ENDOSCOPIC (NON-SURGICAL) REMOVAL OF MULTIPLE LARGE TUMORS FROM STOMACH IN A PATIENT WITH PEUTZ-JEGHERS SYNDROME
PEUTZ-JEGHERS SYNDROME: Peutz-Jeghers syndrome (PJS) is a familial syndrome consisting of mucocutaneous pigmentation, gastrointestinal polyposis and cancers of gut & other sites like breast, ovary, and testes. PJS has an autosomal dominant inheritance with variable and incomplete penetrance. Germline mutations of STK11/LKB1 gene on 19p cause this syndrome. Mucocutaneous pigmentation may be noted in early infancy. These deposits of melanin are most commonly found around the mouth, nose, lips, buccal mucosa, hands, and feet, and may also be present in perianal and genital areas. PJS polyps may be found in stomach, small intestine, or colon, but they tend to be prominent in the small intestine. These polyps may increase in size and cause small intestinal obstruction or intussusceptions that may occur in early infancy. Acute upper gastrointestinal bleeding and chronic faecal blood may complicate the disease.
PATIENT: The patient was a 25 yr male who had mucocutaneous pigmentation and multiple polyps in the stomach and duodenum. He presented with bleeding from gastric polyps. As the polyps in stomach were numerous, (more than 20 in number) and were large in size (some equal to small egg size), he had been advised to undergo surgery. Surgery planned was total gastrectomy.
PROCEDURE: The patient underwent video-endoscopy of the esophagus, stomach and duodenum. All polyps were examined for size and presence or absence of stalk. A plan to remove all the gastric polyps at endoscopy was made in the same sitting. He received light conscious sedation. Flat polyps were raised form the gastric wall by injection of saline in to polyp base to let these lesions have a stalk. This was done by needle injector. Each polyp was engaged in a snare and the polyp stalk was cut by coagulation cutting current. The cuts were clean without any bleeding. All polyps were recovered for histology. The histology revealed all polyps to be hamartomous lesions. None of the polyps were cancerous. Patient has been followed up for over one year and is doing fine without any further bleeding or pain.
Video shows the procedure of videoendoscpy and endoscopic removal of polyps.

Laparoscopic fixation of intraabdominal testis into the scrotum in a case of undescended testis.

A video from Loyola medical school, Chicago showing the cardiovascular medical and clinical medical examination

Access to processes within the skull base with lateral extension to the pterygopalatine fossa are reached by combined subfrontal osteotomy and Le Fort I osteotomy

This task requires streching a rubber band around 16 nails on a wooden board. A penalty is calculated when the rubber band is not streched around a nail at the end of the task. Score = time (seconds) + number of missed nails x 10. Performance standard: Score = 62 sec [Kolkman 2008]

Trabeculectomy surgery

Arestin Antibiotic for Periodontal Disease

LASIK Surgery Procedure

Anatomy of the Prostate

Osteochondral Allograft

Choking Child Video Demonstration

Endoscopic Drainage of an Orbital Mucocoele

A discussion and demonstration of suturing techniques with Lee Dresang, MD from the University of Wisconsin Department of Family Medicine

This video illustrates the steps of wound packing

Wound healing, or wound repair, is the body's natural process of regenerating dermal and epidermal tissue. When an individual is wounded, a set of complex biochemical events takes place in a closely orchestrated cascade to repair the damage. These events overlap in time and may be artificially categorized into separate steps: the inflammatory, proliferative, and remodeling phases (Some authors consider healing to take place in four or more stages, by splitting different parts of inflammation or proliferation into separate steps.). In the inflammatory phase, bacteria and debris are phagocytized and removed, and factors are released that cause the migration and division of cells involved in the proliferative phase.

Simple surgery under a local anesthesia can help cluster headaches patients:
www.alisultaneh.8m.com
www.migrainesurgery.4t.com

basic circular cast for Radius and Ulna Fractures

Dr. Thomas Haas, MD, Board Certified plastic surgeon, performed breast augmentation on his patient in November, 2007. The surgery was performed in his JCAHO accredited in-office Surgery Suite (Imaage) located in Louisville, Kentucky. With so many women interested in this surgery, this video can answer many of their questions. Dr. Haas specializes in cosmetic and aesthetic surgery and has been in practice over 15 years

Laparoscopic varicocellectomy for Varicocele

Insight eNO has revolutionized asthma treatment. Apieron’s asthma products as shown in this demo in AARC (American Association for Respiratory Care)help in managing asthma for patients suffering from acute asthma attacks by detecting exhaled nitric oxide (eNO) present in the human breath.