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Breast reconstruction 3D Animation
on Friday, December 17, 2010
The primary part of the procedure can often be carried out immediately following the mastectomy. As with many other surgeries, patients with significant medical comorbidities (high blood pressure, obesity, diabetes) and smokers are higher-risk candidates. Surgeons may choose to perform delayed reconstruction to decrease this risk. Patients expected to receive external beam radiation as part of their adjuvant treatment are also commonly considered for delayed autologous reconstruction due to significantly higher complication rates with tissue expander-implant techniques in those patients. Breast reconstruction is a large undertaking that usually takes multiple operations. Sometimes these follow-up surgeries are spread out over weeks or months. If an implant is used, the individual runs the same risks and complications as those who use them for breast augmentation but has higher rates of capsular contracture (tightening or hardening of the scar tissue around the implant) and revisional surgeries. Outcomes based research on quality of life improvements and psychosocial benefits associated with breast reconstruction served as the stimulus in the United States for the 1998 Women's Health and Cancer Rights Act which mandated health care payer coverage for breast and nipple reconstruction, contralateral procedures to achieve symmetry, and treatment for the sequelae of mastectomy. This was followed in 2001 by additional legislation imposing penalties on noncompliant insurers. Similar provisions for coverage exist in most countries worldwide through national health care programs. There are many methods for breast reconstruction. The two most common are: * Tissue Expander - Breast implants This is the most common technique used in worldwide. The surgeon inserts a tissue expander, a temporary silastic implant, beneath a pocket under the pectoralis major muscle of the chest wall. The pectoral muscles may be released along its inferior edge to allow a larger, more supple pocket for the expander at the expense of thinner lower pole soft tissue coverage. The use of acellular human or animal dermal grafts have been described as an onlay patch to increase coverage of the implant when the pectoral muscle is released, which purports to improve both functional and aesthtic outcomes of implant-expander breast reconstruction. o In a process that can take weeks or months, saline solution is percutaneously injected to progressively expand the overlaying tissue. Once the expander has reached an acceptable size, it may be removed and replaced with a more permanent implant. Reconstruction of the areola and nipple are usually performed in a separate operation after the skin has stretched to its final size. * Flap reconstruction The second most common procedure uses tissue from other parts of the patient's body, such as the back, buttocks, thigh or abdomen. This procedure may be performed by leaving the donor tissue connected to the original site to retain its blood supply (the vessels are tunnelled beneath the skin surface to the new site) or it may be cut off and new blood supply may be connected. o The latissimus dorsi muscle flap is the donor tissue available on the back. It is a large flat muscle which can be employed without significant loss of function. It can be moved into the breast defect still attached to its blood supply under the arm pit (axilla). A latissimus flap is usually used to recruit soft-tissue coverage over an underlying implant. Enough volume can be recruited occasionally to reconstruct small breasts without an implant. o Abdominal flaps The abdominal flap for breast reconstruction is the TRAM flap or its technically distinct variants of microvascular "perforator flaps" like the DIEP/SIEP flaps. Both use the abdominal tissue between the umbilicus and the
Keratoderma Blennorrhagicum is a manifestation on the skin that appears in patients diagnosed with reactive arthritis (this condition was previously known as Reiter syndrome). The condition manifests itself by lesions that appear on the skin, initially on the palm of the hands and soles of the feet. The lesions have the tendency to spread, affecting other parts of the body, such as the scrotum, scalp or trunk. Because of their appearance, the lesions might be easily confused with the ones from psoriasis. Keratoderma blennorrhagicum is one of the symptoms that can be used for the clinical diagnosis of reactive arthritis.
Overview
Heart bypass surgery creates a new route, called a bypass, for blood and oxygen to reach the heart.
Heart bypass surgery begins with an incision in the chest, and the breastbone is cut exposing the heart. Next, a portion of the saphenous vein, which is very large, is harvested from the inside of the leg. Pieces of this large vein are used to bypass the blocked coronary arteries, which are arteries that supply blood to the heart. The venous graft is sewn to the aorta, the main artery of the body, and to the affected coronary artery, to bypass the blocked site.
The internal mammary artery from the chest may also be used to bypass a clogged artery.
Several arteries may be bypassed depending on the condition of the heart. After the graft is created, the breastbone and chest are closed.
If you have an active lifestyle or are often on the go with work, travel or family, then peritoneal dialysis at home may be the right choice. Home peritoneal dialysis offers additional freedom and flexibility as a treatment option thatโs closest to natural kidney function and may require fewer dietary restrictions and medications. To learn more about Home PD, visit https://www.FreseniusKidneyCar....e.com/ckd-treatment/
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Thought a snake in your boot was bad? That old 19th-century idiom is nothing compared to one in your ear.
Shocking footage captured the alleged moment that a โsurgeonโ tried to remove a live snake that infiltrated a womanโs ear. Video of the herpetological surgery has racked up more than 125,000 views as viewers speculate whether or not the squirm-inducing footage is authentic.
โThe snake has gone in the ear,โ reads the caption to the bizarre Facebook clip, which was posted Sept. 1 by an India-based social media star named Chandan Singh to his 20,126 followers. However, itโs unclear where, when or how this unfortunate event transpired, local outlet the Economic Times reported.
In the nearly four-minute clip, an alleged medical practitioner can be seen using tweezers in a desperate attempt to extract a black and yellow serpent thatโs peeking its head out from a female patientโs ear.
A new and safer method of inserting a Foley catheter suprapubically. The technique allows the insertion to be carried out in an Outpatient setting, thus saving time, cost and effort. By using the Seldinger technique, the product reduces the chances of bowel or bladder perforation and resultant morbidity.
The product has been chosen by The NHS National Technology Adoption Centre to help facilitate adoption of the product.
See www.mediplus.co.uk for more information
Duke Sports Medicine Specialists Jocelyn Wittstein, MD, Janna Fonseca, ATC, and Michael Messer ,PT, present on Soccer Injury Prevention including Concussion Management and the 11+ program that significantly reduces ACL tear rates in soccer.
At Hologic, we are committed to delivering innovative educational tools and programming that empower you to deliver life-changing care. Learn more about us at Hologic.com.
Inguinal hernia repair without mesh, Desarda Repair, no recurrence, pain, no mesh hernia surgery, hernia operation, no mesh, without mesh, hernia operation, hernia surgery, new method.http://www.desarda.com
Endometriosis surgery
The term subarachnoid hemorrhage (SAH) refers to extravasation of blood into the subarachnoid space between the pial and arachnoid membranes. SAH constitutes half of all spontaneous atraumatic intracranial hemorrhages; the other half consists of bleeding that occurs within the brain parenchyma. Subarachnoid hemorrhage occurs in various clinical contexts, the most common being head trauma. However, the familiar use of the term SAH refers to nontraumatic (or spontaneous) hemorrhage, which usually occurs in the setting of a ruptured cerebral aneurysm or arteriovenous malformation (AVM).
A case of replantation of a completely amputated arm
Peripheral Vascular Examination OSCE - Clinical Skills - Dr Gill
In the cardiovascular examination, particularly in the case of an OSCE station, we conclude the examination often by stating that the examiner would want to perform:
- An ECG
- Check full blood count
- and "do a peripheral vascular examination
In this video, we demonstrate that oft-talked about, but comparatively less common examination.
Starting off, with the examination of the hands, the radial, brachial and carotid pulses. before moving down to assess for a AAA, checking the femoral and popliteal pulses, before wrapping up around the ankle with the posterior tibial and dorsalis pedis pulses
For completeness, the cardiovascular examination is demonstrated here
https://www.youtube.com/watch?v=ECs9O5zl6XQ&t=2s
#PeripheralVascular #ClinicalSkills #DrGill
Laparoscopic anterior resection for cancer colon in Qatar by Dr. Al-Emadi
MRCPCH Clinical Revision - more videos at http://mrcpch.paediatrics.co.uk
Revise for your MRCPCH Clinical exam, with videos and high quality content created by the London Paediatrics Trainees Committee.
Video Credits: Dr Caroline Fertleman, Dr Hermione Race, Dr Camilla Sen, Dr Chloe Macaulay, Dr Emma McLaren, Chris Knapp
Penile Injection Therapy
New Minimally Invasive Procedure with No Pain or Downtimeโฆ From Dr. Michael Goodman, Caring For Women Wellness Center Laser Vaginal Tightening for Improved Sexual Pleasure and Relief from Minimal Urinary Incontinence Laser Vaginal Therapy for reversing Vaginal Atrophy (Good also for Breast Cancer Survivors with Vaginal Atrophy)