ENDOSCOPIC (NON-SURGICAL) REMOVAL OF MULTIPLE LARGE TUMORS FROM STOMACH IN A PATIENT WITH PEUTZ-JEGHERS SYNDROME
PEUTZ-JEGHERS SYNDROME: Peutz-Jeghers syndrome (PJS) is a familial syndrome consisting of mucocutaneous pigmentation, gastrointestinal polyposis and cancers of gut & other sites like breast, ovary, and testes. PJS has an autosomal dominant inheritance with variable and incomplete penetrance. Germline mutations of STK11/LKB1 gene on 19p cause this syndrome. Mucocutaneous pigmentation may be noted in early infancy. These deposits of melanin are most commonly found around the mouth, nose, lips, buccal mucosa, hands, and feet, and may also be present in perianal and genital areas. PJS polyps may be found in stomach, small intestine, or colon, but they tend to be prominent in the small intestine. These polyps may increase in size and cause small intestinal obstruction or intussusceptions that may occur in early infancy. Acute upper gastrointestinal bleeding and chronic faecal blood may complicate the disease.
PATIENT: The patient was a 25 yr male who had mucocutaneous pigmentation and multiple polyps in the stomach and duodenum. He presented with bleeding from gastric polyps. As the polyps in stomach were numerous, (more than 20 in number) and were large in size (some equal to small egg size), he had been advised to undergo surgery. Surgery planned was total gastrectomy.
PROCEDURE: The patient underwent video-endoscopy of the esophagus, stomach and duodenum. All polyps were examined for size and presence or absence of stalk. A plan to remove all the gastric polyps at endoscopy was made in the same sitting. He received light conscious sedation. Flat polyps were raised form the gastric wall by injection of saline in to polyp base to let these lesions have a stalk. This was done by needle injector. Each polyp was engaged in a snare and the polyp stalk was cut by coagulation cutting current. The cuts were clean without any bleeding. All polyps were recovered for histology. The histology revealed all polyps to be hamartomous lesions. None of the polyps were cancerous. Patient has been followed up for over one year and is doing fine without any further bleeding or pain.
Video shows the procedure of videoendoscpy and endoscopic removal of polyps.

This video is a collection of selected cases of Plastic Surgery performed on children with congenital deformities.

Errata: Cleft Lip Case 2 has a center photo which belongs to case 1 at day of surgery.

OB_A_1013
3D animation depicting the operating room and initial procedure preparing the patient for a laparoscopic hysterectomy. The patient is prepped and draped in the usual fashion and surrounded by the surgeon and surgical assistants. The skin is elevated, an infraumbilical incision is made, a trocar port is inserted through the incision and the abdomen is insufflated. Finally, a laparoscope is inserted into the port to allow for direct visualization of the uterus and the surgery can begin.

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Rheumatoid arthritis is a chronic inflammatory disorder that can affect more than just your joints. In some people, the condition also can damage a wide variety of body systems, including the skin, eyes, lungs, heart and blood vessels. An autoimmune disorder, rheumatoid arthritis occurs when your immune system mistakenly attacks your own body's tissues. Unlike the wear-and-tear damage of osteoarthritis, rheumatoid arthritis affects the lining of your joints, causing a painful swelling that can eventually result in bone erosion and joint deformity. The inflammation associated with rheumatoid arthritis is what can damage other parts of the body as well. While new types of medications have improved treatment options dramatically, severe rheumatoid arthritis can still cause physical disabilities.

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Lattrell Wells was a perfect candidate for the MACI procedure. Dr. Michael O'Malley is a sports medicine surgeon at Carilion Clinic, "It’s a two stage procedure. So what we do is we actually harvest a small portion of the patient's cartilage and bone cells and we send it to a lab where the lab then that grows additional cartilage cells. It comes back to us in a little sheet and six weeks after that initial surgery, we re-implant the cartilage in a second surgery where we implant that sheet depending on the size of lesion right where his defect. This the only option where there’s virtually no risk of any kind of graft rejection or anything of that nature.

Juvenile rheumatoid arthritis, also known as juvenile idiopathic arthritis, is the most common type of arthritis in children under the age of 17. Juvenile rheumatoid arthritis causes persistent joint pain, swelling and stiffness. Some children may experience symptoms for only a few months, while others have symptoms for the rest of their lives. Some types of juvenile rheumatoid arthritis can cause serious complications, such as growth problems and eye inflammation. Treatment of juvenile rheumatoid arthritis focuses on controlling pain, improving function and preventing joint damage.

Watch that Stuck Sex Toy Removal Surgery

Pulmonary edema is almost always treated in the emergency room or hospital. You may need to be in an intensive care unit (ICU). Oxygen is given through a face mask or tiny plastic tubes are placed in the nose. A breathing tube may be placed into the windpipe (trachea) so you can be connected to a breathing machine (ventilator) if you cannot breathe well on your own. The cause of edema should be identified and treated quickly. For example, if a heart attack has caused the condition, it must be treated right away. Medicines that may be used include: Diuretics that remove excess fluid from the body Medicines that strengthen the heart muscle, control the heartbeat, or relieve pressure on the heart

Thanks to a new, state-of-the-art procedure for total knee replacement developed by surgeons at the Detroit Medical Center's Sinai-Grace Hospital, the rehabilitation time for patients has been reduced from six months to six weeks. ~ Detroit Medical Center

A modified radical mastectomy is a procedure in which the entire breast is removed, including the skin, areola, nipple, and most axillary lymph nodes; the pectoralis major muscle is spared. Historically, a modified radical mastectomy was the primary method of treatment of breast cancer. [1, 2] As the treatment of breast cancer evolved, breast conservation has become more widely used. [3, 4] However, mastectomy still remains a viable option for women with breast cancer. [5, 6]

Ovarian dermoid cyst and mature cystic ovarian teratoma are terms often used interchangeably to refer to the most common ovarian neoplasm. These slow-growing tumours contain elements from multiple germ cell layers and are best assessed with ultrasound.

Orchidectomy and Orchidopexy in testis Torsion

A chalazion is a swollen bump on the eyelid. It happens when the eyelid’s oil gland clogs up. It may start as an internal hordeolum (stye). At first, you might not know you have a chalazion as there is little or no pain. But as it grows, your eyelid may get red, swollen, and sometimes tender to touch. If the chalazion gets large, it can press on your eye and cause blurry vision. Rarely, the whole eyelid might swell.

The cardiac cycle is the sequence of events that occurs when the heart beats. As the heart beats, it circulates blood through pulmonary and systemic circuits of the body. There are two phases of the cardiac cycle. In the diastole phase, the heart ventricles are relaxed and the heart fills with blood

Mesenteric cyst is one of the rarest abdominal tumours, with approximately 820 cases reported since 1507. The incidence varies from 1 per 100,000 to 250,000 admissions. The lack of characteristic clinical features and radiological signs may present great diagnostic difficulties.

Varicose veins are caused by weakened valves and veins in your legs. Normally, one-way valves in your veins keep blood flowing from your legs up toward your heart. When these valves do not work as they should, blood collects in your legs, and pressure builds up. The veins become weak, large, and twisted.

Total Knee Replacement Surgery Video