At Hutzel Women's Hospital, Dr. Giancarlo Mari performs breakthrough in-utero surgery to save the lives of high-risk twins developing with a rare "shared" circulatory problem. ~ Detroit Medical Center

Simple technique to harvest Connective tissue graft from the Palate.

Closed Reduction of Distal Radius Fractures - Discussion: (distal radius fracture menu) - closed reduction & immobilization in plaster cast remains accepted method of treatment for majority of stable distal radius frx; - unstable fractures will often lose reduction in the cast and will slip back to the pre-reduction position; - patients should be examined for carpal tunnel symptoms before and after reduction; - carpal tunnel symptoms that do not resolve following reduction will require carpal tunnel release; - cautions: - The efficacy of closed reduction in displaced distal radius fractures. - Technique: - anesthesia: (see: anesthesia menu) - hematoma block w/ lidocaine; - w/ hematoma block surgeon should look for "flash back" of blood from hematoma, prior to injection; - references: - Regional anesthesia preferable for Colles' fracture. Controlled comparison with local anesthesia. - Neurological complications of dynamic reduction of Colles' fractures without anesthesia compared with traditional manipulation after local infiltration anesthesia. - methods of reduction: - Jones method: involves increasing deformity, applying traction, and immobilizing hand & wrist in reduced position; - placing hand & wrist in too much flexion (Cotton-Loder position) leads to median nerve compression & stiff fingers; - Bohler advocated longitudinal traction followed by extension and realignment; - consider hyper-extending the distal fragment, and then translating it distally (while in extended position) until it can be "hooked over" proximal fragment; - subsequently, the distal fragment can be flexed (or hinged) over the proximal shaft fragment; - closed reduction of distal radius fractures is facilitated by having an assistant provide counter traction (above the elbow) while the surgeon controls the distal fragment w/ both hands (both thumbs over the dorsal surface of the distal fragment); - flouroscopy: - it allows a quick, gentle, and complete reduction; - prepare are by prewrapping the arm w/ sheet cotton and have the plaster or fibroglass ready; - if flouroscopy is not available, then do not pre-wrap the extremity w/ cotton; - it will be necessary to palpate the landmarks (outer shaped of radius, radial styloid, and Lister's tubercle, in order to judge success of reduction; - casting: - generally, the surgeon will use a pre-measured double sugar sugar tong splint, which is 6-8 layers in thickness; - more than 8 layers of plaster can cause full thickness burns: - reference: Setting temperatures of synthetic casts. - position of immobilization - follow up: - radiographs: - repeat radiographs are required weekly for 2-3 weeks to ensure that there is maintenance of the reduction; - a fracture reduction that slips should be considered to be unstable and probably require fixation with (pins, or ex fix ect.) - there is some evidence that remanipulation following fracture displacement in cast is not effective for these fractures; - ultimately, whether or not a patient is satisfied with the results of non operative treatment depends heavily on th

Arterial Cannulation

A hematoma is a common complication of surgical procedures. A large, expanding hematoma can result in necrosis of the overlying skin (1,2) or adjacent subcutaneous fat, increased incidence of infection, scarring, skin hyperpigmentation, tissue edema and a prolonged convalescence.

Dilation and curettage (D&C) is a procedure to remove tissue from inside your uterus. Doctors perform dilation and curettage to diagnose and treat certain uterine conditions — such as heavy bleeding — or to clear the uterine lining after a miscarriage or abortion.

An enlarged spleen may cause: No symptoms in some cases. Pain or fullness in the left upper abdomen that may spread to the left shoulder. Feeling full without eating or after eating only a small amount from the enlarged spleen pressing on your stomach. Anemia. Fatigue. Frequent infections. Easy bleeding.

This poor old lady came with swelling in her left buttock for 10 days.She had history of injection in her buttocks two weeks back. She developed painful swelling and redness in her left gluteal region with difficulty in walking.It was diagnosed as injection abscess left gluteal region which needs incision and drainage under local anesthesia.Patient part painted and drapped.2% Lignocaine with adrenaline was infiltrated around the swelling for proper filed block.I use no-11 blade for stab incision over the swelling at the most fluctuating point of the abscess.You can watch how pus was flowing out from the cavity.The aim is to drain all pus from the abscess cavity.Finger exploration is essential to break all loculi inside the cavity, to know the depth and extend of the cavity and to fascilitate proper drainage of residual pus.after pus evacuation,, the cavity should be irrigated with normal saline and betadine solution.lastly the cavity to be packed with betadine soaked guage pieces.Proper dressing is essential.the dressing to be changed after 24 hours.daily dressing is essential with a good antibiotic coverage.the cavity usually obliterates within a period of seven to ten days.

Hysteroscopy is a procedure that allows your doctor to look inside your uterus in order to diagnose and treat causes of abnormal bleeding. Hysteroscopy is done using a hysteroscope, a thin, lighted tube that is inserted into the vagina to examine the cervix and inside of the uterus.

This video is really sad. You can literally watch this man dying. He was shot in the chest and rushed to the emergency room. His heart has stopped beating or has arrested. As a last resort, surgeons did an extreme procedure called an open thoracotomy which is that crazy tool you see there that basically splits the ribs open and allows easy open access to the heart. They did this so they could give him a cardiac massage. A cardiac massage is when surgeons are manually trying to pump the heart after it has stopped working on its own (cardiac arrest). Unfortunately he lost so much blood from his gun shot wound and he was pronounced dead. There are cases of patients surviving after having this kind of invasive resuscitation but it is rare.

Gall Stones

Watch that video to know How to Shape Your Saggy Breasts Naturally

Ultrasound guided Femoral Nerve stimulating Catheter

Watch that Full Human Body Medical Anatomy Autopsy

Learn how to give an intramuscular injection

Watch that Female Foley Catheter Insertion Procedure

To facilitate the delivery of fluids during labour, obstetric anaesthetists from Coventry designed a triple IV peripheral connector with a central high-flow anti-reflux valve. This connector, now rightly known as the Coventry valve, can be used for all theatre settings and is especially useful in obstetrics, ICU, HDU and orthopaedics. More details on www.mediplus.co.uk

Watch that video to learn How To Insert Enema

Laser tattoo removal is simple, safe, and produces fantastic...

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