Sean Langenfeld, M.D., UNMC College of Medicine

Kite flap, Guy Fouchier flap, 2nd finger to thumb. Cadaver dissection. Prof Steven Hovius demonstrates dissection technique and planning for a kite flap.

Urogenital neoplasms spreading to the inguinal lymph nodes are penile carcinoma (the most frequent), urethral and scrotum cancers, tumors of the testis with scrotal violation. Penile carcinoma is an uncommon malignant disease and accounts for as many 0.4-0.6% of male cancers. Most patients are elder...ly. It rarely occurs in men under age 60 and its incidence increases progressively until it reaches a peak in the eighth decade 1. The risk of a lymph node invasion is greater with high grade and high stage tumors 2. Some investigators have reported the inaccuracy of the sentinel node biopsy 3, 4, described by Cabanas 5. Patients with metastatic lymph node penis cancer have a very poor prognosis if penectomy only is performed. Ilioinguinal lymphadenectomy is basically carried out as a treatment modality and not only as a staging act. Patients with lymph node invasion have a 30-40% cure rate. Ilioinguinal lymphadenectomy should be also performed in patients with disseminated neoplasms for the local control of the disease. The 5 years survival rate of patients with clinically negative lymph nodes treated with a modified inguinal lymphadenectomy is 88% versus 38% in patients not initially treated with lymphadenectomy 6. This video-tape clearly shows a therapeutic algorithm, the anatomy of the inguinal lymph nodes, according to Rouviere 7 and Daseler 8, the radical ilioinguinal node dissection with transposition of the sartorius muscle and the modified inguinal lymphadenectomy proposed by Catalona 9. References: 1. Lynch D.F. and Schellhammer P: Tumors of the penis. In Campbell’s Urology Seventh Edition, edited by Walsh P.C., Retik A.B., Darracott Vaughan E. and Wein A.J. W.B. Saunders Company, Vol. 3, chapt. 79, p. 2458, 1998. 2. Pizzocaro G., Piva L., Bandieramonte G., Tana S. Up-to-date management of carcinoma of the penis. Eur. Urol. 32: 5-15, 1997 3. Perinetti E., Crane D.B. and Catalona W.J. Unreliability of sentinel lymph node biopsy for staging penile carcinoma. J. Urol. 124: 734, 1980 4. Fowler J.E. Jr. Sentinel lymph node biopsy for staging penile cancer. Urology 23: 352, 1984 5. Cabanas R.M. An approach for the treatment of penile carcinoma. Cancer 39: 456, 1977 6. Russo P. and Gaudin P. Management strategies for carcinoma of the penis. Contemporary Urology;5:48-66, 2000 7. Rouviere H. Anatomy of the human lymphatic system. Edwards Brothers, p. 218, 1938 8. Daseler E.H., Anson B.J., Reimann A.F. Radical excision of the inguinal and iliac lymph glands: a study based on 450 anatomical dissections and upon supportive clinical observations. Surg. Gynecol. Obstet. 87: 679, 1948 9. Catalona W.J. Modified inguinal lymphadenectomy for carcinoma of the penis with preservation of saphenous veins: technique and preliminary results. J. Urol. 140: 306-310, 1988

51 yr old female with right flank pain and recurrent UTI. IVP showed a UPJ calculus on the right.

Histology of Female Urethra

A technique of goniotomy. Sent by Prof. Dr. Daljit Singh. I think it has been done by Dr. Jan Worst and the video is probably more than 15 years old.

Intussuseption and Appendectomy

Psoriasis: treatment options related issues

World-renowned surgeons at Shriners Hospitals for Children – Northern California provide complex pediatric surgery for children one-year and older with congenital and acquired conditions. Children from throughout the Western United States with chest wall malformations, gastro-intestinal disease, ano-rectal disorders, urologic conditions and other complex surgical needs benefit from the expert care. The pediatric surgery team is devoted to the development of innovative and minimally invasive surgical techniques.

The cyst was technically 46.5 pounds and her doctors call it the largest in world history. I am not sure if that is true, but it is a massive cyst

Reverse sural flap for ankle and heel soft tissues reconstruction

Upper right quadrant: The right upper quadrant contains the liver and gallbladder, which are protected by the lower right part of the ribcage. The large intestine, or colon, also spends a little time in this section. Upper left quadrant: The left upper quadrant contains part of the stomach and the spleen.

Watch that Cutting Inside Human Fat Body video

How to Get Rid of Vaginal Discharge - Treating Normal Discharge.

This video gives you an overview of how a cardiac catheterization is performed.

Breast Cancer spreads by 3 mechanisms- local spread, by lymph nodes, or through the blood. Dr. Lorraine Champion, and Dr. Lisa Bailey discuss how breast cancer spreads. They discuss the different methods of spread and how this will affect the treatment of breast cancer.