Top videos

• All Time
• Today
• This week
• This month
• This year

Bleeding control during laparoscopic pelvic surgery

Mesh repair is based on the anatomical principle with associated complications of a foreign body and recurrence. Use of an un-detached strip of the external oblique aponeurosis in place of mesh between the muscle arch and the inguinal ligament gives a strong and physiologically dynamic posterior wal...l that gives radical cure.

Various laparoscopic techniques have been described for the insertion of peritoneal dialysis catheters. However, most use 3 to 4 ports, thus multiplying the potential risk for abdominal wall complications (hemorrhage, hernia, leaking). With the technique presented herein a Tenckhoff catheter is plac...ed laparoscopically, using just 1 port, in 13 consecutive patients with end-stage renal failure. The catheter is fixed in the abdominal cavity with no additional ports for this purpose. The simplicity and the rapidity of the method justifies serious consideration for its use as the standard Tenckhoff catheter placement.

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.

ANEURYSMS OF THE CEREBRAL VESSELS CAUSE SUBARACHNOID HEMORRHAGE. MICRONEUROSURGICAL CLIPPING ELIMINATES DEFINITIVE THE RISK OF RERUPTURE, ENABLES TO TREAT VASOSPASMS AND ELIMINATES THE NEED FOR RE-ANGIOGRAPHIES. INTRAOPERATIVE PUNCTURE CHECKS IMMEDIATLY THE ELIMINATION OF THE ANEURYSM.

Resection of a glioblastoma multiforme, a very malignant, aggressive brain tumor.

Repair performed with the PROLIFT Pelvic Floor Repair System - the total implant. The objective of the PROLIFT procedure is to achieve a a complete anatomic repair of pelvic floor defects in a standardized way. The repair is achieved by the placement of the synthetic non-absorbable polyprolylen mesh... implant via a vaginal approach.

Breast Massage Technique For Good Breast Health

Thyroid Exam Physical Exam

Intra-Uterine Device IUD Removal

Intra-Uterine Device IUD Insertion Demonstration

Anatomy of The Axillary Fossa

Anatomy of The Infratemporal Fossa

Histology of Female Urethra

Chest Expansion Clinical Exam

Feeding Tube

Preventing Perineal Tears HD

Birth Esercise for easier Childbirth HD

CT Scanner 64 slice Inside HD

Whole Body CT scan with contrast media HD