Bimanual Hip Examination of the Female genitalia

minimally invasive procedure is the new gold standard for hemorrhoidectomy, according to American and European experts in the field. The procedure, known as PPH (procedure for prolapse and hemorrhoids) stapled hemorrhoidectomy, combines hemorrhoidal devascularization and repositioning to return the veins to the anal canal. “This year, this is the revolutionary new procedure in the United States,” Gary Hoffman, MD, clinical faculty member in general and colorectal surgery, Cedars-Sinai Medical Center, Los Angeles, told General Surgery News after moderating a live PPH telesurgery at the 2003 annual meeting of the Society of American Gastrointestinal Endoscopic Surgeons.

Iatrogenic injury to the ureter is a potentially devastating complication of modern surgery. The ureters are most often injured in gynecologic, colorectal, and vascular pelvic surgery. There is also potential for considerable ureteral injury during endoscopic procedures for ureteric pathology such as tumor or lithiasis. While maneuvers such as perioperative stenting have been touted as a means to avoid ureteral injury, these techniques have not been adopted universally, and the available literature does not make a case for their routine use. Distal ureteral injuries are best managed with ureteroneocystostomy with or without a vesico-psoas hitch. Mid-ureteral and proximal ureteral injuries can potentially be managed with ureteroureterostomy. If the distal segment is unsuitable for anastomosis then a number of techniques are available for repair including a Boari tubularized bladder flap, transureteroureterostomy, or renal autotransplantation. In rare cases renal autotransplantation or ureteral substitution with gastrointestinal segments may be warranted to re-establish urinary tract continuity. Laparoscopic and minimally invasive techniques have been employed to remedy iatrogenic ureteral injuries.

This video shows an ovarian cyst and its removal using a laparoscopic technique.

Funny musical anoscope. I bet you will want to add it to your tools

Endoscopic Removal of a Large Choanal Polyp

The examination of the groin, hernial orifices and male external genitalia are clinical examinations which undergraduate medical students are commonly less confident about performing competently, due to the lack of clinical exposure.

Doctor makes magic - Doctor hace magia (Sorprendente) - Doctor Magic

To record the sequence, Stephan Gordts and Ivo Brosens of the Leuven Institute for Fertility & Embryology in Belgium performed transvaginal laparoscopy, which involves making a small cut in the vaginal wall and observing the ovary with an endoscope.

"This allows us direct access to and observation of the tubo-ovarian structures without manipulation using forceps," says Gordts.

For the photos of ovulation, which only accidentally captured the critical moment, Jacques Donnez at the Catholic University of Louvain (UCL) in Brussels, Belgium, used gas to distend the organs for photography. However, Gordts and Brosens planned the procedure to coincide with ovulation and used saline solution to "float" the structures.
Perfect timing

Observation was timed for the day of the peak of the patient's luteal hormone cycle. Ovulation was predicted to occur on the evening of the day of the LH peak, and the endoscope introduced at 6 pm.

A small amount of saline was used to float the opening of the fallopian tube, its fimbriae (the "fingers" that sweep the egg into the tube) and the ovary itself. This gives a more natural appearance than gas, says Gordts.

In the video, the fimbriae can be seen sweeping in time with the patient's heartbeat. A mucus plug can be seen protruding from the ovary – this contains the egg.

"The ovum is not captured 'naked'," says Gordts. "There is no eruption like a volcano."

Gordts says that in clinical practice it is not easy to organise the observation of ovulation. "We were probably lucky to be successful at our first attempt," he says.

The heart and circulatory system (also called the cardiovascular system) make up the network that delivers blood to the body's tissues. With each heartbeat, blood is sent throughout our bodies, carrying oxygen and nutrients to all of our cells.

A bone marrow biopsy removes a small amount of bone and a small amount of fluid and cells from inside the bone (bone marrow). A bone marrow aspiration removes only the marrow. These tests are often done to find the reason for many blood disorders and may be used to find out if cancer or infection has spread to the bone marrow. Bone marrow aspiration removes a small amount of bone marrow fluid and cells through a needle put into a bone. The bone marrow fluid and cells are checked for problems with any of the blood cells made in the bone marrow. Cells can be checked for chromosome problems. Cultures can also be done to look for infection. A bone marrow biopsy removes bone with the marrow inside to look at under a microscope. The aspiration (taking fluid) is usually done first, and then the biopsy.

Gallstone ileus is an important, though infrequent, cause of mechanical bowel obstruction, affecting older adult patients who often have other significant medical conditions. It is caused by impaction of a gallstone in the ileum after being passed through a biliary-enteric fistula. The diagnosis is often delayed since symptoms may be intermittent and investigations fail to identify the cause of the obstruction. The mainstay of treatment is removal of the obstructing stone after resuscitating the patient. Gallstone ileus continues to be associated with relatively high rates of morbidity and mortality.

The Epley Maneuver for Vertigo can be very effective at relieving vertigo symptoms, but it’s a procedure that should be performed by a physical therapist or other health care professional. This video is for demonstration purposes only. See Doctor Jo’s blog post about the Epley

An unnamed Russian scientist has introduced the concept of a device that attaches to the wall of the artery. It would first stop blood flow to the area to prevent breakaway plaque. A drill would then scrape the plaque from the artery wall. The procedure of treating plaque buildup could include bypass surgery, stent replacement and balloon angioplasty. Since the plaques are of different types and locations in the body, the inventor proposed using different types of cutting mills.

Repair of the umbilical hernia, and placing the omentum back in

Urinary tract infections (UTIs) are infections of the urethra, bladder, ureters, or the kidneys, which comprise the urinary tract. E. coli bacteria cause the majority of UTIs, but many other bacteria, fungi, and parasites may also cause UTIs. Females have a higher risk for UTIs than most males, probably because of their anatomy; other risk factors for UTIs include any condition that may impede urine flow (e.g., enlarged prostate, kidney stones, congenital urinary tract abnormalities, and inflammation). Patients with catheters or those who undergo urinary surgery and men with enlarged prostates are at higher risk for UTIs.

Rhomboid muscle strain and spasm causes upper back pain between the shoulder blades. Some patients describe the muscle spasms and discomfort as knots in the back. Early treatment is important to speed healing and recovery. Ice therapy for the first few days followed by moist heat can help relieve symptoms.Oct 12, 2015

Menstrual cramps (dysmenorrhea) are throbbing or cramping pains in the lower abdomen. ... Menstrual cramps may be caused by identifiable problems, such as endometriosis or uterine fibroids. Treating any underlying cause is key to reducing the pain

Asthma was originally described as an inflammatory disease that predominantly involves the central airways. Pathological and physiological evidence reported during the past few years suggests that the inflammatory process extends beyond the central airways to the peripheral airways and the lung parenchyma. The small airways are capable of producing T-helper-2 cytokines, as well as chemokines, and they have recently been recognized as a predominant site of airflow obstruction in asthmatic persons. The inflammation at this distal site has been described as more severe than large airway inflammation. These findings are of great clinical significance, and highlight the need to consider the peripheral airways as a target in any therapeutic strategy for treatment of asthma.

Bacterial meningitis is very serious and can be deadly. Death can occur in as little as a few hours. While most people with meningitis recover, permanent disabilities such as brain damage, hearing loss, and learning disabilities can result from the infection. There are several types of bacteria that can cause meningitis. Some of the leading causes of bacterial meningitis in the United States include Streptococcus pneumoniae, group B Streptococcus, Neisseria meningitidis, Haemophilus influenzae, and Listeria monocytogenes.