Mini-Laparoscopic Cholecystectomy with Intraoperative Cholangiogram for Symptomatic Cholelithiasis (Gallstones) - Extended
Authors: Brunt LM1, Singh R1, Yee A2
Published: September 26, 2017

AUTHOR INFORMATION
1 Department of Surgery, Washington University, St. Louis, Missouri
2 Division of Plastic and Reconstructive Surgery, Washington University, St. Louis, Missouri

DISCLOSURE
No authors have a financial interest in any of the products, devices, or drugs mentioned in this production or publication.

ABSTRACT
Minimal invasive laparoscopic cholecystectomy is the typical surgical treatment for cholelithiasis (gallstones), where patients present with a history of upper abdominal pain and episodes of biliary colic. The classic technique for minimal invasive laparoscopic cholecystectomy involves four ports: one umbilicus port, two subcostal ports, and a single epigastric port. The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) has instituted a six-step strategy to foster a universal culture of safety for cholecystectomy and minimize risk of bile duct injury. The technical steps are documented within the context of the surgical video for (1) achieving a critical view of safety for identification of the cystic duct and artery, (2) intraoperative time-out prior to management of the ductal structures, (3) recognizing the zone of significant risk of injury, and (4) routine intraoperative cholangiography for imaging of the biliary tree. In this case, the patient presented with symptomatic biliary colic due to a gallstone seen on the ultrasound in the gallbladder. The patient was managed a mini-laparoscopic cholecystectomy using 3mm ports for the epigastric and subcostal port sites with intraoperative fluoroscopic cholangiogram. Specifically, the senior author encountered a tight cystic duct preventing the insertion of the cholangiocatheter and the surgical video describes how the author managed the cystic duct for achieving a cholangiogram, in addition to the entire technical details of laparoscopic cholecystectomy.

Watch that Large Jelly Like Hematoma Extraction

Vaginal discharge serves an important housekeeping function in the female reproductive system. Fluid made by glands inside the vagina and cervix carries away dead cells and bacteria. This keeps the vagina clean and helps prevent infection. Most of the time, vaginal discharge is perfectly normal. The amount can vary, as can odor and hue (its color can range from clear to a milky white-ish), depending on the time in your menstrual cycle. For example, there will be more discharge if you are ovulating, breastfeeding, or are sexually aroused. The smell may be different if you are pregnant or you haven't been diligent about your personal hygiene. None of those changes is cause for alarm. However, if the color, smell, or consistency seems significantly unusual, especially if it accompanied by vaginal itching or burning, you could be noticing an infection or other condition. What causes abnormal discharge? Any change in the vagina's balance of normal bacteria can affect the smell, color, or discharge texture. These are a few of the things that can upset that balance:

When diving into a Breast Reduction procedure, there are many things to consider. Even as a patient, being aware of any concerns and how the procedure works is important. Therefore, when a plastic surgeon operates on a patient, the results are clear. Dr. Linder, a Breast surgeon specialist in Beverly Hills, helps explain what goes into a Breast Reduction Procedure.

Worst Nail Infection: Paronychia

SPIDER Surgery-- Single Incision Gallbladder Removal

Delivery Video

-Tibial stress fractures are common in athletes and nonathletes who suddenly increase their physical activity. Clinical features include pain, localized tenderness, and swelling. Plain x-ray is <50% sensitive for stress fractures, especially in the first 2-3 weeks after the onset of symptoms. MRI is preferred over bone scan or ultrasound as it can show the fracture line that extends through the cortex into the medullary line. MRI can also identify ligament, muscle, and cartilage injuries. However, MRI findings may be persistently abnormal for up to 1 year after the stress fracture has healed.

A biopsy is a diagnostic test that involves collecting small pieces of tissue, usually through a needle, for examination with a microscope. A kidney biopsy can help in forming a diagnosis and in choosing the best course of treatment.

he inflatable penile prosthesis consists of two attached cylinders -- a reservoir and a pump -- which are placed surgically in the body. The two cylinders are inserted in the penis and connected by tubing to a separate reservoir of saline. The reservoir is implanted under the rectus muscles in the lower abdomen.

This particular video is intended as a demonstration of Neurologic Examination. This demonstration is intended as an example of a neurologic exam which may be used as part of the initial evaluation of patients with complaints that may have an underlying neurologic origin. This video is solely for educational purposes and intended for use to prepare for OSCEs incorporating standardized patient encounters. It is not intended as a demonstration of a comprehensive neurologic examination and is not intended as medical advice or medical guidelines.

It is not intended as a complete instructional video and should not be considered a source of complete physical examination instruction.

Instead, it should be treated as a supplement to independent learning using primary Osteopathic Clinical Skills instructional resources. Clinical skills are best learned and developed with support from faculty in the context of a complete Osteopathic Medical School Curriculum.

Osteopathic Clinical Skills is a channel dedicated to discussing and exploring Osteopathic Clinical Skills concepts for medical students, residents, and clinicians and presenting them in an easy to understand manner.

Attributions:
Many thanks to the University of North Texas Health Science Center Texas College of Osteopathic Medicine (UNTHSC - TCOM) for permitting use of the Simulation facilities and equipment during the production of this video.

Additional thanks to the UNTHSC-TCOM standardized patient and faculty volunteers who participated in this production and provided permission for the use of their image in this video.

http://sin-celulitis.good-info.co/ Como Eliminar La Celulitis, Celulitis Infecciosa Tratamiento, Celulitis Tratamiento,quitar Celulitis. Yo se muy bien lo devastadora que puede llegar a ser la tan odiada piel de naranja para ti. No hay nada peor que la vergüenza que causa en la piel femenina. Esta puede perfectamente aplastar el autoestima de cualquier mujer. Pero sabes muy bien que eso no es todo, a causa de la celulitis también te suceden cosas como estas: Sientes tremenda vergüenza de que vean tus piernas y glúteos con hoyuelos. Tu pareja te ha hecho comentarios que te incomodan sobre tus piernas (o sabes que lo piensa) No puedes usar ropa ajustada ni blanca por temor de que se note el “alto relieve” de tu piel. Te deprimes cada vez que te miras al espejo. Ir a la playa se ha convertido en una tortura cuando tus amigas usan traje de baño y tu tratas de cubrirte lo más posible. Has gastado muchísimo dinero en tratamientos para eliminar la celulitis que nunca funcionaron. No puedes acariciar tu piel sin sentir la desagradable piel de naranja. Aviso: Los Secretos Tras Una Piel Libre De Celulitis Al Descubierto. Haga Clic Aqui. http://sin-celulitis.good-info.co

A Pap smear (also called a Pap test) is a screening procedure for cervical cancer. It tests for the presence of precancerous or cancerous cells on the cervix, the opening of the uterus. It's named after the doctor who determined that this was a useful way to detect signs of cervical cancer.

Bone marrow examination refers to the pathologic analysis of samples of bone marrow obtained by bone marrow biopsy (often called a trephine biopsy) and bone marrow aspiration. Bone marrow examination is used in the diagnosis of a number of conditions, including leukemia, multiple myeloma, anemia, and pancytopenia. The bone marrow produces the cellular elements of the blood, including platelets, red blood cells and white blood cells. While much information can be gleaned by testing the blood itself (drawn from a vein by phlebotomy), it is sometimes necessary to examine the source of the blood cells in the bone marrow to obtain more information on hematopoiesis; this is the role of bone marrow aspiration and biopsy.

Histology of Small Intestine Jejunum

A subdural hematoma is most often the result of a severe head injury. This type of subdural hematoma is among the deadliest of all head injuries. The bleeding fills the brain area very rapidly, compressing brain tissue. This often results in brain injury and may lead to death. Subdural hematomas can also occur after a minor head injury. The amount of bleeding is smaller and occurs more slowly. This type of subdural hematoma is often seen in older adults. These may go unnoticed for many days to weeks, and are called chronic subdural hematomas. With any subdural hematoma, tiny veins between the surface of the brain and its outer covering (the dura) stretch and tear, allowing blood to collect. In older adults, the veins are often already stretched because of brain shrinkage (atrophy) and are more easily injured.

all you need to know about the female orgasm

Describe pre-procedure considerations for administering a subcutaneous injection.

Describe and demonstrate the preparation for administering a subcutaneous injection.

Describe and demonstrate needle and blood safety.

Describe and demonstrate suitable injection sites for subcutaneous injections.

Discuss the appropriate needle and syringe sizes for subcutaneous injection.

Describe and demonstrate the preparation of the substance to be injected.

Describe and demonstrate safe and correct administration of a subcutaneous injection.

Understand and apply Occupational Safety and Health Administration (OSHA) guidelines.

Understand and apply drug administration safety guidelines (seven rights).

Understand correct post-procedure considerations.

Describe and demonstrate correct documentation.

Define and demonstrate correct recording and reporting procedures.

Define and use related medical terminology.

Explain the Patient Privacy Rule (HIPAA), Patient Safety Act, and Patients' Bill of Rights.

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Today on Crash Course Anatomy & Physiology, Hank breaks down the parts and functions of one of your body's unsung heroes: your epithelial tissue.

Pssst... we made flashcards to help you review the content in this episode! Find them on the free Crash Course App!
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Chapters:
Introduction 00:00
Proper Epithelium & Glandular Epithelium 1:38
We're All Just Tubes! 2:12
Cell Shapes: Squamous, Cuboidal, or Columnar 3:34
How Form Relates to Function 4:15
Layering: Simple or Stratified 5:26
Epithelial Cells: Apical & Basal Sides 7:06
Glandular Epithelial Tissue Forms Endocrine & Exocrine Glands 8:20
Review 9:16
Credits 9:54

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