Top videos
Alexandra J. Golby, MD, Director, Image-guided Neurosurgery at Brigham and Women’s Hospital, discusses technological advancements to improve the precision of surgery to remove brain tumors.
It’s estimated that each year nearly 80,000 people are diagnosed with primary brain tumors and 100,000 with metastatic brain tumors. Nearly everybody is at risk for developing a brain tumor. Brain tumors can affect people from childhood to the last years of their lives. Men are slightly more affected than women and the causes of most brain tumors are not known.
There are a number of unique challenges in treating brain tumors. One challenge is that primary tumors can have indistinct margins that are difficult to see. Another challenge is that the tissue around a brain tumor is uniquely important and may impact things like language, visual and motor function.
The AMIGO Suite, opened in 2011 at Brigham and Women’s Hospital, is the Advanced Multimodality Image Guided Operating Suite. It's an NIH-funded national center which was developed with the goal of translating technological advances into improvements in surgical and interventional care for patients. In the AMIGO Suite, there is an intraoperative MRI scanner which can be brought in and out of the operating room during surgery to help surgeons visualize a patient’s tumor better.
Image-guided surgery uses the information obtained from advanced imaging and translates that into the planning and execution of surgery by acquiring high resolution and specialty structural images of the brain and also functional images of the brain. These images can be registered to one another and then to the patient's head during surgery. This allows surgeons to pinpoint the location of the tumor as well as the areas that we would like to preserve, areas that serve critical brain functions are located.
One of the big challenges, even with image-guided surgery, is that as we perform the surgery, the configuration of the brain is changing, and we call that brain shift. And it's due to changes in the brain itself and also as we remove tissue, things are constantly shifting and moving. When we're talking about doing brain tumor surgery, a few millimeters of movement can be a big difference. How to measure and track brain shift is an important area of research and a number of technologies are being studied to understand how to measure brain shift during surgery.
The development of various intraoperative imaging technologies allows surgeons to provide the most accurate surgical treatment for each individual patient.
Learn more about precision brain surgery at Brigham and Women’s Hospital:
https://www.brighamandwomens.o....rg/neurosurgery/brai
Majority of patients these days prefer PCNL ( Minimal Invasive Telescopic removal of kidney stones broken with lithoclast, removed through a button hole incision ). This patient with a big stone in the pelvis of the kidney wanted it open only so I did an open pyelolithotomy for this patient after a long time as I use to do it in routine in the past. Except for the long incision and scar as compared to PCNL the recovery time was the same and patient went home third day happily walking and eating.
Thyroid nodules increase with age and are present in almost 10% of the adult population. Autopsy studies reveal the presence of thyroid nodules in 50% of the population, so they are fairly common. 95% of solitary thyroid nodules are benign, and therefore, only 5% of thyroid nodules are malignant.
Kendall Lee, M.D., describes deep brain stimulation surgery, and how it is is typically done with patients who remain awake, so neurological functions can be measured and maintained. For more information on deep brain stimulation, visit http://mayocl.in/2A09T80.
http://penilepapules.plus101.com/ ----- White Spots On Shaft, Pearly Penile Papules Treatment Cream, Single Red Bump On Shaft, Ppp Surgery. Common Home Made Remedies for Pearly Penile Papules. When it comes to treating pearly penile papules many people find it very difficult to reach one of the medical treatments. This is mainly because they are highly expensive and not many people can afford spending large amounts of money on surgery and recovery. In addition to that, these procedures have been reported as being quite risky, which make the men suffering from pearly penile papules think twice before going for one of the available surgeries. This is why, along the time, many homemade, natural treatments have been experienced, so that a cheaper and less risky way of curing pearly penile papules would be found. Some of the methods which have been tried proved to be very less effective, while some did not have any effect at all. Yet, there have also been methods which not only proved to be effective, but they were also considered to be much better than the medical treatment. Most of those who have tried the tea tree oil treatment reported significant diminish of the number of the papules from their penises. In addition to the clearing of the skin, they have also noticed that there were no side effects and the skin remained soft after the papules were removed. As the method was quite simple to put in practice (it requires the application of tea tree oil on the affected area with a cotton swab for three or four times per day), many men decided this was indeed a great solution to their problem.
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.