Mohs surgery is a procedure used to remove skin cancers (most commonly basal and squamous cell carcinoma and melanoma) in a way that preserves a maximum amount of healthy tissue. It is useful for skin cancers when:

(1) the location of the cancer is near sensitive areas, like the fingers or face;
(2) earlier treatments have not worked;
(3) a skin cancer is large; and
(4) regular surgery is less likely to remove the cancer.

This procedure video illustrates the procedure on 2 patients with basal cell carcinoma. Click https://ja.ma/3b4scuY to learn more.

0:00 Disclaimer
0:07 Introduction
0:28 What this video will cover
0:43 Mohs "stage" steps
1:09 Marking surgical sites
1:27 Stage 1: skin layer resection (patient 1)
1:59 Maintaining skin layer orientation
2:55 Stage 1: processing layer onto slides (patient 1)
3:53 Stage 1: histology review for cancer (patient 1)
4:31 Discussion on wound closure
5:10 Wound closure (patient 1)
5:47 Stage 1: histology review for cancer (patient 2)
6:24 Stage 2: skin layer resection (patient 2)
6:38 Stage 2: histology review for cancer (patient 2)
6:56 Stage 3: skin layer resection (patient 2)
7:07 Stage 3: histology review for cancer (patient 2)
7:20 Wound closure (patient 2)
7:57 1-week follow-up before-and-after wound healing

On the day of your surgery, your health care team will take you to a preparation room. Your blood pressure and breathing will be monitored. You may receive an antibiotic medication through a vein in your arm. You will then be taken to an operating room and positioned on a table. You'll be given a general anesthesia medication to put you in a sleep-like state so that you won't be aware during your operation. The surgical team will then proceed with your colectomy. Colon surgery may be performed in two ways: Open colectomy. Open surgery involves making a longer incision in your abdomen to access your colon. Your surgeon uses surgical tools to free your colon from the surrounding tissue and cuts out either a portion of the colon or the entire colon. Laparoscopic colectomy. Laparoscopic colectomy, also called minimally invasive colectomy, involves several small incisions in your abdomen. Your surgeon passes a tiny video camera through one incision and special surgical tools through the other incisions. The surgeon watches a video screen in the operating room as the tools are used to free the colon from the surrounding tissue. The colon is then brought out through a small incision in your abdomen. This allows the surgeon to operate on the colon outside of your body. Once repairs are made to the colon, the surgeon reinserts the colon through the incision. The type of operation you undergo depends on your situation and your surgeon's expertise. Laparoscopic colectomy may reduce the pain and recovery time after surgery. But not everyone is a candidate for this procedure. Also, in some situations your operation may begin as a laparoscopic colectomy, but circumstances may force your surgical team to convert to an open colectomy. Once the colon has been repaired or removed, your surgeon will reconnect your digestive system to allow your body to expel waste. Options may include: Rejoining the remaining portions of your colon. The surgeon may stitch the remaining portions of your colon together, creating what is called an anastomosis. Stool then leaves your body as before. Connecting your intestine to an opening created in your abdomen. The surgeon may attach your colon (colostomy) or small intestine (ileostomy) to an opening created in your abdomen. This allows waste to leave your body through the opening (stoma). You may wear a bag on the outside of the stoma to collect stool. This can be permanent or temporary. Connecting your small intestine to your anus. After removing both the colon and the rectum (proctocolectomy), the surgeon may use a portion of your small intestine to create a pouch that is attached to your anus (ileoanal anastomosis). This allows you to expel waste normally, though you may have several watery bowel movements each day. As part of this procedure, you may undergo a temporary ileostomy.

Four-Step Guide to ABG Analysis Is the pH normal, acidotic or alkalotic? Are the pCO2 or HCO3 abnormal? Which one appears to influence the pH? If both the pCO2 and HCO3 are abnormal, the one which deviates most from the norm is most likely causing an abnormal pH. Check the pO2. Is the patient hypoxic?

why you should keep your ears clean.

irregular, curved toenails. footwear that places a lot of pressure on the big toes, such as socks and stockings that are too tight or shoes that are too tight, narrow, or flat for your feet. toenail injury, including stubbing your toe, dropping something heavy on your foot, or kicking a ball repeatedly. poor posture.

Transposition of the great arteries is a serious but rare heart defect present at birth (congenital), in which the two main arteries leaving the heart are reversed (transposed). Transposition of the great arteries changes the way blood circulates through the body, leaving a shortage of oxygen in blood flowing from the heart to the rest of the body. Without an adequate supply of oxygen-rich blood, the body can't function properly and your child faces serious complications or death without treatment.

Surfactant. Surfactants are compounds that lower the surface tension (or interfacial tension) between two liquids or between a liquid and a solid. Surfactants may act as detergents, wetting agents, emulsifiers, foaming agents, and dispersants.

Rehydration Tips: Kids & Teens (Ages 1+) Give clear liquids (avoid milk and milk products) in small amounts every 15 minutes. ... If your child vomits, start over with a smaller amount of fluid (2 teaspoons, or about 10 milliliters) and continue as above. ... After no vomiting for about 8 hours, introduce solid foods slowly.

Wilms tumor, also known as nephroblastoma, is a cancer of the kidneys that typically occurs in children, rarely in adults. It is named after Dr. Max Wilms, the German surgeon (1867–1918) who first described it. Approximately 500 cases are diagnosed in the U.S. annually.

What's helping me become a better doctor

Bone tumors develop when cells in the bone divide without control, forming a mass of tissue. Most bone tumors are benign, which means they are not cancer and cannot spread. However, they may still weaken bone and lead to fractures or cause other problems. Bone cancer destroys normal bone tissue and may spread to other parts of the body (called metastasis). Benign Bone Tumors Benign tumors are more common than malignant tumors of the bones. These are a few common types of benign bone tumors: Osteochondroma is the most common benign bone tumor. It is more common in people under age 20. Giant cell tumor is a benign tumor, typically affecting the leg (malignant types of this tumor are uncommon). Osteoid osteoma is a bone tumor, often occurring in long bones, that occurs commonly in the early 20s. Osteoblastoma is a single tumor that occurs in the spine and long bones, mostly in young adults. Enchondroma usually appears in bones of the hand and feet. It often has no symptoms. It is the most common type of hand tumor.

Laparoscopic use of Palmer's Point

You may have heard that some positions, such as your partner on top (missionary position), are better than others for getting pregnant. In fact, there's no evidence to back these theories up. Experts just haven't done the research yet. What experts have done, though, is use scanning to show what's going on inside when you're doing the deed. The research looked at two positions: the missionary position and doggy style. (Doggy style being when you're on all fours, and your partner enters you from behind). Common sense tells us that these positions allow for deep penetration. This means that they're more likely to place sperm right next to your cervix (the opening of your uterus). The scans confirm that the tip of the penis reaches the areas between the cervix and vaginal walls in both of these positions. The missionary position allows the penis to reach the area at the front of the cervix. The rear entry position reaches the area at back of the cervix. It's amazing what some experts spend their time doing, isn't it! Other positions, such as standing up, or woman on top, may be just as good for getting sperm right next to the cervix. We just don't know yet. http://www.babycentre.co.uk/sex-for-getting-pregnant#ixzz4XKnPLbxL

A small-bowel obstruction (SBO) is caused by a variety of pathologic processes. The leading cause of SBO in industrialized countries is postoperative adhesions (60%), followed by malignancy, Crohn disease, and hernias, although some studies have reported Crohn disease as a greater etiologic factor than neoplasia.

The first transplant of a bionic eye on a patient with a rare disease.

Treatment of a stroke interventionaly

Most minor cuts you can treat yourself -- but know when to see a doctor:

You have a good hearing again baby

This technique could solve the organ shortage crisis.

The inflatable penile prosthesis consists of two attached cylinders -- a reservoir and a pump -- which are placed surgically in the body. The two cylinders are inserted in the penis and connected by tubing to a separate reservoir of saline. The reservoir is implanted under the rectus muscles in the lower abdomen. A pump is also connected to the system and sits under the loose skin of the scrotal sac, between the testicles. This penile prosthesis is referred to as a 3-piece inflatable penile prosthesis, due to the three different components. A 2-piece inflatable penile prosthesis consists of only two components: the attached cylinders and the combined reservoir and pump unit. Instead of the reservoir being placed behind the groin, it is combined with the pump into one housing unit that fits comfortably within the scrotum. The advantage of a 2-piece prosthesis in that the surgery is shorter and less complicated and there is no device parts in the abdomen. The disadvantage of the 2-piece prosthesis is that the smaller reservoir may not result in adequate erections in some men. To inflate the prosthesis, the man presses on the pump. The pump transfers saline from the reservoir to the cylinders in the penis, inflating them and causing an erection. Pressing on a deflation valve at the base of the pump returns the fluid to the reservoir, deflating the penis and returning it to the normal flaccid state.