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This procedure, and other types of soft palate surgery, targets the back of the roof of your mouth. It involves removing and repositioning excess tissue in the throat to make the airway wider. The surgeon can trim down your soft palate and uvula, remove your tonsils, and reposition some of the muscles of the soft palate. UPPP and other soft palate procedures are the most common type of surgery for sleep apnea. But UPPP alone is unlikely to cure moderate to severe sleep apnea. It may be combined with surgeries that target other sites in the upper airway.
The robotic approach to renal surgery, particularly partial nephrectomy, has some inherent challenges, and some familiarity with the da Vinci robotic system is necessary. The surgeon must gain an understanding of the robotic arm movements and range of motion, especially in relation to the clutch and camera. The advent of robotically assisted prostatectomy in 2001 [23] paved the way for widespread accessibility to the da Vinci robotic unit and its application to renal surgery. Since that time, at least one multi-institutional survey has demonstrated superiority of the robotic approach when compared to laparoscopic for outcomes of blood loss, hospital stay and a substantially shorter warm ischemia time, while maintaining equivalence in positive margin rate, operative time and complications. [11] A transperitoneal approach is most commonly used. Prior abdominal operation is not necessarily a contraindication to this procedure, but access should be approached with regard for previous operation(s) by an experienced team.
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If you suffer a knee injury, what do you do about it? Should you be concerned? On one hand, you could give it a few days to see if it gets better on its own. How can you know if you risk making the problem worse? In this Ask Dr. Geier video, I offer four signs you have a serious knee injury that could require surgery.
Please note: I don't respond to questions and requests for specific medical advice left in the comments to my videos. I receive too many to keep up (several hundred per week), and legally I can't offer specific medical advice to people who aren't my patients (see below). If you want to ask a question about a specific injury you have, leave it in the comments below, and I might answer it in an upcoming Ask Dr. Geier video. If you need more detailed information on your injury, go to my Resources page: https://www.drdavidgeier.com/resources/
The content of this YouTube Channel, https://www.youtube.com/user/drdavidgeier (“Channel”) is for INFORMATIONAL PURPOSES ONLY. The Channel may offer health, fitness, nutritional and other such information, but such information is intended for educational and informational purposes only. This content should not be used to self-diagnose or self-treat any health, medical, or physical condition. The content does not and is not intended to convey medical advice and does not constitute the practice of medicine. YOU SHOULD NOT RELY ON THIS INFORMATION AS A SUBSTITUTE FOR, NOR DOES IT REPLACE, PROFESSIONAL MEDICAL ADVICE, DIAGNOSIS, OR TREATMENT. You should consult with your healthcare professional before doing anything contained on this Channel. You agree that Dr. Geier is not responsible for any actions or inaction on your part based on the information that is presented on the Channel. Dr. David Geier Enterprises, LLC makes no representations about the accuracy or suitability of the content. USE OF THE CONTENT IS AT YOUR OWN RISK.
SWELLING
If you have a knee that is much more swollen than the opposite knee, especially if the swelling developed soon after you got hurt, then it could be a sign of structural damage. While a small amount of swelling could be normal or a sign of inflammation in the knee, a knee that is really swollen and much larger than the other knee could represent a fracture, torn ACL or other ligament or some other damaged structure.
INABILITY TO FULLY STRAIGHTEN YOUR KNEE
Pain can make it difficult for you to straighten your knee. But being unable to get your knee completely flat can be a sign of an injury like an ACL tear or meniscus tear.
LOCKING OF THE KNEE
Locking is a term orthopedic surgeons use to describe a knee that gets stuck in a certain position. Maybe you can straighten it to a certain point, but it gets stuck around 30 degrees short of fully straight. Or you can’t bend it past a certain point because something inside the knee is blocking it. Catching is a milder form of the same problem, where you can get to the point that the motion stops, but you can twist or rotate your knee past that point.
BUCKLING OR GIVING WAY
Having the tibia (shin bone) shift out from under the femur (thigh bone) usually represents an ACL injury. If your knee buckled during the traumatic injury and keeps happening in the days after the injury, you risk doing more damage to the other structures inside the knee.
This list is not comprehensive, so if you are concerned about your knee injury or knee pain, it never hurts to see your doctor or an orthopedic surgeon.
A small-bowel obstruction (SBO) is caused by a variety of pathologic processes. The leading cause of SBO in industrialized countries is postoperative adhesions (60%), followed by malignancy, Crohn disease, and hernias, although some studies have reported Crohn disease as a greater etiologic factor than neoplasia.
Ultrasound or ultrasonography is a medical imaging technique that uses high frequency sound waves and their echoes. The technique is similar to the echolocation used by bats, whales and dolphins, as well as SONAR used by submarines. In ultrasound, the following events happen: The ultrasound machine transmits high-frequency (1 to 5 megahertz) sound pulses into your body using a probe. The sound waves travel into your body and hit a boundary between tissues (e.g. between fluid and soft tissue, soft tissue and bone). Some of the sound waves get reflected back to the probe, while some travel on further until they reach another boundary and get reflected. The reflected waves are picked up by the probe and relayed to the machine. The machine calculates the distance from the probe to the tissue or organ (boundaries) using the speed of sound in tissue (5,005 ft/s or1,540 m/s) and the time of the each echo's return (usually on the order of millionths of a second). The machine displays the distances and intensities of the echoes on the screen, forming a two dimensional image like the one shown below.
Pinch air out of the tip of the condom. Unroll condom all the way down the penis. After sex but before pulling out, hold the condom at the base. Then pull out, while holding the condom in place. Carefully remove the condom and throw it in the trash.
Cancer starts when cells in a part of the body begins to grow out of control and can spread to other areas of the body. There are many kinds of cancer. Cells in nearly any part of the body can become cancer. To learn more about how cancers start and spread, see What Is Cancer? Leukemias are cancers that start in cells that would normally develop into different types of blood cells. Here we will talk about acute myeloid leukemia (AML). Acute myeloid leukemia (AML) has many other names, including acute myelocytic leukemia, acute myelogenous leukemia, acute granulocytic leukemia, and acute non-lymphocytic leukemia. “Acute” means that this leukemia can progress quickly if not treated, and would probably be fatal in a few months. “Myeloid” refers to the type of cell this leukemia starts from. Most cases of AML develop from cells that would turn into white blood cells (other than lymphocytes), but some cases of AML develop in other types of blood-forming cells. The different types of AML are listed in “ How is acute myeloid leukemia classified?” AML starts in the bone marrow (the soft inner part of certain bones, where new blood cells are made), but in most cases it quickly moves into the blood. It can sometimes spread to other parts of the body including the lymph nodes, liver, spleen, central nervous system (brain and spinal cord), and testicles. Other types of cancer can start in these organs and then spread to the bone marrow. But these cancers that start elsewhere and then spread to the bone marrow are not leukemias. Normal bone marrow, blood, and lymphoid tissue To understand the different types of leukemia, it helps to know about the blood and lymph systems.
Barbed sutures first received US Food and Drug Administration approval for soft tissue approximation in 2005 and early adopters readily embraced this device to develop new techniques. It has become apparent that the advantages are more than just "skin deep." Superficial and deep fascia, cartilage, tendon, joint capsule, and fibrous periprosthetic capsules can also be manipulated. Barbed sutures have revolutionized our approach to facial rejuvenation and body contouring by enhancing our ability to quilt and powerfully lift tissue. The elimination of surgical drains and shorter surgical times has made this a true boon for plastic surgeons as well as many other surgical specialists. This article summarizes some of the current and evolving applications of this exciting new tool.
Claudication, which is defined as reproducible ischemic muscle pain, is one of the most common manifestations of peripheral arterial occlusive disease (PAOD) caused by atherosclerosis. Claudication occurs during physical activity and is relieved after a short rest. Pain develops because of inadequate blood flow. Examination of a patient with claudication should include a complete lower-extremity evaluation and pulse examination, including measuring segmental pressures. Attempt to palpate pulses from the abdominal aorta to the foot, with auscultation for bruits in the abdominal and pelvic regions. When palpable pulses are not present, a handheld Doppler device may be used to assess circulation.
Nystagmus is a condition of involuntary (or voluntary, in rare cases) eye movement, acquired in infancy or later in life, that may result in reduced or limited vision. Due to the involuntary movement of the eye, it has been called "dancing eyes"
Invasive intracranial pressure monitoring. The most common surgically placed monitors for ICP measurement are intraventricular catheters (external ventricular drain [EVD] or a ventriculostomy drain) and fiberoptic ICP monitors implanted into the parenchyma of the brain.
Dr. Ebraheim’s educational animated video describing the anatomy and associated injuries of the knee joint.
Disrupted quadriceps
•Patient is unable to actively extend the knee.
The most common cause of ACL ruptures:
•Traumatic force being applied during twisting motion.
•Side stepping or landing from a jump.
Patient complains of:
•Immediate pain
•Knee giving way
•Swelling
Aspiration of the knee
•If aspiration of the knee joint shows evidence of blood within the joint there is 75-80% chance of ACL and meniscal injury.
Lachamn’s test- ACL knee exam
•Knee is flexed at 30 degrees.
•ACL tear of the knee is identified by pulling on the tibia and examining the frontward motion of the lower leg in comparison to the upper leg.
Radiological exam – ACL
•MRI of the knee joint shows bone lesions or bruising associated with tears of the ACL. Injury is found in the typical location; middle of the femoral condyle and posterior part of the tibia laterally.
Posterior cruciate ligament tear (PCL)
•Common cause of injury is a bent knee hitting a dashboard in a car accident.
Tibial Sag Test –PCL knee exam
Quadriceps active test-PCL knee exam
•The examiner stabilizes the leg of the patient and then the patient is asked to actively contract the quadriceps muscle.
•The tibia is seen actively reduced from the posterior subluxed position.
Lachman’s test-PCL knee exam
•Knee is bent 20-30 degrees.
•The posterior drawer test is carried out while the patient is in a supine position and the knee is flexed to 90 degrees.
•The amount of translation of the tibia relative to the femur is observed.
The dial test is performed while the patient is in the supine or prone position and both knees are in 90 and 30 degrees of flexion. More than 10 degrees of external rotation indicates significant injury.
Common meniscal tears
Symptoms include
•Knee pain
•Pain with straightening the knee
•Swelling
•Locking
•Weakness
Urological surgeons have become proficient at performing complex pelvic urological procedures, such as radical prostatectomy, using the laparoscopic approach. Declan Murphy and Daniel Moon share their experience of four less common procedures they have performed recently using laparoscopic techniques. These include: excision of a urachal cyst; partial cystectomy for endometriosis (combined endoscopic-laparoscopic approach); repair of an intra-peritoneal bladder rupture; and repair of a ureteric injury (combined endoscopic-laparoscopic approach).
As a pediatric surgeon at NewYork-Presbyterian/Weill Cornell Medical Center, Dr. Nitsana Spigland treats newborns, children, teens, and young adults requiring surgical interventions. She specializes in antenatal counseling and newborn congenital malformations.
Learn more about Dr. Spigland at: https://www.nyp.org/physician/nspigland.