Henry Anhalt DO FAAP
Ped Eddo

Respiratory Examination video

Child Unresponsive Airway Obstruction

An Emergency Medicine video showing how to perform Jaw Thrust technique

Superficial Palpation of the Abdomen

If you are a medical student, a resident, a primary care physician or you practice in an emergency department, you can improve your suture skills with this detailed instruction. As you practice towards a cosmetically perfect technique, your confidence will increase, especially when dealing with complex wounds. Areas of study include: methods of closure, closure materials, anesthetics, suture removal, infection, prophylaxis, when to call in a plastic surgeon, recapping techniques and more

Squared Notch

An animation showing what PCO is

A video-animation presentation about sentinel lymph node biopsies for breast cancer diagnosis. 3D graphics are used to explain the process. Topics include the lymphatic system and the methods used. This video is part of the breast cancer education series produced by CancerQuest at Emory University

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.

We herein describe endoscopic treatment of symptomatic pancreatic pseudocyst with significant necrosis and a fistula. Fifty eight year old man had presented to us with a large pseudocyst following an episode of acute pancreatitis. He was complaining of significant abdominal pain for two months. A... CT scan abdominal had revealed a large retro-gastric pseudocyst with necrosis and portal venous thrombosis. An upper GI endoscopy had revealed small linear fundal varcies. Endoscopic as well as surgical treatment for the cyst was discussed with the patient. Patient wished not to undergo surgical treatment and therefore endoscopic treatment was selected after a proper consent. EUS was performed to see for the interposed vessel prior to the pseudocyst puncture. Needle knife puncture was made and a guide wire was passed in the pseudocyst cavity. After confirming the wire placement in the cyst, the tract was dilated up to 20 mms using a CRE balloon. Fluid from the cyst was emptied out in the stomach. An ERCP scope was passed in to the cyst cavity, which revealed a significant necrotic material (much more than what the CT scan had revealed). All the free lying necrotic material was taken out with the help of a snare and a dormia basket. A lot of necrotic was stuck to the cyst wall, which was removed with the help of water jet, mechanical scooping and cutting through using a needle knife papillotome. Three 10 fr. Pigtail stents were placed at the end of the procedure. Further necrosectomy was carried out on alternate days for three more sessions. Dilation was required prior to each session three pigtail trans-gastric stents were placed at the end of each session. Single stent was kept in situ during each procedure to guide the path (the position of the stoma changed dramatically once the cyst was empty). During the last lesion (session four), a pancreatogram was taken. It revealed a mildly dilated CBD in the head, normally duct in the proximal body with a leak from the distal body, and contrast was seen going in to the pseudocyst cavity. The duct could not be opacified distally. A 7 fr. 15 cms stent was placed trans-papillary. When the cyst cavity was reentered through trans-gastric route, the trans-papillary pancreatic stent was clearly visible with soft necrotic material around it. In fact, the stent guided further necrosis removal. It also helped in diverting the pancreatic juice to the duodenum rather than in the pseudocyst cavity. Patient was discharged after this session and was followed up regularly. A CT scan was obtained after three months, which revealed a complete resolution of the necrosis and pseudocyst. There was a possibility of a persistent fistula after the removal of trans-papillary stent and a recurrence of the pseudocyst. Fistula closure with cyanoacrylate glue is well described in the literature. The procedure can have obvious complications secondary to accidental blockage of the main pancreatic duct. So, we thought it prudent to use a safer alternative to treat the condition. We removed the longer pancreatic stent and replaced it with a shorter pancreatic stent occupying only the head region. The patient was followed up after a month; sonography of the abdomen did not reveal any recurrence of the pseudocyst. All the stents were removed at this examination.

Purpose The complication rate in patients treated with the Linton procedure was unacceptably high. SEPS is minimal invasive treatment modality for chronic venous insufficiency and venous ulcers. Materials and Methods252 limbs of 229 patients who underwent SEPS procedure and/or safenous vein ablati...on from May 2003 to January 2008. Tourniquet was not used and two-port technique was preferred for operation. Skin graft was not used. Honeysoft (medical honey) was used for wound care in selected cases. Results According to CEAP clinical Classification 112 limbs were class 6, 70 limbs (class 5), 70 limbs (Class4) respectively. Greater saphenous vein stripping and/or high ligation, and varicose vein excision accompanied SEPS in 241limbs who had combined Sapheno-femoral junction and perforator vein insufficiencyand SEPS was performed alone 23 limbs who had recanalised deep venous thrombosis (19) and PVI alone(4). Mean patient follow-up was 35 months. No early deaths or thromboembolism occurred. Complications included severe subcutaneous emphysema(1), neuralgia (7), 1 year later cellulites (1). Ulcers healed in 124 limbs in two months and 58 limbs in 3 months. ulcer recurrence was seen on 12(%6.6) limbs. Clinical severity and disability scores improved significantly after surgery. Conclusion All venous ulcers healed with SEPS combined or not ablation of superficial venous reflux and remain healed 5 year period and symptom-free except recurrent ulcers during the long-term follow-up. SEPS is an effective and safety treatment modality.

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.

This video shows how to draw a blood sample which is medically known as venepuncture

A video teaching how to give an intravenous injection

Removal of 5 Releasable sutures from the Eye

Bilateral High flex knee replacements for British patient. 81 year old Ken Perris is highly satisfied after double flexible knee replacements in Chennai hospital by Orthopaedic surgeon Dr.A.K.Venkatachalam of www.kneeindia.com. High flex or flexible knee replacements confer the ability to kneel, squat, sit cross legged. Minimally invasive surgical approaches reduce pain and hasten recovery.

How pregnancy can affect gingivitis

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.