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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.
A no-scalpel vasectomy is performed in this detailed urology video, showing how the vas deferens is accessed through a tiny puncture rather than a conventional incision. The technique is a widely used method of permanent male contraception. For students and for men researching the procedure. Educational only — not medical advice.
In this animation it depicts an artery with cholesterol plaque (the yellowish area) which is blocking most of the inside of this artery. Then small cells called platelets become clumped together and cause the red blood cells to form a clot. This is what causes a HEART ATTACK.
A Cesarean section (C-section) is surgery to deliver a baby. The baby is taken out through the mother's abdomen. In the United States, almost one in three women has their babies this way. Some C-sections are planned, but many are done when unexpected problems happen during delivery. Reasons for a C-section may include Health problems in the mother The mother carrying more than one baby The size or position of the baby The baby's health is in danger Labor is not moving along as it should
It is held in place with a balloon at the end, which is filled with sterile water to prevent the catheter from being removed from the bladder. The urine drains through the catheter tube into a bag, which is emptied when full. The procedure to insert a catheter is called catheterization.
Anoscopy performed with the patient in the jackknife position is demonstrated in this educational video. Anoscopy uses a short, lighted instrument to examine the anal canal and lower rectum. A clinical-skills resource for students of colorectal examination. Educational only — not medical advice.
Dr. Alex Campbell and Dr. Carolina Restrepo of Premium Care Plastic Surgery in Cartagena, Colombia perform a Mommy Makeover on an international patient. Watch the procedure as Dr. Campbell and Dr. Restrepo work together to offer this patient more surgery in less time, which leads to a quicker recovery and better results.
This physical examination video demonstrates the clinical breast examination, part 1 of the Loyola University series. The recording shows the inspection and palpation techniques doctors use to assess the breast for masses or other abnormalities. Breast examination is a standard part of women's health assessment.
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