Dr. David Rivadeneira from Stony Brook University in Stony Brook, NY will host a panel discussion on how to obtain improved outcomes during open surgery through the application of advanced techniques and technologies, including the new LigaSure Impact™ instrument. "It provides excellent and reliable hemostasis on major blood vessels, but the big advancement is that it is faster than traditional techniques and leaves no foreign material behind."

The program will begin with a brief introduction of the topic, followed by video presentation of two procedures, a right hemicolectomy and a sigmoid colectomy. Dr. Rivadeneira will discuss the techniques that he uses. "You'll be able to see the impact of applying multifunctional energy-based instruments to enable rapid and reliable dissection of the mesentery and ligation of colonic blood supply. This is particularly evident on tough diverticular cases, where it works very well with complicated tissue." Joining Dr. Rivadeneira, to review and discuss the cases, will be Dr. Sang Lee from Weill Cornell Medical College, NY.

small bowel anastomosis (the luminescent material check for leaks, and good flow)

Demonstrates some of the procedures of the Cardio Vascular / Peripheral Vascular exam.

A drug allergy is the abnormal reaction of your immune system to a medication. Any medication — over-the-counter, prescription or herbal — is capable of inducing a drug allergy. However, a drug allergy is more likely with certain medications. The most common signs and symptoms of drug allergy are hives, rash or fever. A drug allergy may cause serious reactions, including anaphylaxis, a life-threatening condition that affects multiple body systems. A drug allergy is not the same as drug side effects, the known possible reactions that are listed on a drug label. A drug allergy is also distinct from drug toxicity caused by an overdose of medication.

Watch that video of The World's Biggest Jigger Removal

Proximal Hypospadias repaired by Tube Onaly Urethroplasty

Thoracentesis is a procedure used to obtain a sample of fluid from the space around the lungs. Normally, only a thin layer of fluid is present in the area between the lungs and chest wall. However, some conditions can cause a large amount of fluid to accumulate. This collection of fluid is called a pleural effusion.

An enlarged spleen can be caused by infections, cirrhosis and other liver diseases, blood diseases characterized by abnormal blood cells, problems with the lymph system, or other conditions. Other causes of an enlarged spleen include: Inflammatory diseases such as sarcoidosis, lupus, and rheumatoid arthritis.

Any independent vertical movement of the transducer or the patient will affect the hydrostatic column of this fluid-filled system and thus alter the pressure measurements. At some time before or after PAC insertion, the system must therefore be zeroed to ambient air pressure. The reference point for this is the midpoint of the left atrium (LA), estimated as the fourth intercostal space in the midaxillary line with the patient in the supine position. With the transducer at this height, the membrane is exposed to atmospheric pressure, and the monitor is then adjusted to zero. Calibration Once zeroed, the monitoring system must be calibrated for accuracy. Currently, most monitors perform an automated electronic calibration. Two methods are used to manually calibrate and check the system. If the catheter has not been inserted, the distal tip of the PAC is raised to a specified height above the LA. For example, raising the tip 20 cm above the LA should produce a reading of approximately 15 mm Hg if the system is working properly (1 mm Hg equals 1.36 cm H 2 O). Alternatively, pressure can be applied externally to the transducer and adjusted to a known level using a mercury or aneroid manometer. The monitor then is adjusted to read this pressure, and the system is calibrated. Dynamic tuning Central pressures are dynamic waveforms (ie, they vary from systole to diastole) and thus have a periodic frequency. To monitor these pressures accurately, the system requires an appropriate frequency response. A poorly responsive system produces inaccurate pressure readings, and differentiating waveforms (eg, PA from pulmonary capillary wedge pressure [PCWP]) can become difficult. When signal energy is lost, the pressure waveform is dampened. Common causes of this are air bubbles (which are compressible), long or compliant tubing, vessel wall impingement, intracatheter debris, transducer malfunction, and loose connections in the tubing. A qualitative test of the frequency response is performed by flicking the catheter and observing a brisk high-frequency response in the waveform. After insertion, the system can be checked by using the rapid flush test. When flushed, an appropriately responsive system shows an initial horizontal straight line with a high-pressure reading. Once the flushing is terminated, the pressure drops immediately, which is represented by a vertical line that plunges below the baseline. A brief and well-defined oscillation occurs, followed by return of the PA waveform. A dampened system will not overshoot or oscillate, and causes a delay in returning to the PA waveform.

Vertigo is a sensation of spinning. If you have these dizzy spells, you might feel like you are spinning or that the world around you is spinning. Causes of Vertigo Vertigo is often caused by an inner ear problem. Some of the most common causes include: BPPV. These initials stand for benign paroxysmal positional vertigo. BPPV occurs when tiny calcium particles (canaliths) clump up in canals of the inner ear. The inner ear sends signals to the brain about head and body movements relative to gravity. It helps you keep your balance. BPPV can occur for no known reason and may be associated with age. Meniere's disease. This is an inner ear disorder thought to be caused by a buildup of fluid and changing pressure in the ear. It can cause episodes of vertigo along with ringing in the ears (tinnitus) and hearing loss. Vestibular neuritis or labyrinthitis. This is an inner ear problem usually related to infection (usually viral). The infection causes inflammation in the inner ear around nerves that are important for helping the body sense balance

Renal replacement therapies are a set of interventions and techniques aimed at replacement of the filtering function of the kidneys. These include both dialysis and renal transplant. In this presentation we will talk about the indication and modalities of dialysis. This includes hemodialysis, peritoneal dialysis and continuous renal replacement therapies. The circuit diagram of each modalities along with its procedure and complications are also discussed.

Biceps tenodesis is a common procedure performed for tendinopathy of the long head of the biceps brachii (LHB). Indications include partial-thickness LHB tear, tendon subluxation with or without subscapularis tear, and failed conservative management of bicipital tenosynovitis. Biceps tenodesis may also be performed for superior labrum anterior to posterior tears.

It's a symptom of heart disease but typically does not cause permanent damage to the heart. It is, though, a sign that you are a candidate for a heart attack at some point in the future. The chest pain may spread to your arm, shoulder, jaw, or back. It may feel like a pressure or squeezing sensation.

What could cause a blockage in the stomach? Mechanical causes of intestinal obstruction may include: Adhesions or scar tissue that forms after surgery. Foreign bodies (objects that are swallowed and block the intestines) Gallstones (rare) Hernias. Impacted stool. Intussusception (telescoping of one segment of bowel into another) Tumors blocking the intestines. Less common radiologic signs are seen in specific circumstances. Most closed-loop obstructions (75%) are caused by adhesions. A closed-loop obstruction occurs when a loop of bowel is not decompressed by the caudal passage of gas and fluid.

If you have a lung disease, a type of surgery called a lobectomy is one treatment option your doctor may suggest. Your lungs are made up of five sections called lobes. You have three in your right lung and two in your left. A lobectomy removes one of these lobes. After the surgery, your healthy tissue makes up for the missing section, so your lungs should work as well or better than they did before.

The procedure was performed under wrist block regional anesthesia with tourniquet control. A single Chinese finger trap was used on the thumb with 5 to 8 lb of ongitudinal traction. The arm was held down with wide tape around the tourniquet securing it to the hand table to serve as countertraction. A shoulder holder, rather than a traction tower, was used to facilitate fluoroscopic intervention more easily. The Trapeziometacarpal joint was detected by palpation. Joint distension was achieved by injecting 1 to 3 mL of normal saline (Fig. 1). It is important to distally direct the needle approximately 20 degrees to clear the dorsal flare of the metacarpal base and enter the joint capsule. This course should be reproduced upon entering with arthroscopic sleeve/ trocar assembly to minimize iatrogenic cartilage injury. Fluid distention is important to facilitate this. The incision for the 1-R (radial) portal, used for proper assessment of the dorsoradial ligament, posterior oblique ligament, and ulnar collateral ligament, was placed just volar to the abductor pollicis longus tendon. The incision for the 1-U (ulnar) portal, for better evaluation of the anterior oblique ligament and ulnar collateral ligament, was made just ulnar to the extensor pollicis brevis tendon. A short-barrel, 1.9-mm, 30- degree inclination arthroscope was used for complete visualization of the CMC joint surfaces, capsule, and ligaments, and then appropriate management was done, as dictated by the stage of the arthritis detected (Fig. 2A). A full-radius mechanical shaver with suction was used in all the cases, particularly for initial debridement and visualization. Most of the cases were augmented with radiofrequency ablation to perform a thorough synovectomy and radiofrequency was also used to perform chondroplasty in the cases with focal articular cartilage wear or fibrillation. Chondroplasty refers to thedebridement of the fibrillated cartilage to improve vascularity of the cartilage and enhance the growth of fibrocartilage. Ligamentous laxity and capsular attenu- ation were treated with thermal capsulorraphy using a radiofrequency shrinkage probe. We were careful to avoid thermal necrosis; hence, a striping technique was used to tighten the capsule of the lax joints. The striping technique refers to thermal shrinkage performed in longitudinal stripes on the lax capsule, so as to leave vascular zones between the stripes; hence, thermal necrosis is prevented. Arthroscopic stage I disease was characterized by synovitis without any cartilage wear, wherein a synovectomy coupled with thermal capsulor- raphy as described was performed.

Ankylosing spondylitis is an inflammatory disease that, over time, can cause some of the vertebrae in your spine to fuse. This fusing makes the spine less flexible and can result in a hunched-forward posture. If ribs are affected, it can be difficult to breathe deeply. Ankylosing spondylitis affects men more often than women. Signs and symptoms typically begin in early adulthood. Inflammation also can occur in other parts of your body — most commonly, your eyes. There is no cure for ankylosing spondylitis, but treatments can lessen your symptoms and possibly slow progression of the disease.

Dr. Horacio Asbun, Mayo Clinic in Florida, explains the Whipple procedure using this animated graphic of a pancreas. Cancer of the pancreas affects 45,000 people every year in the U.S., and it is the fourth leading cause of cancer-related deaths. The five-year overall survival rate if a tumor is detected early and surgically removed is 22 percent, versus 6 percent without early detection and surgery. To learn more, visit http://mayocl.in/2zk7FDi.

This video in Spanish/español: https://www.youtube.com/watch?v=N_zWboNMKWk

Bovine respiratory disease (BRD) has a multifactorial etiology and develops as a result of complex interactions between environmental factors, host factors, and pathogens. Environmental factors (eg, weaning, transport, commingling, crowding, inclement weather, dust, and inadequate ventilation) serve as stressors that adversely affect the immune and nonimmune defense mechanisms of the host. In addition, certain environmental factors (eg, crowding and inadequate ventilation) can enhance the transmission of infectious agents among animals. Many infectious agents have been associated with BRD. An initial pathogen (eg, a virus) may alter the animal’s defense mechanisms, allowing colonization of the lower respiratory tract by bacteria.

Holoprosencephaly (HPE, once known as arhinencephaly) is a cephalic disorder in which the prosencephalon (the forebrain of the embryo) fails to develop into two hemispheres. Normally, the forebrain is formed and the face begins to develop in the fifth and sixth weeks of human pregnancy. The condition also occurs in other species, as with Cy, the Cyclops kitten.