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Michael Marcus, MD Pediatric Pulmonary www.DrMDK.com Maimonides Medical Center Fellowship:Children’s Hospital of Philadelphia www.DrMDK.com
Chest examination video
This video shows how to control bleeding
Modern technique of hernia's operations
Myringotomy is the surgery to place tubes in the ear. This animated video reviews the anatomy of the ear and what happens after frequent infection. As well as treatment with tubes in the ear or myringotomy.
This animated video reviews hyperopia, or farsightedness.
The Principles of Laparoscopic Suturing
The video will describe how lung consolidation appears on a chest x-ray. Please see my website for disclaimer.
How to properly apply a tourniquet
LCHI - Hernia repair done by medical students with guidance and assistance of Professor Luiz Eduardo C. Miranda. Description of surgery is in portuguese.
Liposuction is a surgical procedure that is done to remove fat deposits from underneath the skin. Common areas that are treated: the abdomen, buttocks, thighs, upper arms, chest and neck. (use medical graphic of body with labeled parts) The procedure is usually done as an outpatient under some combination of local anesthesia and/or sedation:. This means you are awake but relaxed and pain free. Depending on the number of areas to be treated and the specific technique selected, it may take from one to several hours. A small incision (cut) is made through the skin near the area of the fat deposit. Multiple incisions may be needed if a wide area or multiple areas are being done. A long hollow tube called a cannula will be inserted through this incision. Prior to inserting the cannula, the doctor may inject a solution of salt water that contains an anesthetic (numbing) medication and another medication to decrease bleeding. The cannula is then inserted and moved under the skin in a way to loosen the fat deposits so they may be suctioned out. Because a significant amount of body fluid is removed with the fat, an intravenous (through the veins) fluid line will be kept going during the procedure.
A recent technique called “ultrasound-assisted lipoplasty” uses a special cannula that liquefies the fat cells with ultrasonic energy. You should ask your doctor which technique he/she will use and how it will affect the type of anesthesia you will need and the length of the procedure.
Why is this procedure performed?
Liposuction is done to restore a more normal contour to the body. The procedure is sometimes described as body sculpting. It should be limited to fat deposits that are not responsive to diet and exercise. It is suggested that you should be within 20of your ideal body weight at the time of surgery. If you are planning to lose weight you should delay this procedure. This is not obesity surgery. The maximum amount of fat that can be removed is usually less than 10 pounds. The best results are achieved in people who still have firm and elastic skin. Although rare, there are risks and complications that can occur with liposuction. You should be aware that all the complications are increased if you are a smoker. You will need to quit smoking or at least avoid smoking for a month before and after surgery. If you have had prior surgeries near any of the areas to be treated, this may increase the risk of complications and you should discuss this with your doctor. Any history of heart disease, diabetes, bleeding problems or blood clots in your legs may make you more prone to post-operative problems and you should discuss these with your doctor. Finally, as with any cosmetic procedure it is important to have realistic expectations. The goals, limitations, and expectations of the procedure should be discussed openly and in detail with your doctor. Most insurance companies do not cover cosmetic surgery.
What should I expect during the post-operative period?
After surgery you should be able to go home but you will need someone to drive you. In the first few days after surgery it is common for the incisions to drain fluid and you will have to change dressings frequently. Fresh blood is not usual and if you have any bleeding you should call your doctor immediately. In some cases a small tube may have been placed through the skin to allow drainage. You will be limited to sponge baths until the drains and dressings are removed. After that you may take showers but no baths for 2 weeks. You may experience pain, burning, and numbness for a few days. Take pain medicine as prescribed by your doctor. You may notice a certain amount of bruising and swelling. The bruising will disappear gradually over 1 to 2 weeks. Some swelling may last for up to 6 months. If you have skin sutures they will be removed in 7 to 10 days. You should be able to be up and moving around the house the day after surgery but avoid any strenuous activity for about 1
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A very simplified method giving information about cystic fibrosis
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AirXpanders Inc. designs, manufactures and distributes the revolutionary AeroFormTM Patient Controlled Tissue Expander. A first for women who choose reconstructive surgery following a mastectomy, the AeroForm tissue expander does not use intrusive and painful saline injections via syringe needles. The AeroForm patient controlled tissue expander utilizes a needle-free inflation system via a patient-controlled handheld device, which releases specified amounts of air in the form of carbon dioxide
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Today, hair transplant physicians are able to make use of different techniques to extract and transplant large numbers of hair follicles (follicular units). There are two primary techniques for hair transplantation currently in use. The FUE (Follicular Unit Extraction) and the FUT (Follicular Unit Transplantation) methods. They differ primarily in the way hair follicles are extracted from the donor area. Follicular Unit Transplantation (FUT) The FUT process involves removing a small strip of tissue from the back of the head, from which the donor hair follicles will be extracted. The hair follicles are harvested from the strip by a skilled clinical team before being individually transplanted to the recipient areas. In most cases, and especially cases of advanced hair loss, FUT is the preferred method because it allows the physician to fully utilize the scalp area to deliver results consistent with patient expectations. FUT typically allows for the greatest number of grafts to be transplanted in a single session. Pain Management Some patients report higher levels of discomfort with FUT procedures compared to FUE due the potential swelling in the area where the strip of tissue was removed, but both methods have a very manageable recovery period and pain medication can be prescribed by your physician if needed. Both techniques of hair transplantation are relatively simple. Hair transplantation procedures are outpatient surgeries with some patients going back to work as soon as the very next day. Scarring The FUT strip extraction method typically results in a very narrow linear scar in the back of the head (typically 1mm in diameter or less in size). Since the scar is very thin, it’s easily concealed by all but the shortest of haircut styles. A short to moderate crop setting on most clippers is sufficient to conceal the scar for the majority of patients, and over time the scar will become less noticeable as it fades. Costs The industry norm for pricing is on a per-graft basis. This allows each individual to pay for only what they need and receive in number of grafts, and not a flat rate that in the end may cost you more. The per-graft cost of a FUT procedure is generally lower than that of a FUE procedure. Lately however, in response to the rising popularity of the FUE technique, many hair transplantation clinics have started lowering the per graft cost on FUE procedures, so that the cost difference between the two types of procedure are not as much as most people think. The costs of medical procedures always vary by patients’ conditions, needs and objectives. For the most accurate assessment of your hair loss and the associated cost of your hair restoration, you will need to speak to a physician. Follicular Unit Extraction (FUE) In an FUE hair transplantation, each follicular unit is individually taken directly from the scalp with no strip of tissue being removed. Hair follicles are removed in a random fashion and the result is less density in the donor area that many say is not even noticeable. This is the main difference between FUE & FUT. Since follicles are removed one at a time, fewer follicles can be harvested during a typical session, making FUE a better option to restore hair in smaller cases (number of grafts) compared to the traditional FUT method. FUE is constantly evolving and what was once utilized for only smaller cases is now being utilized for larger and larger cases. Some people that prefer the FUE method may have the option of splitting their procedure into two days in order to complete their recommended transplantation goals. Pain Management With no stitches required and no linear scar left to heal, FUE procedures do have a faster healing time and less post-procedure discomfort compared to the traditional FUT procedure. Scarring Since FUE procedures involve removing hairs individually from the scalp, there is no linear scar left behind. However, there will be tiny 1mm in diameter or less puncture marks that tend to heal by themselves after scabbing-over in the days following the procedure. These tiny wounds typically heal within three to seven days. Costs Since the physician must remove each hair follicle individually, the time-sensitive nature of an FUE procedure typically makes it more expensive than an FUT procedure. As stated earlier, FUE technology is improving as well as gaining popularity and many hair restoration practices (including Bosley) have started to lower the cost per graft price for FUE procedures. Nowadays, the cost difference between a FUE and a FUT procedures is less disparate.