posterior augmentation

Dr. Debbie Song at Gillette Children's describes in detail selective rhizotomy surgery.

A selective dorsal rhizotomy is an operation performed to treat spasticity. It is thought that high tone and spasticity arise from abnormal signals that are transmitted through sensory or dorsal nerve roots to the spinal cord. In a selective dorsal rhizotomy we identify and cut portions of the dorsal nerve roots that carry abnormal signals thereby disrupting the mechanisms that lead to spasticity. Potential patients go through a rigorous assessment that includes an in-depth gait and motion analysis as well as a physical therapy evaluation.

They are evaluated by a multidisciplinary team that includes a pediatric rehabilitation doctor, a neurosurgeon, and an orthopedist, Appropriate patient selection is vital. Ideal candidates for selective dorsal rhizotomy are children who are between four and ten years of age, have a history of being born prematurely, and have a diagnosis of diplegia cerebral palsy. These patients usually walk independently or with the assistance of crutches or a walker. They typically function at a level one, two, or three in the gross motor function classification system or gmfcs. A selective dorsal rhizotomy involves the coordinated efforts of the neurosurgery, physiatry, anesthesia and nursing teams. The operation entails making an incision in the lower back that is approximately six to eight inches long. We perform what we call a laminoplasty in which we remove the back part of the spinal elements from the lumbar one or l1 to l5 levels. At the end of the procedure the bone is put back on. We identify and open up the Dural sac that contain the spinal fluid spinal cord and nerve roots. Once the Dural sac is opened ,we expose the lumbar and upper sacral nerve roots that transmit information to and from the muscles of the lower extremities.

At each level we isolate the dorsal nerve root, which in turn is separated into as many as 30 smaller thread light fruitlets.

Each rootlet is then electrically stimulated. Specialized members of the physiatry team look for abnormal responses in the muscles of the legs as each rootless is being stimulated. If an abnormal response is observed then the rootlet is cut.

If a normal response is observed, then the rootlet is not cut. We usually end up cutting approximately 20 to 40 percent of the rootlets. The Dural sac is sutured closed and the l1 through l5 spinal elements are put back into anatomic position, thus restoring normal spinal alignment. The overlying tissues and skin are then closed and the patient is awoken from surgery. The entire operation takes between four and five hours. A crucial component to the success of our rhizotomy program is the extensive rehabilitation course following surgery. With their tone significantly reduced after a rhizotomy, patients relearn how to use their muscles to walk more efficiently through stretching, strengthening, and gait training. Approximately one to two years after a rhizotomy patients undergo repeat gait and motion analysis. The orthopedic surgeons assess the need for interventions to correct bone deformities, muscle contractures, poor motor control, impaired balance, or other problems related to cerebral palsy.

At Gillette we work closely with patients and families to ensure that our selective dorsal rhizotomy program meets their goals for enhancing their function and improving their quality of life.

VISIT https://www.gillettechildrens.org/ to learn more

0:00 Why choose selective dorsal rhizotomy?
0:56 Who is a good candidate for selective dorsal rhizotomy?
1:31 What does a selective dorsal rhizotomy entail?
3:26 What is recovery from selective dorsal rhizotomy like?

This video demonstrates the Retrograde Wire Intubation

CTR is a surgery in which the narrowed part of the airway just below the voice box (larynx) is removed and the voice box and windpipe (trachea) are sewn back together. It is also used to treat other airway problems.

Rheumatoid arthritis is a chronic inflammatory disorder that can affect more than just your joints. In some people, the condition also can damage a wide variety of body systems, including the skin, eyes, lungs, heart and blood vessels. An autoimmune disorder, rheumatoid arthritis occurs when your immune system mistakenly attacks your own body's tissues. Unlike the wear-and-tear damage of osteoarthritis, rheumatoid arthritis affects the lining of your joints, causing a painful swelling that can eventually result in bone erosion and joint deformity. The inflammation associated with rheumatoid arthritis is what can damage other parts of the body as well. While new types of medications have improved treatment options dramatically, severe rheumatoid arthritis can still cause physical disabilities.

Dr. Neel Joshi, Clinical Chief, Department of Surgery at Cedars Sinai, describes his technique for trocar removal at the end of laparoscopic cholecystectomy.

#medicaleducation #laparoscopicsurgery

Children are not little adults, which is why even the simplest of procedures requires a hospital that is 100 percent dedicated to caring for children. Children’s Mercy is one of only 10 centers in the country to be as recognized as a Level 1 Children’s Surgery Center, the highest possible rating. The result? An organization with pediatrics specialists in every subspecialty that sets the standard of care instead of just practicing it.

Women are routinely invited to have cervical screening tests (also called smear tests). The tests are done to prevent cervical cancer, not to diagnose cancer. During each test some cells are removed from the neck of the womb (cervix), with a plastic brush. The cells are examined under a microscope to look for early changes that, if ignored and not treated, could develop into cancer of the cervix. You are very unlikely to develop cervical cancer if you have regular cervical screening tests at the times advised by your doctor. If the test shows any abnormality, you will have treatment to stop you ever getting cancer of the cervix. So, an abnormal test does not mean you have cancer. It means you should have some treatment to stop you getting cancer.

Have you heard any medical lingo you've thought is strange? Funny healthcare speaker Dr. Brad Nieder discusses funny medical terminology he's learned in his medical career. He brings his medical comedy to a healthcare conference, describing how he didn't know what "stat" meant.

He goes on about how he thought up many funny terms he could say in return to the doctor who introduced him to the word. His healthcare comedy makes the crowd burst with laughter.

Dr. Brad knows how to adapt his hilarious real-life stories into customized presentations for any in-person or virtual event. Watch more of his videos as a medical comedian and all-around funny guy by browsing his videos.

Train with some of the region’s very best pediatric general surgeons — in a two-year, pediatric surgical fellowship training program at Nemours/Alfred I. duPont Hospital for Children. Our hospital’s Division of Pediatric Surgery is offering this program in affiliation with Sidney Kimmel Medical College at Thomas Jefferson University .

The goal of the fellowship is to give individuals who have completed an accredited general surgery residency advanced knowledge and training in the management and surgical treatment of newborns, infants and children.

Our Fellowship Program
This fellowship will help you prepare for certification by the American Board of Surgery, and is accredited by the Accreditation Council for Graduate Medical Education (ACGME).

The Pediatric Surgery Fellowship aims to:

train a well-rounded, empathetic, safe pediatric surgeon who is confident managing all aspects of the surgical care of children.
steward our fellow in quality improvement projects and methodology, and provide research opportunities.
provide a rigorous didactic curriculum for our fellow utilizing 360 degree feedback.
cultivate opportunities for our fellow to educate residents and students.
encourage our fellow to collaborate across specialties.
develop our fellow’s presentation skills during M&M conferences and multi-disciplinary educational meetings.
The program features the full participation of all nine of the pediatric surgical division’s full-time faculty members. Each of these physicians will contribute greatly to your education. Your training will include operating room and outpatient clinic experience, as well as bedside evaluation of children. You’ll also play a role in the organization of formal teaching conferences, held weekly. Formal rotations will be spent on Pediatric Urology, PICU and Neonatology during the first 12 months. The last year will be spent entirely on the Pediatric Surgical Service.
The majority of your inpatient consultative time will take place at Nemours/Alfred I. duPont Hospital for Children, a freestanding children’s hospital in Wilmington, Del. The hospital:

is nationally ranked by U.S. News & World Report in eight pediatric specialties
recently opened expansion with 260 beds
performs more than 2,800 inpatient and 9,300 outpatient surgical procedures each year in our operating rooms
has an on-site delivery center for newborns with complex congenital anomalies
receives more than 50,000 annual visits in our Emergency Department (ED)
is accredited by The American College of Surgeons as a Level One Pediatric Trauma Center
is accredited by the Commission on Accreditation of Rehabilitation Facilities (CARF)


Visit https://www.nemours.org/educat....ion/gme/fellowships/ to learn more.

this video show the surgical technique of a perforator propeller flap for the reconstruction of the lower limb.

What to expect during the day of a pediatric surgery at Sutter Children's Center Sacramento.

Vetical Mattress Suture

Funny Video from hospital waiting room

Smead Jones Sutures - Far Far- Near Near

Ellis and Cathy demonstrate how to administer blood to a patient.

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 #Blood #bloodtransfusion #HESI #Kaplan #ATI #NursingSchool #NursingStudent⁠ #Nurse #RN #PN #Education #LVN #LPN

00:00 What to expect blood transfusion
00:26 First steps for a blood transfusion
1:03 Priming the tubing for blood transfusion
2:29 Confirming the blood for transfusion
4:36 Hanging the blood for transfusion
5:06 Clamping a Y-tube
5:34 Priming the blood for transfusion
7:00 Responding to a blood transfusion reaction


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All of the nurses at Level Up RN are here to help! Cathy Parkes started helping her fellow classmates back when she was in nursing school, tutoring so they could pass their exams and graduate. After she got her BSN and started working as an RN at Scripps Encinitas Hospital, she started this YouTube channel to help nursing students around the world. Since then she has built a team of top-notch dedicated nurses and nurse educators who are focused on improving nursing education and supporting career advancement for nurses everywhere. With flashcards, videos, courses, organizational tools and more, we are singularly focused on helping students and nurses Level Up on their exams and nursing careers.

Follow along on a typical day with UCSF Medical Center's chief of cardiothoracic surgery Dr. Tom Nguyen. Take a walk on rounds with his team as they check on patients who are recovering or preparing for heart valve surgeries to treat conditions such as mitral valve prolapse and mitral regurgitation. Get a glimpse into the operating room as Dr. Nguyen and his team use the latest non-invasive techniques to help patients achieve the best outcomes.

0:00 Surgeon begins day with morning report
0:53 Meet with fellows and visit patients
1:28 Surgeon thoughts on his practice
Minimally Invasive Surgeries
2:09 Mitral valve replacement for mitral stenosis
3:11 Mitral valve repair for AFib and mitral regurgitation
3:36 Stopping the heart
4:15 Culture 1 - Everyone's voice matters
4:45 Mitral valve repair for heart murmur
5:12 Culture 2 - Patient first

To view more UCSF videos relating to Mitral Regurgitation Treatment and Aortic Stenosis Treatment view:
Mitral Regurgitation Treatment Options https://youtu.be/7nUUOMx4tJ0
Aortic Stenosis Treatment Options https://youtu.be/A2rZK0oFWcc

If you want to learn more about the Cardiac Surgery clinic and to request an appointment visit: https://www.ucsfhealth.org/cli....nics/cardiac-surgery



#dayinthelife #heartsurgeon #heartsurgery #CardiacSurgery #Cardiology #ucsf #drnguyen#ucsfhealth #Cardiothoracic

Possible complications could include: Difficulty healing. Infection. Stump pain (severe pain in the remaining tissue) Phantom limb pain (a painful sensation that the foot or toe is still there) Continued spread of gangrene, requiring amputation of more areas of your foot, toes or leg. Bleeding. Nerve damage.

Inguinal or groin hernias are the most common type of hernias and most of the time occur in men. We talked with CU Medicine surgeon, Dr. Sam Phinney, about groin hernias and how they are treated. https://www.cumedicine.us/abou....t-cu-medicine/health