Incision of the bladder neck for a small prostate

New York Plastic Surgery ,Dr. Robert Vitolo ,board certified plastic surgeon , brings you into the operating room for a glimpse at how his transumbilical breast augmentation procedure is performed. Dr. Vitolo, a pioneer in the 'no visible scar' breast enlargement surgery, has been using this technique since 1994. Dr. Vitolo use Allergan Natrelle saline breast implants and Mentor saline implants. Dr. Vitolo also performs a removal of silicone gel implants and replacement with saline implants using the transumbilical method.

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.

I call this technique deep rendering. I basically stacked graphical cross-sections (in this case, MRI rendering data), using proper increments and clip through them with the camera. This way I am able to explore all internal components in full 3D real-time.

I actually was able to figure out how to colorize different organs to help distinguish them apart from each other but couldn't get the shader to render real-time in Maya.

Credit: MRI scans courtesy of University of Washington Digital Anatomist Program

Endoscope-assisted pocket grafting of autologous collagen for correction of facial wrinkles

This 40 yr male had upper abdominal pain for 3 months. A video-endoscopic examination of esophagus, stomach and duodenum was performed. A large 2.5x2.5 cm chronic ulcer was detected in the first part (bulb) of duodenum. A gastric biopsy was taken for diagnosis of Helicobacter infection and a rapid urease test done which was positive. He received triple therapy (2 antibiotics and acid suppressive drug for one week) to eradicate Helicobacter pylori infection. Ulcer disease showed rapid clinical and endoscopic healing. Eradication of Helicobacter pylori infection led to permanent ulcer cure.

A video from Loyola medical school, Chicago showing the cardiovascular medical and clinical examination

Part 5: from Loyola Medical School, Chicago showing clinical examination of the neurological system.

The ABC's of Adult CPR

Squared Notch-1

Ultra Sound-Guided Interscalene Block

Polycystic ovary syndrome (PCOS, also known clinically as Stein-Leventhal syndrome), which is an endocrine disorder that affects 5--10% of women. It occurs amongst all races and nationalities, is the most common hormonal disorder among women of reproductive age, and is a leading cause of infertility. The symptoms and severity of the syndrome vary greatly between women. While the causes are unknown, insulin resistance (often secondary to obesity) is heavily correlated with PCOS.

Recommendations for clipping in endoscopic stomach surgery

Various laparoscopic techniques have been described for the insertion of peritoneal dialysis catheters. However, most use 3 to 4 ports, thus multiplying the potential risk for abdominal wall complications (hemorrhage, hernia, leaking). With the technique presented herein a Tenckhoff catheter is plac...ed laparoscopically, using just 1 port, in 13 consecutive patients with end-stage renal failure. The catheter is fixed in the abdominal cavity with no additional ports for this purpose. The simplicity and the rapidity of the method justifies serious consideration for its use as the standard Tenckhoff catheter placement.

Appendectomy with corpus Luteal rupture

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.

Endoscopic third ventriculostomy in a patient with obstructive hydrocephalus

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

Allograft material is placed submucosally to expand tissue to simulate turbinate tissue. It is placed in a location to direct the airstream toward "virgin" tissue that can sense airflow. Empty Nose Syndrome (ENS) is an iatrogenic disease characterized by paradoxical obstruction: a hugely patent no...

se with subjective "blockage" or poor nasal breathing.

Fibroma Excision in the Cheek