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This medical animation shows laparoscopically assisted gallbladder removal surgery, or cholecystectomy. The animation begins by showing the normal anatomy of the liver and gallbladder. Over time, gallstones form within the gallbladder, blocking the cystic duct, and causing the gallbladder to become enlarged and inflamed. The procedure, sometimes called a "lap-chole", begins with the insertion of four trocar devices, which allow the physician to see inside the abdomen without making a large incision. Air is added to the abdominal cavity to make it easier to see the gall bladder. Next, we see a view through the laparascope, showing two surgical instruments grasping the gallbladder while a third severs the cystic duct. After the gallbladder is removed, the camera pans around to show that the cystic artery and vein, have already been clipped to prevent bleeding.

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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

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An OB/GYN nurse from Erlanger Hospital discusses caring for a newborn baby after a circumcision.

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Intramuscular Injection Techniques (Nursing Skills)

In this video, we’re going to look at proper administration techniques for intramuscular medication administration. Of course, always follow your 5 rights and calculate the correct volume for administration. We love you guys! Go out and be your best selves today! And, as always, happy nursing!

Bookmarks:
0.05 Introduction to Intramuscular injections
0.16 site and needle selection
0.35 site sterilization
0.43 Z track method
0.58 needle insertion
1.10 medication injection
1.14 needle removal
1.25 bandaging and needle disposal
1.30 documentation and patient monitoring
1.35 Outro

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An inguinal hernia is a bulging of the intestine through a defect or weak spot in the wall of the lower abdomen. This video shows how inguinal hernias form and how they are treated.
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