Trabeculectomy surgery

Urogenital neoplasms spreading to the inguinal lymph nodes are penile carcinoma (the most frequent), urethral and scrotum cancers, tumors of the testis with scrotal violation. Penile carcinoma is an uncommon malignant disease and accounts for as many 0.4-0.6% of male cancers. Most patients are elder...ly. It rarely occurs in men under age 60 and its incidence increases progressively until it reaches a peak in the eighth decade 1. The risk of a lymph node invasion is greater with high grade and high stage tumors 2. Some investigators have reported the inaccuracy of the sentinel node biopsy 3, 4, described by Cabanas 5. Patients with metastatic lymph node penis cancer have a very poor prognosis if penectomy only is performed. Ilioinguinal lymphadenectomy is basically carried out as a treatment modality and not only as a staging act. Patients with lymph node invasion have a 30-40% cure rate. Ilioinguinal lymphadenectomy should be also performed in patients with disseminated neoplasms for the local control of the disease. The 5 years survival rate of patients with clinically negative lymph nodes treated with a modified inguinal lymphadenectomy is 88% versus 38% in patients not initially treated with lymphadenectomy 6. This video-tape clearly shows a therapeutic algorithm, the anatomy of the inguinal lymph nodes, according to Rouviere 7 and Daseler 8, the radical ilioinguinal node dissection with transposition of the sartorius muscle and the modified inguinal lymphadenectomy proposed by Catalona 9. References: 1. Lynch D.F. and Schellhammer P: Tumors of the penis. In Campbell’s Urology Seventh Edition, edited by Walsh P.C., Retik A.B., Darracott Vaughan E. and Wein A.J. W.B. Saunders Company, Vol. 3, chapt. 79, p. 2458, 1998. 2. Pizzocaro G., Piva L., Bandieramonte G., Tana S. Up-to-date management of carcinoma of the penis. Eur. Urol. 32: 5-15, 1997 3. Perinetti E., Crane D.B. and Catalona W.J. Unreliability of sentinel lymph node biopsy for staging penile carcinoma. J. Urol. 124: 734, 1980 4. Fowler J.E. Jr. Sentinel lymph node biopsy for staging penile cancer. Urology 23: 352, 1984 5. Cabanas R.M. An approach for the treatment of penile carcinoma. Cancer 39: 456, 1977 6. Russo P. and Gaudin P. Management strategies for carcinoma of the penis. Contemporary Urology;5:48-66, 2000 7. Rouviere H. Anatomy of the human lymphatic system. Edwards Brothers, p. 218, 1938 8. Daseler E.H., Anson B.J., Reimann A.F. Radical excision of the inguinal and iliac lymph glands: a study based on 450 anatomical dissections and upon supportive clinical observations. Surg. Gynecol. Obstet. 87: 679, 1948 9. Catalona W.J. Modified inguinal lymphadenectomy for carcinoma of the penis with preservation of saphenous veins: technique and preliminary results. J. Urol. 140: 306-310, 1988

51 yr old female with right flank pain and recurrent UTI. IVP showed a UPJ calculus on the right.

3D ultrasound of IUD in uterus

indicated in Radius and Ulna Fractures

The video will describe silhouette sign on a chest x-ray. Please see disclaimer on my website. www.academyofprofessionals.com

Orchidectomy and Orchidopexy in Testicular Torsion

Video is an excellent introduction to Hysterosalpingography and summarizes different pathologies. While the information on this presentation is about health care issues, it is not medical advice. People seeking specific medical advice or assistance should contact their personal physician. Although we believe the information in this presentation to be accurate and timely, because of the rapid advances in health care and our reliance on information provided by outside sources, we make no warranty or guarantee concerning the accuracy or reliability of the content or other material which we may reference. When clinical matters are discussed, the opinions presented are those of the discussants only. The material discussed on the presentation is not intended to present the only or necessarily the best method or procedure, but rather presents the approach or opinion of the discussant. This presentation is provided in an “as is” format without warranties of any kind, expressed or implied, including but not limited to warranties of title, non-infringement or implied warranties of merchantability or fitness for a particular purpose.

ACTUAL CATHETERIZATION A clinical view of insertion into the male urethra. A 14 french coude cath was used.

A spontaneous vaginal delivery (SVD) occurs when a pregnant woman goes into labor with or without use of drugs or techniques to induce labor, and delivers her baby in the normal manner, without forceps, vacuum extraction, or a cesarean section. Assisted vaginal delivery (AVD) occurs when a pregnant woman goes into labor with or without the use of drugs or techniques to induce labor, and requires the use of special instruments such as forceps or a vacuum extractor to deliver her baby vaginally.

A closure device and method to close the abdomen between surgical procedures and maintain a normal physiologic tension on the fascia to prevent undue retraction. In one embodiment, the closure device includes a “needled carabiner” attached to a rubberband of specific tension. The rubberband mimics the physiologic tension the abdominal wall normally experiences during daily activities and allows the abdominal compartment to expand as needed to maintain a healthy intra-abdominal pressure. The bands contract to maintain the intra-abdominal pressure and slowly pull the abdominal fascia back to the midline to facilitate surgical closure of the abdomen. In one embodiment, the “needled carabiner” includes a hinged surgical needle with a protected cap. The hinged needle is placed outside the normal suture line, thereby limiting the amount of surgical trauma the fascia endures. The strength of the rubberbands may be varied to accommodate differently sized individuals.

The pelvic floor or pelvic diaphragm is composed of muscle fibers of the levator ani, the coccygeus, and associated connective tissue which span the area underneath the pelvis. The pelvic diaphragm is a muscular partition formed by the levatores ani and coccygei, with which may be included the parietal pelvic fascia on their upper and lower aspects. The pelvic floor separates the pelvic cavity above from the perineal region (including perineum) below.

The right and left levator ani lie almost horizontally in the floor of the pelvis, separated by a narrow gap that transmits the urethra, vagina, and anal canal. The levator ani is usually considered in three parts: pubococcygeus, puborectalis, and iliococcygeus. The pubococcygeus, the main part of the levator, runs backward from the body of the pubis toward the coccyx and may be damaged during parturition. Some fibers are inserted into the prostate, urethra, and vagina. The right and left puborectalis unite behind the anorectal junction to form a muscular sling . Some regard them as a part of the sphincter ani externus. The iliococcygeus, the most posterior part of the levator ani, is often poorly developed.

The coccygeus, situated behind the levator ani and frequently tendinous as much as muscular, extends from the ischial spine to the lateral margin of the sacrum and coccyx.

The pelvic cavity of the true pelvis has the pelvic floor as its inferior border (and the pelvic brim as its superior border.) The perineum has the pelvic floor as its superior border.

Some sources do not consider “pelvic floor” and “pelvic diaphragm” to be identical, with the “diaphragm” consisting of only the levator ani and coccygeus, while the “floor” also includes the perineal membrane and deep perineal pouch. However, other sources include the fascia as part of the diaphragm. In practice, the two terms are often used interchangeably.

Inferiorly, the pelvic floor extends into the anal triangle.

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.

An excellent video demonstrating how a laparoscopy is performed to evaluate the uterus (note a small fibroid appearing as a bulge in the uterus), fallopian tubes and ovaries. Blue dye is injected into the uterus, entering the fallopian tubes and spilling from the end of the tubes into the abdominal cavity, confirming that both tubes are open

Vaginal Hysterectomy Procedure of a 42 years old female patient with a 3 months history of symptomatic vaginal bulge

A video showing breast examination after breast implants

A report of Female Genital Mutilationn FGM (female circucision) in Menya In Egypt تقرير من مدينة المنيا في صعيد مصر عن ختان لاناث

A video showing the examination of femoral hernia.

腹腔镜右斜疝修补术+胆囊切除术

• Define and use related medical terminology.
• Describe and demonstrate techniques for imaging the thyroid gland.
• Discuss functional abnormalities of the thyroid gland.
• Correlate laboratory data relevant to the thyroid and parathyroid glands.
• Describe, and recognize on images, pathologies of the thyroid gland.
• Identify the anatomy of the parathyroid glands on diagrams and sonograms.
• Describe and demonstrate techniques for imaging the parathyroid glands.
• Describe, and recognize on images, pathologies of the parathyroid glands.
• List and describe other neck masses.
• Follow relevant protocols when scanning.
• Differentiate the sonographic appearances of the female reproductive organs in relation to the menstrual cycle, the use of contraceptives and hormone replacement, and following chemotherapy.
• Explain the Patient Privacy Rule (HIPAA) and Patient Safety Act (see reference).