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.

Amniotomy is the official term for artificially breaking the bag of waters during labor. It is believed that breaking the bag of waters will help to speed up an otherwise slow labor. Amniotomy is part of the Active Management of Labor practiced in some hospitals. Amniotomy is performed by a midwife or doctor. A long, thin instrument with a hook on the end is inserted into the vagina and through the cervix so it can catch and rip the bag of waters. To perform an amniotomy, the cervix must be dilated enough to allow the instrument through the cervix, generally at least a two. Why choose Amniotomy? Unlike other medical methods of starting labor, amniotomy does not add synthetic hormones to your labor. Instead it seems to stimulate your body’s own labor process. Amniotomy allows the use of an internal electronic fetal monitor. How effective is Amniotomy? Amniotomy alone is unpredictable, it may take hours for labor to start with amniotomy. Because amniotomy increases the risk for infection, most caregivers use amniotomy in combination with synthetic oxytocin. Birth does happen faster when amniotomy is combined with synthetic oxytocin than when amniotomy is used alone. Risks of Amniotomy Risks for Mother Increases the risk for infection. This risk is increased with length of time the waters are broken and with vaginal exams. Because of the infection risk, a time limit is given by which the mother must give birth. As the time limit approaches attempts to progress labor will become more aggressive. The fore waters equalize pressure on the cervix so it will open uniformly. When they are broken, the mother increases her chances of having uneven dilation. Risks for Baby Increases the risk of umbilical cord compression. The fore waters equalize pressure on the baby’s head as it presses against the cervix. When they are broken, the pressure on the baby’s head may be uneven causing swelling in some parts.

http://www.vaginal-ultrasound.com A demonstration of a vaginal ultrasound.

J Vasc Surg. 2009 Jul;50(1):134-9. Celiac artery compression syndrome managed by laparoscopy. Baccari P, Civilini E, Dordoni L, Melissano G, Nicoletti R, Chiesa R. Department of General Surgery, Scientific Institute San Raffaele University Hospital, Milan, Italy. paolo.baccari@hsr.it Abstr...

act OBJECTIVE: Celiac artery compression syndrome (CACS) is an unusual condition caused by abnormally low insertion of the median fibrous arcuate ligament and muscular diaphragmatic fiber resulting in luminal narrowing of the celiac trunk. Surgical treatment is the release of the extrinsic compression by division of the median arcuate ligament overlying the celiac axis and skeletonization of the aorta and celiac trunk. The laparoscopic approach has been recently reported for single cases. Percutaneous transluminal angioplasty (PTA) and stenting of the CA alone, before or after the surgical relief of external compression to the celiac axis, has also been used. We report our 7-year experience with the laparoscopic management of CACS caused by the median arcuate ligament. METHODS: Between July 2001 and May 2008, 16 patients (5 men; mean age, 52 years) were treated. Diagnosis was made by duplex ultrasound scan and angiogram (computed tomography [CT] or magnetic resonance). The mean body mass index of the patients was 21.2 kg/m(2). One patient underwent laparoscopic surgery after failure of PTA and stenting of the CA, and two patients after a stenting attempt failed. RESULTS: All procedural steps were laparoscopically completed, and the celiac trunk was skeletonized. The laparoscopic procedures lasted a mean of 90 minutes. Two cases were converted to open surgery for bleeding at the end of the operation when high energies were used. The postoperative course was uneventful. Mean postoperative hospital stay was 3 days. On follow-up, 14 patients remained asymptomatic, with postoperative CT angiogram showing no residual stenosis of the celiac trunk. One patient had restenosis and underwent aortoceliac artery bypass grafting after 3 months. Another patient had PTA and stenting 2 months after laparoscopic operation. All patients reported complete resolution of symptoms at a mean follow-up of 28.3 months. CONCLUSIONS: The laparoscopic approach to CACS appears to be feasible, safe, and successful, if performed by experienced laparoscopic surgeons. PTA and stenting resulted in a valid complementary procedure only when performed after the release of the extrinsic compression on the CA. Additional patients with longer follow-up are needed.

Recurrent varicose veins are a common problem. The patient in this video was operated for great saphenous vein insufficiency and a “neocrosse” occurred after few years. Surgical exploration revealed a “cavernoma” just over the nodes of the crural area, feeding varicose veins of thigh and leg.

"The act of cutting off the prepuce or foreskin of males, or the internal labia of females." Webster's Revised Unabridged Dictionary (1913)

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

Orchidectomy and Orchidopexy in testis Torsion

Basic well-male examination of the genitals and digital rectal exam.

This is a 4 minute video depicting the basic technique of the Mohs micrographic procedure and how the tissue is processed in the lab. Visit us @ www.skincancercentre.com

In human anatomy, the radial artery is the main blood vessel, with oxygenated blood, of the lateral aspect of the forearm.

The E.coli bacteria has claimed 14 lives and infected more than 300 hundred in the country. It has now spread to other European states.

Facing an increasing number of cases, German health authorities warned people to avoid eating raw cucumber, tomatoes and lettuce.

Reinhard Burger, President of Robert Koch Institute, said, "As for the present situation there is no reason to give the all-clear yet and it is possible the original source of the infection is still active and could lead to further infections."

The first cases of the EHEC outbreak were noticed in Northern Germany, but infections are now spreading across the country.

Cases haves spiked compared to other years, and are still rising.

Daniel Bahr, German Health Minister, said, "The result is that we unfortunately still have to prepare for a rising number of cases. Exercising caution is still recommended and we ask our citizens to be particularly careful. "

But, the German government says it's working around the clock to stop the outbreak and clarify how it arose.

Ilse Aigner, German Agriculture Minister, said, "Together, we face a big challenge to piece together hundreds or thousands of mosaic pieces from Germany and abroad into an overall picture that gives us a clear answer on how this terrible infection arose. "

In the meantime, experts are advising not to eat pre-packaged or prepared salad, which may contain the bacteria.

Skin cancer is the most common of all cancer types, accounting for an estimated one third of all new cases. It’s important to take the right steps to ensure proper protection and adopt good sun care habits no matter what your age or stage in life.

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