Dr. Debbie Song at Gillette Children's describes in detail selective rhizotomy surgery.

A selective dorsal rhizotomy is an operation performed to treat spasticity. It is thought that high tone and spasticity arise from abnormal signals that are transmitted through sensory or dorsal nerve roots to the spinal cord. In a selective dorsal rhizotomy we identify and cut portions of the dorsal nerve roots that carry abnormal signals thereby disrupting the mechanisms that lead to spasticity. Potential patients go through a rigorous assessment that includes an in-depth gait and motion analysis as well as a physical therapy evaluation.

They are evaluated by a multidisciplinary team that includes a pediatric rehabilitation doctor, a neurosurgeon, and an orthopedist, Appropriate patient selection is vital. Ideal candidates for selective dorsal rhizotomy are children who are between four and ten years of age, have a history of being born prematurely, and have a diagnosis of diplegia cerebral palsy. These patients usually walk independently or with the assistance of crutches or a walker. They typically function at a level one, two, or three in the gross motor function classification system or gmfcs. A selective dorsal rhizotomy involves the coordinated efforts of the neurosurgery, physiatry, anesthesia and nursing teams. The operation entails making an incision in the lower back that is approximately six to eight inches long. We perform what we call a laminoplasty in which we remove the back part of the spinal elements from the lumbar one or l1 to l5 levels. At the end of the procedure the bone is put back on. We identify and open up the Dural sac that contain the spinal fluid spinal cord and nerve roots. Once the Dural sac is opened ,we expose the lumbar and upper sacral nerve roots that transmit information to and from the muscles of the lower extremities.

At each level we isolate the dorsal nerve root, which in turn is separated into as many as 30 smaller thread light fruitlets.

Each rootlet is then electrically stimulated. Specialized members of the physiatry team look for abnormal responses in the muscles of the legs as each rootless is being stimulated. If an abnormal response is observed then the rootlet is cut.

If a normal response is observed, then the rootlet is not cut. We usually end up cutting approximately 20 to 40 percent of the rootlets. The Dural sac is sutured closed and the l1 through l5 spinal elements are put back into anatomic position, thus restoring normal spinal alignment. The overlying tissues and skin are then closed and the patient is awoken from surgery. The entire operation takes between four and five hours. A crucial component to the success of our rhizotomy program is the extensive rehabilitation course following surgery. With their tone significantly reduced after a rhizotomy, patients relearn how to use their muscles to walk more efficiently through stretching, strengthening, and gait training. Approximately one to two years after a rhizotomy patients undergo repeat gait and motion analysis. The orthopedic surgeons assess the need for interventions to correct bone deformities, muscle contractures, poor motor control, impaired balance, or other problems related to cerebral palsy.

At Gillette we work closely with patients and families to ensure that our selective dorsal rhizotomy program meets their goals for enhancing their function and improving their quality of life.

VISIT https://www.gillettechildrens.org/ to learn more

0:00 Why choose selective dorsal rhizotomy?
0:56 Who is a good candidate for selective dorsal rhizotomy?
1:31 What does a selective dorsal rhizotomy entail?
3:26 What is recovery from selective dorsal rhizotomy like?

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watch that Enema Insertion Medical Procedure

Sex reassignment surgery for male-to-female involves reshaping the male genitals into a form with the appearance of, and, as far as possible, the function of female genitalia. Prior to any surgeries, patients usually undergo hormone replacement therapy (HRT), and, depending on the age at which HRT begins, facial hair removal. There are associated surgeries patients may elect to, including facial feminization surgery, breast augmentation, and various other procedures

-A finding of ASC on cytology requires further investigation to exclude precancerous lesions. Recommendations differ for women age 21 -24 and those age ;::25. For women age 21 -24 with ASCUS or low-grade squamous intraepitheliallesion (LSIL), current guidelines recommend repeating Pap smear in one year. In this younger patient population, HPV infection is transient and malignant transformation is rare. Therefore, colposcopy is not performed unless the patient demonstrates ASC-US or LSIL on 3

This patient presented to the ER for umbilical pain and had a history of umbilical hernia. He was concerned about the possibility of incarceration of the hernia.

In this video we explain how the clinical exam helps to differentiate a simple painful hernia from an incarcerated one.

***Thanks to the patient for sharing his history and exam with YouTube world***

Watch that video to know How To Increase Your Testosterone Levels, Naturally

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.

Tummy Tuck ( Classic Method ) : Surgery | 3D Animation

How long does tummy tuck last?
Tummy tuck results are considered permanent, insofar that the fat cells and skin removed during an abdominoplasty cannot grow back. Likewise, the internal sutures placed to repair abdominal muscles are designed to remain in place indefinitely.

What is tummy tuck surgery?
A tummy tuck — also known as abdominoplasty — is a cosmetic surgical procedure to improve the shape and appearance of the abdomen. During a tummy tuck, excess skin and fat are removed from the abdomen. Connective tissue in the abdomen (fascia) usually is tightened with sutures as well.

How much does tummy tuck cost?
How much does it cost? It can cost from about £5,000 to £10,000 to have an abdominoplasty in the UK, plus the cost of any consultations or follow-up care.

How painful is a tummy tuck?
A tummy tuck requires significant downtime

At the beginning, you will be fatigued, swollen and sore. It is normal to have moderate pain during these first several days, although this will steadily improve. It is vital to allow yourself time to focus on rest and healing.

What is the disadvantage of tummy tuck?
The cons of a tummy tuck include: A full abdominoplasty is a major operation with a considerable recovery. Expect to postpone strenuous activities for at least 6 weeks. Results take time.


Is tummy tuck more painful than C section?
That's something many women want to know. While patients have different experiences, most plastic surgeons would agree that a cesarean section is more painful than most tummy tucks.


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⁣Immune Responses During a Lupus Flare Video

Traditional Liposuction VS Vaser Liposuction

A side-by-side comparison of traditional liposuction and a #Vaser liposuction. Both of these were performed by our skilled surgeons at Divine Cosmetic Surgery.

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Know more about liposuction
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Traditional Liposuction vs 360 High Def Vaser Liposuction - https://www.youtube.com/watch?v=r_bBI2p9fVI&t=14s
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Why Vaser Is Best For Thigh Liposuction - https://youtu.be/dlzpdDEZcS4
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Abdomen Vaser Liposuction - Live - https://www.youtube.com/watch?v=_Cvl2Txn8LQ
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Back Vaser Liposuction In Female - https://youtu.be/OC60UdgtIWU
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For more details about Liposuction Visit - https://www.divinecosmeticsurgery.com/
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Dr. Amit Gupta
MBBS, M.S., DNB (Plastic & Cosmetic Surgery)
Divine Cosmetic Surgery | +91 9811994417
info@divinecosmeticsurgery.com | 01141828787
Delhi | Mumbai | Gurgaon

𝗦𝗼𝗰𝗶𝗮𝗹 𝗠𝗲𝗱𝗶𝗮 𝗮𝗻𝗱 𝗬𝗼𝘂𝘁𝘂𝗯𝗲 𝘃𝗶𝗱𝗲𝗼 𝗰𝗵𝗮𝗻𝗻𝗲𝗹 : -

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Disclaimer: The information on our videos & social media is provided for informational purposes only and is not meant for the advice provided by your surgeon.
We are not responsible for any harm if anyone misguides you from our name. Our all-social media official handles are linked up on our website. All images & content used on our videos & social media are for illustrative concerns only, original results and processes may vary.

In this video I show the steps to give a woman a full body energy orgasm without even touching her.

Full examination of the female from head to toe by Loyola Medical School, Chicago. Part 4

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Patient Glenn Williams had a hernia measuring 20cm x 30cm. Consultant Graham Offer has performed ground breaking surgery to help Glenn.

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This is how Paraumbilical hernia looks like and how it is examined although it looks very simple but in exam it can be very difficult to perform all steps in small amount of time. This can be short case or even long of #cpsp #fcps #mbbs #medicalstudent #mbbsexams #plab2 #plab #plab1 and MS #genernalknowledge #surgery exams

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Video showing normal vagina delivery and child birth