This 81 year old man with severe CAD and CHF was referred for VCE following a negative endoscopic workup for chronic guaiac positive stools. Seen on only three frames, this sequence reveals a single mid small bowel telangectasia, a possible source for his chronic GI blood loss. He has been managed c...onservatively and continues to require intermittent transfusions despite oral iron therapy.

Natural Orifice Endoscopic Transgastric Distal Pancreatectomy, A Prospective Randomized Controlled Trial. Natural orifice surgery may represent a paradigm shift in the area of minimally invasive surgery and therapeutic endoscopy. However, studies to date have been limited primarily to small ca...se series with small sample sizes. There has been no large rigorous randomized controlled trial of natural orifice surgery to date. Early work on procedures such as peritoneoscopy, oophorectomy and tubal ligation, while pioneering, have reproduced laparoscopic procedures with minimal morbidity and mortality. In contrast, distal pancreatectomy has a post-operative morbidity of more than 50% even in high volume tertiary care centers. As a highly morbid surgery, the post-operative event rate would allow for a significant difference to be seen in a trial of conventional versus NOTES distal pancreatectomy. We have recently completed a prospective randomized controlled trial of NOTES versus laparoscopic distal pancreatectomy in a swine model which builds on our earlier non-survival work. This video focuses on the endoscopic technique.

The colonoscope is slowly withdrawn during this screening colonoscopy down from the transverse colon, back around the splenic flexure, and down the descending colon, and reveals this finding a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.

Total laparoscopic hysterectomy using staples to secure major blood vessels. Vaginal colpotomy and mobilization of bladder performed initally with suture line at junction of vagina and cervix visualized laparoscopically.

A video showing how to insert an intravenous line also called intravenous drip

Challenges of cataract surgery in the eye with a history of radial keratotomy include IOL power calculation, protection of the cornea and aviodance of capsular complications.

Removal of 5 Releasable sutures from the Eye

A 49-year old female patient complainig of cough. X-ray and chest CTscan showed a 2.5cm nodule in the left upper lobe. Transthoracic biopsy was consistent with adenocarcinoma. PET-Scan and CT Scan showed no mediastinal disease. The procedure was performed through three incisions.

How pregnancy can affect gingivitis

Hemostasis after Tooth Extraction

A LASAG Yag laser is in thermal mode, 1.5 Joules/pulse to treat the trabecular meshwork between the cornea and iris for glaucoma. The view is of the inside anterior eyeball.

LASIK or Laser-Assisted In Situ Keratomileusis is a surgical procedure intended to reduce a person's dependency on glasses or contact lenses.

LASIK surgery is most commonly performed as a cure for myopia (nearsightedness), but can also be used to cure hyperopia (farsightedness) or astigmatism (corneal irregularities).

LASIK is a procedure that permanently changes the shape of the cornea using a special laser and thus focusing the light rays exactly on the retina.

The steps of the procedure are as follows:

A suction ring is placed on the eye to stabilize and check the eye pressure.

The microkeratome, a cutting instrument, is attached to the suction ring.

The blade of the microkeratome is used to cut a flap in the cornea.

The exposed inner layer of the cornea is then reshaped with an excimer laser.

The corneal flap is returned to its original position.

LASIK is an ambulatory procedure; the patient can walk into the surgery center, have the procedure and walk out again and is awake the whole time. Occasionally, the doctor may administer a mild oral sedative.

Using a common laser for treatment of eye cancer may benefit some patients by preserving site.

Oral Surgery and Dental Implants

Percutaneous Endoscopic Colostomy

Mesenteric artery illuminated with luciferase

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.

nurses removing chest tube from surgery after spontaneous pneumothorax

Sprains and Strains

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