Maintaining sufficient blood flow to the gastric tube after a subtotal esophagectomy for esophageal cancer is crucial for decreasing the esophagogastric anastomotic leakage. After subtotal esophagectomy for esophageal cancer, to additionally revascularize the gastric tube using the splenic artery a...nd vein, external carotid artery, and internal jugular vein, the supercharge technique was performed in esophageal reconstruction patients. Operative results of these patients (supercharge group) were retrospectively compared with those of patients not receiving the technique (control group). Both operation time and operative blood loss in the supercharge group were significantly longer and larger than those of the control group. However, the incidence of anastomotic leakage was significantly lower in the supercharge group than in the control group, and a 30-day reduction in the mean postoperative hospital stay was achieved with the supercharge group. This practical supercharge technique could be a breakthrough less to reduce leakage during esophageal anastomosis.

Esophagomyotomy for Achalasia

Surgical technique: A 3cm skin incision under spinal or general anesthesia, depending on the patients’ preference, starts half way the line between the superior anterior iliac spine towards the midline in a 30° angle to the pubic tubercle. Scarpa’s fascia is opened as well as the external obliq...ue aponeurosis. By using this skin line incision the internal ring will be immediately visualized. Although it is important to look for both direct and indirect hernias evaluating the groin, we do not taper the cord and directly evaluate the ring for indirect hernias. In case of an indirect hernia the sac is reduced or resected according to the preference of the surgeon and the preperitoneal space is entered bluntly through the dilated internal ring. In case of a direct hernia the approach slightly differs. One could prefer to open the transversalis fascia through the internal ring over a few centimeters or you can open the fascia more medially, at the site of the direct hernia. As primary point of concern the epigastric vessels should be identified and retracted softly upwards. Then a gauze can be introduced into the preperitoneal space and by doing so most of the space needed medially will be created. Then one can already palpate Cooper’s ligament and the pubic bone. Laterally to the internal ring more digital dissection is needed to create just the appropriate space for the mesh. By placing the mesh it is important not to introduce the mesh too medially. Laterally of the internal ring an adequate overlap of the mesh is necessary, especially in indirect hernias. No splitting of the mesh seems necessary. The patient will be asked to strain and push on the ring to control its place and to check adequate spreading of the mesh to cover the whole myopectineum of Fruchaud. One single stitch of vicryl 3/0 is placed taking both the fascia transversalis and the mesh.

This video clip shows an upper track endoscopy of A 75 year-old female, presented with severe adominal pain since three days. Endoscopy displays a deep ulcer at the lesser curvature of the stomach. This patient has a klatskin´s tumor (bile duct bifurcation).

This video shows how to draw a blood sample which is medically known as venepuncture

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

SCOOP transtracheal oxygen is indicated for patients with chronic hypoxemia which persists in spite of optimal medical therapy. Arterial blood gases obtained while breathing room air should show a PaO2< 55 mm Hg. SCOOP transtracheal oxygen is also indicated for patients with a PaO2 of 56-59 mm Hg ...

if they also have: 1) dependent edema suggesting congestive heart failure, 2) "P" pulmonale on EKG (P wave greater than 3mm in standard leads II, III or AVF), or 3) erythrocythemia with a hematocrit of >55%.

Porcelain Veneers

Microkeratome in Lasik

This animated video reviews how the ear works and some of the typical problems with the ear.

Prostate Cancer spreads in 3 ways. First is spreads by local growth. Second it spreads through the lymphatic system, and lastly, it spreads through the blood stream. Dr. Patrick Swift, a radiation oncologist, discusses how prostate cancer spreads.

Finding out that you have zero sperm count can be a heartbreaking moment for any man. Azoospermia, the medical term for this condition, doesn't always mean you can’t have a biological child. With the right diagnosis, testing, and treatment, many men go on to father children successfully, offering hope and possibilities.

This episode of Fertility Focus explains everything you need to know about Azoospermia, from causes and types to real options available for hopeful fathers.

What’s covered in this episode?
✅What does a zero sperm count report really mean?
It could be temporary or due to incorrect lab testing—repeat it at an IVF centre.
✅How do you confirm if it’s true Azoospermia or just very low count (Cryptozoospermia)?
Only proper centrifugation by an embryologist can detect hidden sperm.
✅What tests are important after a confirmed Azoospermia diagnosis?
Physical exam, hormone blood tests, and genetic testing are crucial.
✅What is the difference between Obstructive and Non-Obstructive Azoospermia?
Obstructive means sperm is being produced but blocked; non-obstructive means no sperm production.
✅Can injections or hormone therapy help?
Yes, but only in select cases like hypogonadotropic hypogonadism.
✅What is Micro-TESE, and when is it needed?
A surgical sperm retrieval method used in non-obstructive cases where regular aspiration fails.
✅What role does testicular volume play in diagnosis?
Low testicular volume often signals poor sperm production.
✅Should sperm retrieved through aspiration be frozen?
Yes—always freeze immediately during invasive procedures to avoid losing the opportunity.
✅Can a normal pathology lab give accurate Azoospermia results?
No. It must be done at an IVF centre by trained embryologists.

Azoospermia is not the end of the road. With early and accurate diagnosis, personalised testing, and advanced techniques like Micro-TESE, many men can still have a biological child. Consult with fertility specialists and avoid assumptions based on a single test.

If you're seeking expert guidance on male infertility or looking for hope beyond the report, subscribe to our channel and stay updated with Fertility Focus.

------------------------------------------------------------------------------------------

About Dr. Rhythm Gupta and Excel IV

Founded by Dr. Rhythm Gupta, a highly qualified IVF expert in Delhi, Excel IVF offers treatments of an exceptional team of specialists, sonographers, nurses, counselors, etc. who have high-end experience and exceptionally professional in their respective fields.

To know more
Consult Dr. Rhythm Gupta, an Infertility Specialist at Excel IVF.
☎️ 98114-74471 | 89209-63596
📧 drrhythmgupta@gmail.com
🌎 Visit our website: https://excelivf.com/
https://www.instagram.com/excel_ivf/
https://www.facebook.com/excelivf/
https://www.linkedin.com/in/rhythm-ahuja-1a4752b3

#azoospermia #zerospermcount #maleinfertility #cryptozoospermia #ivfindia

Upper Endoscopy for a normal Esophagus

DMC Sports Medicine Specialist Dr. Scott Lemos helps a young football start get back in the game after an ACL injury. ~ Detroit Medical Center

The revision knee operation with real implants is completed and the wound is closed.

This video demonstrates the Retrograde Wire Intubation

The video will describe what is Tree in bud sign on CT scan of Chest. Please see disclaimer on my website www.academyofprofessionals.com

Check new lightweight laptop being flown in air by bees amazingly! A funny advertisement shoot for laptop!

Secondary Cataract

Recto-vaginal medical examination