29 What should patients do in advance of surgery?
1:10 Do you recommend physical therapy BEFORE surgery?
1:43 Will joint implants set off metal detectors at airports?
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Trabeculectomy, also called Filtration Surgery, is a surgical procedure performed for treatment of glaucoma. The treatment involves removing part of the trabecular meshwork and creating a new escape route for the aqueous humor. When successful, it allows the aqueous fluid to drain from the eye into an area underneath the conjunctiva where it is subsequently absorbed by the body's circulatory system or filtered into tears.
In this procedure:
- A conjunctival pocket is created and maybe treated with Mitomycin or other antimetabolites for a few minutes. These drugs are used to prevent scarring of the operation site. Scarring, if occurs, may clog the new drainage canal, and is therefore the major reason the procedure may fail.
- A half thickness flap is then made in the sclera and is dissected all the way to the clear cornea.
- A block of scleral tissue including part of the trabecular meshwork and Schlemm's canal is then removed to make a hole into the anterior chamber of the eye.
- As the iris may plug up this hole from the inside, a piece of the iris maybe removed at this time. This is called iridectomy.
- The scleral flap is then sutured loosely back in place. These sutures can be released gradually during a couple of weeks after surgery. This allows adjustment of the aqueous flow in order to achieve target pressure and to avoid the complication of having a too low intraocular pressure.
- The conjunctiva is sewn back in place to cover the area.
After surgery, aqueous humor drains into a filtering area called a "bleb" under the conjunctiva. Since the surgery is usually performed near the top of the eye, the bleb can easily be concealed behind the upper eyelid.
This video has been updated to include an alternate name for the internal thoracic arteries. View the updated video here: https://youtu.be/kxc22Fjd1NQ
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This video, created by Nucleus Medical Media, shows a coronary artery bypass graft (CABG) procedure used to combat coronary artery disease. Beginning with a midline sternal incision, the heart is connected to a perfusion machine which will take over the duties of the heart while the surgery takes place. Two different grafts are used to bypass the blocked coronary arteries: the internal thoracic artery from inside the chest wall, and the saphenous vein from the leg. After the procedure, the heart is shocked to restart its beating. A drainage tube is left at the incision site to drain away excess fluid. The animation continues to show two other types of approaches to a coronary artery bypass graft, off-pump bypass surgery and minimally invasive bypass surgery.
This is similar to the procedure performed on former president Bill Clinton and former California governor Arnold Schwarzenegger.
#HeartBypassSurgery #CABG #heart
ANCE00199
Dr. Horacio Asbun, Mayo Clinic in Florida, explains the Whipple procedure using this animated graphic of a pancreas. Cancer of the pancreas affects 45,000 people every year in the U.S., and it is the fourth leading cause of cancer-related deaths. The five-year overall survival rate if a tumor is detected early and surgically removed is 22 percent, versus 6 percent without early detection and surgery. To learn more, visit http://mayocl.in/2zk7FDi.
This video in Spanish/español: https://www.youtube.com/watch?v=N_zWboNMKWk
World-renowned surgeons at Shriners Hospitals for Children – Northern California provide complex pediatric surgery for children one-year and older with congenital and acquired conditions. Children from throughout the Western United States with chest wall malformations, gastro-intestinal disease, ano-rectal disorders, urologic conditions and other complex surgical needs benefit from the expert care. The pediatric surgery team is devoted to the development of innovative and minimally invasive surgical techniques.
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Chapters
0:00 Introduction
1:04 Why do doctors perform laparoscopy?
2:11 How is laparoscopy performed?
3:22 Result
3:47 Risk of laparoscopy
Laparoscopy (from Ancient Greek λαπάρα (lapára) 'flank, side', and σκοπέω (skopéō) 'to see') is an operation performed in the abdomen or pelvis using small incisions (usually 0.5–1.5 cm) with the aid of a camera. The laparoscope aids diagnosis or therapeutic interventions with a few small cuts in the abdomen.[1]
Laparoscopic surgery, also called minimally invasive procedure, bandaid surgery, or keyhole surgery, is a modern surgical technique. There are a number of advantages to the patient with laparoscopic surgery versus an exploratory laparotomy. These include reduced pain due to smaller incisions, reduced hemorrhaging, and shorter recovery time. The key element is the use of a laparoscope, a long fiber optic cable system that allows viewing of the affected area by snaking the cable from a more distant, but more easily accessible location.
Laparoscopic surgery includes operations within the abdominal or pelvic cavities, whereas keyhole surgery performed on the thoracic or chest cavity is called thoracoscopic surgery. Specific surgical instruments used in laparoscopic surgery include obstetrical forceps, scissors, probes, dissectors, hooks, and retractors. Laparoscopic and thoracoscopic surgery belong to the broader field of endoscopy. The first laparoscopic procedure was performed by German surgeon Georg Kelling in 1901. There are two types of laparoscope:[2]
A telescopic rod lens system, usually connected to a video camera (single-chip or three-chip)
A digital laparoscope where a miniature digital video camera is placed at the end of the laparoscope, eliminating the rod lens system
The mechanism mentioned in the second type is mainly used to improve the image quality of flexible endoscopes, replacing conventional fiberscopes. Nevertheless, laparoscopes are rigid endoscopes. Rigidity is required in clinical practice. The rod-lens-based laparoscopes dominate overwhelmingly in practice, due to their fine optical resolution (50 µm typically, dependent on the aperture size used in the objective lens), and the image quality can be better than that of the digital camera if necessary. The second type of laparoscope is very rare in the laparoscope market and in hospitals.[citation needed]
Also attached is a fiber optic cable system connected to a "cold" light source (halogen or xenon) to illuminate the operative field, which is inserted through a 5 mm or 10 mm cannula or trocar. The abdomen is usually insufflated with carbon dioxide gas. This elevates the abdominal wall above the internal organs to create a working and viewing space. CO2 is used because it is common to the human body and can be absorbed by tissue and removed by the respiratory system. It is also non-flammable, which is important because electrosurgical devices are commonly used in laparoscopic procedures.[3]
Procedures
Surgeons perform laparoscopic stomach surgery.
Patient position
During the laparoscopic procedure, the position of the patient is either in Trendelenburg position or in reverse Trendelenburg. These positions have an effect on cardiopulmonary function. In Trendelenburg's position, there is an increased preload due to an increase in the venous return from lower extremities. This position results in cephalic shifting of the viscera, which accentuates the pressure on the diaphragm. In the case of reverse Trendelenburg position, pulmonary function tends to improve as there is a caudal shifting of viscera, which improves tidal volume by a decrease in the pressure on the diaphragm. This position also decreases the preload on the heart and causes a decrease in the venous return leading to hypotension. The pooling of blood in the lower extremities increases the stasis and predisposes the patient to develop deep vein thrombosis (DVT).[4]
Gallbladder
Rather than a minimum 20 cm incision as in traditional (open) cholecystectomy, four incisions of 0.5–1.0 cm, or more recently, a single incision of 1.5–2.0 cm,[5] will be sufficient to perform a laparoscopic removal of a gallbladder. Since the gallbladder is similar to a small balloon that stores and releases bile, it can usually be removed from the abdomen by suctioning out the bile and then removing the deflated gallbladder through the 1 cm incision at the patient's navel. The length of postoperative stay in the hospital is minimal, and same-day discharges are possible in cases of early morning procedures.[citation needed]
Colon and kidney
Shoutout to director/videographer Valentina Vee and producer Sean Tien for helping me bring this to life.
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So you want to be a cardiothoracic surgeon. You like the idea of open heart surgery and the glory that comes with being a CT surgeon. Let’s debunk the public perception myths of what it means to be a cardiothoracic surgeon, and give it to you straight. This is the reality of cardiothoracic surgery.
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TIME STAMPS:
00:41 - What is Cardiothoracic Surgery?
04:08 - How to Become a Cardiothoracic Surgeon
06:29 - Subspecialties within Cardiothoracic Surgery
07:49 - What You’ll Love About Cardiothoracic Surgery
09:10 - What You Won’t Love About Cardiothoracic Surgery
10:04 - Should You Become a Cardiothoracic Surgeon?
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Ellis demonstrates how to perform a sterile wound dressing change. It would be appropriate to perform hand hygiene between glove changes.
Our Critical Nursing Skills video tutorial series is taught by Ellis Parker MSN, RN-BC, CNE, CHS and intended to help RN and PN nursing students study for your nursing school exams, including the ATI, HESI and NCLEX.
#NCLEX #ClinicalSkills #woundcare #HESI #Kaplan #ATI #NursingSchool #NursingStudent #Nurse #RN #PN #Education #LVN #LPN #nurseeducator
00:00 What to expect
00:51 Prepping for wound dressing change
1:15 Removing the old wound dressing
1:40 Assessing a wound
2:05 Setting up sterile field
2:49 Sterile gloving
4:02 Preparing equipment for wound dressing change
5:09 Cleaning a wound
6:13 Drying a wound
6:28 Packing a wound
7:19 Covering a wound
7:47 Labeling a wound dressing
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Today, the most common approach for open-heart surgery is a sternotomy, which requires a 12-14-inch incision through the breastbone. But in the hands of experienced minimally invasive surgeons, many cardiac procedures can be performed through smaller 2- to 3-inch incisions between the ribs without the need to cut through the breastbone. Learn more in this medical animation from Sarasota Memorial's Minimally Invasive Cardiac Surgery Team and medical director Jonathan Hoffberger, DO. For information or referrals, visit smhheart.com.
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Watch Spinal Stenosis Videos Spinal stenosis occurs when the spinal cord in the neck (cervical spine) or the spinal nerve roots in the lower back (lumbar spine) are compressed. Symptoms of lumbar stenosis often include leg pain (sciatica) and leg tingling, weakness, or numbness. Arm pain is a typical symptom of cervical spinal stenosis. For cervical spinal stenosis with myelopathy, difficulty with coordination often occurs. Stenosis treatment may include non-surgical options (exercise, anti-inflammatory medication, epidural injections, and activity modification) or back surgery.
Autonomous Tumor Localization and Extraction: Palpation, Incision, Debridement and Adhesive Closure with the da Vinci Research Kit. This video demonstrates a successful trial of the entire five-step procedure where human input is required only at four points to change tools. We also show failure modes of the current autonomous system and we are working on experiments to characterize the reliability of each step and on incorporating computer vision and new probing algorithms to improve robustness.