Sanjeev Dutta, MD, FACS discusses the fascinating new world of surgical technology. The pediatric general surgeon shares how medicine and technology have combined to achieve less invasive procedures and healthier outcomes for surgical patients.

Dr. Dutta is a pediatric general surgeon at Lucile Packard Children's Hospital. He is also an Associate Professor of Surgery at Stanford School of Medicine and Surgical Director of the Multidisciplinary Initiative for Surgical Technology Research.

Learn more about Stanford Children's Health. http://www.stanfordchildrens.org.

For patients in extremis from respiratory failure or shock, securing vascular access is crucial, along with establishing an airway and ensuring adequacy of breathing and ventilation. Peripheral intravenous catheter insertion is often difficult, if not impossible, in infants and young children with circulatory collapse. Intraosseous (IO) needle placement, shown in the images below, provides a route for administering fluid, blood, and medication. An IO line is as efficient as an intravenous route and can be inserted quickly, even in the most poorly perfused patients.

Comprehensive physical examination

Surgical procedure of Tonsillectomy and Adenoidectomy

The video demonstrates complete excision of endometrosis in a variety of challenging situations.

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The headache, lethargy, and neck stiffness suggest subarachnoid hemorrhage secondary to rupture of a mycotic aneurysm. Mycotic or infected arterial aneurysms can develop due to metastatic infection from IE, with septic embolization and localized vessel wall destruction in the cerebral (or systemic) circulation. Intracerebral mycotic aneurysms can present as an expanding mass with focal neurologic findings or may not be apparent until aneurysm rupture with stroke or subarachnoid hemorrhage. The diagnosis of mycotic cerebral aneurysm can usually be confirmed with computed tomography angiography. Management includes broad-spectrum antibiotics (tailored to blood culture results) and surgical intervention (open or endovascular).

Not every woman undergoes a traditional vaginal delivery with the birth of her child. Under conditions of fetal or maternal distress, or in the case of breech presentation (when a baby is turned feet first at the time of delivery), or if the woman’s first baby was born by cesarean delivery, a procedure called a cesarean section may be required. During a cesarean, a doctor will make either a lateral incision in the skin just above the pubic hair line, or a vertical incision below the navel. As the incision is made, blood vessels are cauterized to slow bleeding. After cutting through the skin, fat, and muscle of the abdomen, the membrane that covers the internal organs is opened, exposing the bladder and uterus. At this time the physician will generally insert his or her hands into the pelvis in order to determine the position of the baby and the placenta. Next, an incision is made into the uterus and any remaining fluids are suctioned from the uterus. The doctor then enlarges the incision with his or her fingers. The baby’s head is then grasped and gently pulled with the rest of its body from the mother’s uterus. Finally, the abdominal layers are sewn together in the reverse order that they were cut. The mother is allowed to recover for approximately three to five days in the hospital. She will also be quite sore and restricted from activity for the following several weeks. There are several potential complications associated with this procedure that should be discussed with a doctor prior to surgery.

Breech Baby Position Exercise!

A Cesarean section (C-section) is surgery to deliver a baby. The baby is taken out through the mother's abdomen. In the United States, almost one in three women has their babies this way. Some C-sections are planned, but many are done when unexpected problems happen during delivery. Reasons for a C-section may include Health problems in the mother The mother carrying more than one baby The size or position of the baby The baby's health is in danger Labor is not moving along as it should

The surgical video details a robotic assisted hysterectomy in a patient with early stage endometrial/uterine cancer. Anatomy of the pelvis and the technique of a robotic hysterectomy is demonstrated in this video.

Ultrasound-guided internal jugular cannulation

For more information, visit https://ukhealthcare.uky.edu/doctors.

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Orchidectomy and Orchidopexy in testis Torsion

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My baby is breech. Is it okay to get an external cephalic version (ECV)?

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