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.

Arterial Coronary Off-Pump Revascularization

This 81 year old man with severe CAD and CHF was referred for VCE following a negative endoscopic workup for chronic guaiac positive stools. Seen on only three frames, this sequence reveals a single mid small bowel telangectasia, a possible source for his chronic GI blood loss. He has been managed c...onservatively and continues to require intermittent transfusions despite oral iron therapy.

Chromoendoscopy of Colon Polyps

Excision of breast cancer that is visible only on mammogram. diagnosis is typically established on stereotactic biospy and excision is done with wire localization. This techniques involves localization by sonography of the hematoma that is left behind at the time of biopsy. It provides not only accu...rate location of the tumor but ensures adequate margins of excision.

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.

Subcutaneous Abdominal Injection

A 49-year old female patient complainig of cough. X-ray and chest CTscan showed a 2.5cm nodule in the left upper lobe. Transthoracic biopsy was consistent with adenocarcinoma. PET-Scan and CT Scan showed no mediastinal disease. The procedure was performed through three incisions.

Fibroma Excision in the Cheek

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

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.