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This Basic Laparoscopic Surgery: Abdominal Access and Trocar Introduction course will teach you the steps of Laparoscopic Surgery. View the full course for free by signing up on our website: https://www.incision.care/
What is Laparoscopic Surgery:
Laparoscopic surgery describes procedures performed using one or multiple small incisions in the abdominal wall in contrast to the larger, normally singular incision of laparotomy. The technique is based around principles of minimally invasive surgery (or minimal access surgery): a large group of modern surgical procedures carried out by entering the body with the smallest possible damage to tissues. In abdominopelvic surgery, minimally invasive surgery is generally treated as synonymous with laparoscopic surgery as are procedures not technically within the peritoneal cavity, such as totally extraperitoneal hernia repair, or extending beyond the abdomen, such as thoraco-laparoscopic esophagectomy. The term laparoscopy is sometimes used interchangeably, although this is often reserved to describe a visual examination of the peritoneal cavity or the purely scopic component of a laparoscopic procedure. The colloquial keyhole surgery is common in non-medical usage.
Surgical Objective of Laparoscopic Surgery:
The objective of a laparoscopic approach is to minimize surgical trauma when operating on abdominal or pelvic structures. When correctly indicated and performed, this can result in smaller scars, reduced postoperative morbidity, shorter inpatient durations, and a faster return to normal activity. For a number of abdominopelvic procedures, a laparoscopic approach is now generally considered to be the gold-standard treatment option.
Definitions
Developments of Laparoscopic Surgery:
Following a number of smaller-scale applications of minimally invasive techniques to abdominopelvic surgery, laparoscopic surgery became a major part of general surgical practice with the introduction of laparoscopic cholecystectomy in the 1980s and the subsequent pioneering of endoscopic camera technology. This led to the widespread adoption of the technique by the early- to mid-1990s. The portfolio of procedures that can be performed laparoscopically has rapidly expanded with improvements in instruments, imaging, techniques and training — forming a central component of modern surgical practice and cross-specialty curricula [2]. Techniques such as laparoscopically assisted surgery and hand-assisted laparoscopic surgery have allowed the application of laparoscopic techniques to a greater variety of pathology. Single-incision laparoscopic surgery, natural orifice transluminal endoscopic surgery, and minilaparoscopy-assisted natural orifice surgery continue to push forward the applications of minimally invasive abdominopelvic techniques; however, the widespread practice and specific indications for these remain to be fully established. More recently, robotic surgery has been able to build on laparoscopic principles through developments in visualization, ergonomics, and instrumentation.
This Basic Laparoscopic Surgery: Abdominal Access and Trocar Introduction course will teach you:
- How to access the abdomen using an open, closed, and direct optical-entry technique
- Principles underlying safe abdominal insufflation
- The vascular anatomy of the abdominal wall and its implications for trocar placement
- How to introduce trocars into the peritoneal cavity
- The principle of triangulation and how this can be applied to organizing a laparoscopic surgical field
Specific attention is given to these hazards you may encounter:
- Intravascular, intraluminal, or extraperitoneal needle position
- Limitations of a closed introduction technique
- Abdominal surgical history
- Limitations of an open introduction technique
- Optical trocar entry in thin individuals
- Visualization of non-midline structures
- Limitations of direct optical-entry techniques
- Limitations of clinical examination to confirm intraperitoneal insufflation
- Leakage of insufflation gas
These tips are designed to help you improve your understanding and performance:
- Alternative left upper quadrant approach
- Testing Veress needle before use
- Lifting the abdominal wall for Veress needle introduction
- "Hanging-drop test"
- Palmer's test
- Confirming intra-abdominal insufflation
- Subcutaneous tissue retraction
- Anatomy of the umbilicus
- Retraction of abdominal wall fascia
- Finger sweep of anterior abdominal wall
- Lifting the abdominal wall for optical trocar introduction
- Identification of venous bleeding at the end of a procedure
- Identification of inferior epigastric vessels by direct vision
- Peritoneal folds of the anterior abdominal wall
- Transillumination of superficial epigastric vessels
- Infiltration of local anesthetic at port sites
- Aiming of trocars
- Selection of trocar size
- Maintaining direct vision
Nystagmus is a vision condition in which the eyes make repetitive, uncontrolled movements. These movements often result in reduced vision and depth perception and can affect balance and coordination. These involuntary eye movements can occur from side to side, up and down, or in a circular pattern.
Brachytherapy or localized radiation treatment can be used in certain patients with breast cancer. Depending on tumor size and other factor, physicians may use APBI or accelerated partial breast irradiation. Dr. Elizabeth Tapen, a radiation oncologist, reviews brachytherapy for breast cancer.
A simple test of fingernail clippings could replace a blood draw as a way to diagnose and monitor type 2 diabetes mellitus (T2DM), with huge implications for tracking the disease in the developing world. Research on this method by a team of Belgian researchers was reported July 28, 2015, at the 2015 American Association for Clinical Chemistry (AACC) Annual Meeting and Clinical Lab Expo in Atlanta. The team, led by Joris R. Delanghe, MD, PhD, of the Department of Global Chemistry, Microbiology and Immunology at Ghent University, collected nail clippings from 25 people with T2DM and 25 without the disease. The clippings were ground into a powder and tested with an inexpensive FT-IR photometer to measure how much the protein in the nails had bonded with sugar molecules, a process known as glycation. “We found a striking difference in the measurements between the control group and the patients with diabetes,” Delanghe said. In an interview with Evidence-Based Diabetes Management, he said replacing the standard blood test to measure glycated hemoglobin is a huge advantage. In many cultures, he said, “Taking blood is something that cannot be tolerated.” - See more at: http://www.ajmc.com/journals/evidence-based-diabetes-management/2015/september-2015/fingernail-tests-may-offer-cheap-simple-way-to-diagnose-diabetes#sthash.XQxnBcNO.dpuf
A grand mal seizure causes a loss of consciousness and violent muscle contractions. It's the type of seizure most people picture when they think about seizures. A grand mal seizure — also known as a generalized tonic-clonic seizure — is caused by abnormal electrical activity throughout the brain. Usually, a grand mal seizure is caused by epilepsy. But sometimes, this type of seizure can be triggered by other health problems, such as extremely low blood sugar, a high fever or a stroke. Many people who have a grand mal seizure never have another one and don't need treatment. But someone who has recurrent seizures may need treatment with daily anti-seizure medications to control and prevent future grand mal seizures
Dr. Fizan Abdullah is head of the Division of Pediatric Surgery and vice chair of the Department of Surgery at Ann & Robert H. Lurie Children's Hospital of Chicago. His special interests include Chest wall deformities, pectus excavatum, abdominal wall defects, neonatal surgery, pulmonary and upper airway malformations, congenital diaphragmatic hernia, esophageal and gastrointestinal anomalies, hernia repair, tissue engineering, extracorporeal membrane oxygenation (ECMO), surgical safety protocols and surgical infections.
Learn more at www.luriechildrens.org
-Intrapartum antibiotic prophylaxis for mothers colonized with group B Streptococcus can prevent early-onset neonatal disease. Adequate prophylaxis consists of ampicillin, penicillin, or cefazolin for ;::4 hours before delivery. Regardless of intrapartum treatment, all high-risk infants must be observed for ;::49 hours. A complete blood count with differential and blood culture are indicated if the infant is preterm <37 weeks or was exposed to prolonged rupture of membranes.>18 hrs.
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Stoma Care- Changing a Colostomy Bag (Nursing Skills)
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Stoma Care- Changing a Colostomy Bag (Nursing Skills)
In this video, we’re going to talk about stoma care. Now, the wafer and bag for an ostomy only NEEDS to be changed every 3 days, or if it’s leaking. But, you still need to be able to assess the stoma itself. In this case we’re going to show you how to replace the bag and clean and assess the stoma. Start by putting a towel under the patient on the side of the stoma. We love you guys! Go out and be your best selves today! And, as always, happy nursing!
Bookmarks:
0.05 Introduction to Stoma Care
0:20 Assessing the stoma
0:47 Cleaning the stoma
1:12 Inspecting the stoma
1:25 Measuring and cutting the stoma
2:00 Applying and sealing the bag
2:35 Documentation
2:41 Outro
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-Tibial stress fractures are common in athletes and nonathletes who suddenly increase their physical activity. Clinical features include pain, localized tenderness, and swelling. Plain x-ray is <50% sensitive for stress fractures, especially in the first 2-3 weeks after the onset of symptoms. MRI is preferred over bone scan or ultrasound as it can show the fracture line that extends through the cortex into the medullary line. MRI can also identify ligament, muscle, and cartilage injuries. However, MRI findings may be persistently abnormal for up to 1 year after the stress fracture has healed.
Hypertensive emergencies encompass a spectrum of clinical presentations in which uncontrolled blood pressures lead to progressive or impending end-organ dysfunction. In these conditions, the BP should be lowered aggressively over minutes to hours. Neurologic end-organ damage due to uncontrolled BP may include hypertensive encephalopathy, cerebral vascular accident/cerebral infarction, subarachnoid hemorrhage, and/or intracranial hemorrhage.[1] Cardiovascular end-organ damage may include myocardial ischemia/infarction, acute left ventricular dysfunction, acute pulmonary edema, and/or aortic dissection. Other organ systems may also be affected by uncontrolled hypertension, which may lead to acute renal failure/insufficiency, retinopathy, eclampsia, or microangiopathic hemolytic anemia.[1] With the advent of antihypertensives, the incidence of hypertensive emergencies has declined from 7% to approximately 1% of patients with hypertension.[2] In addition, the 1-year survival rate associated with this condition has increased from only 20% (prior to 1950) to a survival rate of more than 90% with appropriate medical treatment
Podalic version is an obstetric procedure wherein the fetus is turned within the womb such that one or both feet present through the cervix during childbirth. It is used most often in cases where the fetus lies transversely or in another abnormal position in the womb.