Laparoscopy in acute bowel obstruction following previous surgery is a difficult procedure and avoided by most of the surgeons due to the difficulty in obtaining pneumoperitoneum, port placement, lack of working space, adhesions and risk of bowel injury.
Here is a patient who had a previous laparotomy for trauma with a midline incision from xyphysternum to pubis; after unsuccessful conservative management he underwent a laparoscopy; a prior CT scan showed adhesions in the left side and a distal-mid small bowel obstruction. The pneumoperitoneum was obtained with the Visiport placed in the right lower quadrant; although the abdomen was grossly distended, under significant tension and distended loops of small bowel were occupying most the peritoneal cavity, with muscle relaxation there is usually enough space to perform a thorough inspection of the abdominal cavity. Port placement has to be done with special care as there is no room to push and usually a blunt trocar directed away from the bowel is employed in my practice. The collapsed loops of small bowel point quickly to the site of obstruction -- it is better to avoid manipulating the distended bowel as it is heavy, oedematous and prone to be lacerated with the instruments; once the pathology is identified, in this case the obstructive band, light packing is performed in order to expose the working space and protect the bowel from instruments like scissors or diathermy. In this case the band adhesion was slightly more difficult to separate from the bowel and required a combination of sharp and gentle blunt dissection.
Once the obstruction is release and the transit of contents is confirmed in the collapsed bowel the procedure is terminated. No abdominal drainage is usually necessary.

very funny medical video..DO NOT TRY AT CLINIC

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.

The use of breast MRI as part of the screening for breast cancer.

The anatomy and function of the heart

How bunions appear

What is a Cataract

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 Vessel Ligation

Demonstration of subcuticular or intradermal suturing technique for wound closure in the operating room.

Video shows a Hip resurfacing operation done using the Durom hip from Zimmer.
The patient is a young active male. Hip resurfacing is emerging as the surgical procedure of choice in young and active patients for pain relief from Hip arthritis.

This video demonstrates how use a commercially-prepared "dip-stick" to test a random urine specimen for the presence of protein or glucose.

Medication Through Running IV

After losing control of his entire right side from a massive stroke, a teenager overcomes a long, difficult, and uncertain recovery with courage, grit, and determination. ~ Detroit Medical Center

Arterial Blood Gas Sampling ABG

esophago-gastro- duodinoscopy
Gastroduodinoscopy requires special training and considerable experience but affords valuable information.
By its implement the whole of the interior of the stomach as well as esophagus, the first part and the proximal section of the second part of the duodenum and both efferent and afferent loops of the gastrojujenostomy if present can be scrutinized.
Gastroscopy is valuable in the diagnosis of gastric ulcers, in checking the results of medical treatment of chronic gastric ulcer. Gastroduodinoscopy is valuable in differential diagnosis between chronic peptic ulcer and gastric carcinoma, in diagnosis of small gastric neoplasm, in the detection of certain forms of gastritis, in examination of a stoma, in cases of gastrojujenostomy, in cases of duodinitis and duodenal ulcer.
Now its' the Era of
VIDEOGASROSCOPE
Direct means of diagnosis of upper G.I. diseases
Continuous Video recording of the entire procedure is there by which
we can review the whole procedure by playing the Video.
We are doing final diagnosis of upper G.I. lesions with biopsy.
Treatment becomes easy and to the point.
Early detection of pre malignant and malignant lesions is appreciable.

Vaccines are extremely safe. Adverse reactions are uncommon. The most common reaction is pain and swelling at the vaccine site, which is easily treated, and has no longterm problems. An allergic reaction to vaccines are rare. Dr. Michael Davis dispells this and other vaccine myths, including myths about autism and vaccines.

Clean hands can help prevent the spread of infectious diseases, such as flu. This podcast explains the proper way to wash your hands.

Treatment of a Penetrating Chest Trauma

Echocardiography showing an Embolus