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Loop duodenal switch is an end-to-side proximal duodeno-ileal bypass with a sleeve gastrectomy. The proximal duodenal stump is anastomosed to an ileal loop, 200 cm from the ileocecal valve. The procedure is a malabsorptive operation with some theoretical advantages: only one anastomosis is performed..., and so the operative time is shorter, and there is no mesenteric opening. It is not a mini-gastric bypass, as the gastric antrum, the pylorus and the first centimeters of the duodenum are preserved. The short term outcome shows a very good weight loss curve with no metabolic disturbances.
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.
This video demonstrates the approach to a large base of tongue tumor, which was invading the ramus of the mandible. The procedure, named after Dr. Trotter, is really a median labiomandibuloglossotomy. In this case this poorly differentiated tumor was resected along with a portion of the floor of mouth. The entire area was reconstructed with a pectoralis major myocutaneous flap.
This video features a testimonial of Okino Mosses from Nigeria recovers from nerve decompression after his Lumber spine decompression surgery at Mumbai in India who recovered from nerve decompression after his lumber spine surgery at Mumbai in India. Okino was suffering from nervous spine decompression and was in need of a good doctor plus medical solution and then he came to know of international quality spine treatment available in India at a reduced cost. Availing the assistance of medical tourism in India Okino was able to get an international quality and cost effective lumber spine decompression surgery at Mumbai in India. Lumber spine decompression surgery is a surgical procedure that is performed to alleviate pain caused by pinched nerves (neural impingement). This surgery provides assured medical recovery to medical patients who suffer from nervous decompression disorder. In the procedure of lumber spine decompression surgery a small portion of the bone over the nerve root and/or disc material from under the nerve root is removed to give the nerve root more space and provide a better healing environment. Several conditions may cause neural impingement, including spinal stenosis, a disc herniation, isthmic spondylolisthesis, degenerative spondylolisthesis, or (rarely) a spinal tumor. And lumber spine decompression surgery provides medical recovery from these spine disorders. Indian spine surgery hospitals of Delhi, Mumbai and Chennai have got good medical state of art facilities for abroad patients who want to get lumber spine surgery in India at a reduced price budget. The price of spine surgery procedure in India is affordable and the best doctors operate them to give patients a positive medical feed back after the surgery. 24/7 hours patient care provided by well trained Indian medical staff makes India a reliable medical destination. Medical tourism in India provides good care and assistance to patients who far in abroad to plan a cost effective medical trip to India. You may get more details about lumber spine surgery in India at http://www.dheerajbojwani.com or mail your queries at contact@dheerajbojwani.com
Urological surgeons have become proficient at performing complex pelvic urological procedures, such as radical prostatectomy, using the laparoscopic approach. Declan Murphy and Daniel Moon share their experience of four less common procedures they have performed recently using laparoscopic techniques. These include: excision of a urachal cyst; partial cystectomy for endometriosis (combined endoscopic-laparoscopic approach); repair of an intra-peritoneal bladder rupture; and repair of a ureteric injury (combined endoscopic-laparoscopic approach).
A thin polymer film that seals surgical wounds could make sutures a relic of medical history.
Measuring just 50 microns, the film is placed on a surgical wound and exposed to an infrared laser, which heats the film just enough to meld it and the tissue, thus perfectly sealing the wound. Known as Surgilux, the device's raw material is extracted from crab shells and has Food and Drug Administration approval in the US