Surgery video of transgastric cholecystectomy

26 week uterus using Gyrus PKS Cutting Forcep, PKS Lyons Dissecting Forceps & PKS Needle.

assessment of the extra-ocular muscles

Heart sounds S1, S2

Examination of varicose veins

Infant Cardio-pulmonary Resuscitation

How to deal with a case of ingested poison

Laparoscopic excision of a 6cm Cornual Ectopic Pregnancy that failed initial MTX treatment.

Utilizing specially engineered lasers, permanent hair removal has never been more comfortable for men and women of all colors and skin types. In just four or five sessions, patients can achieve lasting results without damaging the skin or any surrounding tissue.

Dark pigment (melanin) in the hair shaft and the papilla (the root of the hair follicle) are targeted by a specific light-energy emitted by the laser. In a tiny fraction of a second, the hair is simply vaporized without damaging the skin or any surrounding tissue.

In one pulse (that lasts a tiny fraction of a second) our lasers remove hair on a patch of skin the size of a quarter. The hair removal sensation is like plucking hair or getting snapped by a rubber-band. Our lasers incorporate a patented and state-of-the-art integrated cooling system that acts as a natural anesthetic, cooling down the skin to minimize any discomfort. Patients unanimously report that the hair removal treatment is a "piece of cake" compared to waxing.

Minimally invasive kidney and ureteral stone surgery using holmium laser performed at El Camino Urology Medical Group,

Endoscopic Brain Surgery, third Ventriculostomy

HCG Injection Procedure

Loyola oral Presentation for Rounds video

Tie

Continuous Connell Pattern Suture

Vertical Mattress Pattern Suture

Use of Skin Stapler

Sentinel Lymph Node removal in breast Cancer en Français

The colonoscope is slowly withdrawn during this screening colonoscopy down from the transverse colon, back around the splenic flexure, and down the descending colon, and reveals this finding a colonic diverticula. Diverticulosis is a common, acquired, age-related occurrence affecting over 50% of the... western adult population over the age of 50. It is seen rarely in Africa and Asia where the dietary fiber content is traditionally higher. Thus most investigators feel that low fiber diets are related to the development of this condition. Ironically, colonic diverticula are not true diverticula but rather pseudodiverticula in that the sac includes layers of the mucosa and submucosa that push through rather than include the outer muscular layer. As with the small bowel the colon has an inner circular muscular layer, but the outer longitudinal layer is composed of three bands of muscle that run the length of the colon known as teniae. Diverticula occur in rows between the mesenteric and two antimesenteric teniae where the colonic wall is further weakened by the defect caused by the perforating vasa recti artery which supplies the colonic mucosa. Occasionally, the anatomic propensity of diverticula to form in rows is quite apparent as seen when this clip is replayed in slow motion. Most often, however, the arrangement of the diverticula appears random due to the angulation of the bowel and thickening of the semi lunar folds. The conditions that cause these pulsion diverticula are not know with certainty but may include high intrahaustral pressures, muscular hypertrophy, and age related alterations in collagen cross linking. Diverticula can bleed or can abscess and perforate. The incidence of diverticulitis or diverticular bleeding is in the range of 1:1,000 patients with diverticulosis.

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.