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Breast reconstruction 3D Animation
on Friday, December 17, 2010




The primary part of the procedure can often be carried out immediately following the mastectomy. As with many other surgeries, patients with significant medical comorbidities (high blood pressure, obesity, diabetes) and smokers are higher-risk candidates. Surgeons may choose to perform delayed reconstruction to decrease this risk. Patients expected to receive external beam radiation as part of their adjuvant treatment are also commonly considered for delayed autologous reconstruction due to significantly higher complication rates with tissue expander-implant techniques in those patients. Breast reconstruction is a large undertaking that usually takes multiple operations. Sometimes these follow-up surgeries are spread out over weeks or months. If an implant is used, the individual runs the same risks and complications as those who use them for breast augmentation but has higher rates of capsular contracture (tightening or hardening of the scar tissue around the implant) and revisional surgeries. Outcomes based research on quality of life improvements and psychosocial benefits associated with breast reconstruction served as the stimulus in the United States for the 1998 Women's Health and Cancer Rights Act which mandated health care payer coverage for breast and nipple reconstruction, contralateral procedures to achieve symmetry, and treatment for the sequelae of mastectomy. This was followed in 2001 by additional legislation imposing penalties on noncompliant insurers. Similar provisions for coverage exist in most countries worldwide through national health care programs. There are many methods for breast reconstruction. The two most common are: * Tissue Expander - Breast implants This is the most common technique used in worldwide. The surgeon inserts a tissue expander, a temporary silastic implant, beneath a pocket under the pectoralis major muscle of the chest wall. The pectoral muscles may be released along its inferior edge to allow a larger, more supple pocket for the expander at the expense of thinner lower pole soft tissue coverage. The use of acellular human or animal dermal grafts have been described as an onlay patch to increase coverage of the implant when the pectoral muscle is released, which purports to improve both functional and aesthtic outcomes of implant-expander breast reconstruction. o In a process that can take weeks or months, saline solution is percutaneously injected to progressively expand the overlaying tissue. Once the expander has reached an acceptable size, it may be removed and replaced with a more permanent implant. Reconstruction of the areola and nipple are usually performed in a separate operation after the skin has stretched to its final size. * Flap reconstruction The second most common procedure uses tissue from other parts of the patient's body, such as the back, buttocks, thigh or abdomen. This procedure may be performed by leaving the donor tissue connected to the original site to retain its blood supply (the vessels are tunnelled beneath the skin surface to the new site) or it may be cut off and new blood supply may be connected. o The latissimus dorsi muscle flap is the donor tissue available on the back. It is a large flat muscle which can be employed without significant loss of function. It can be moved into the breast defect still attached to its blood supply under the arm pit (axilla). A latissimus flap is usually used to recruit soft-tissue coverage over an underlying implant. Enough volume can be recruited occasionally to reconstruct small breasts without an implant. o Abdominal flaps The abdominal flap for breast reconstruction is the TRAM flap or its technically distinct variants of microvascular "perforator flaps" like the DIEP/SIEP flaps. Both use the abdominal tissue between the umbilicus and the

-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.

Computed tomography (CT)-guided transthoracic needle biopsy is a well-established, minimally invasive diagnostic tool for pulmonary lesions. Few large studies have been conducted on the diagnostic performance and adequacy for molecular testing of transthoracic core needle biopsy (TCNB) for small pulmonary lesions.

Histology of Penis

demonstrates how the Epley maneuver is performed to treat POSTERIOR canal BPPV affecting the right ear. Animation showing what is going on within the inner ear is also shown in the 2nd half of the video.

Premature ejaculation occurs when a man ejaculates sooner during sexual intercourse than he or his partner would like. Premature ejaculation is a common sexual complaint. Estimates vary, but as many as 1 out of 3 men say they experience this problem at some time. As long as it happens infrequently, it's not cause for concern. However, you may meet the diagnostic criteria for premature ejaculation if you: Always or nearly always ejaculate within one minute of penetration Are unable to delay ejaculation during intercourse all or nearly all of the time Feel distressed and frustrated, and tend to avoid sexual intimacy as a result Both psychological and biological factors can play a role in premature ejaculation. Although many men feel embarrassed to talk about it, premature ejaculation is a common and treatable condition. Medications, counseling and sexual techniques that delay ejaculation — or a combination of these — can help improve sex for you and your partner.

How to perform a Thyroid Gland Examination - Clinical Skills Revision

The thyroid examination is one of the first sessions of the clinical skills block for medical students at Warwick Medical School - largely as it touches lightly on to other clinical areas, such as the cardiac examination, and the peripheral neurological examination making it an excellent starting point for building further knowledge


This is a clinical examination of the thyroid gland is performed by Dr James Gill following the approach in Macleod’s Clinical examination.


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Please note that there is no ABSOLUTE way to perform a clinical examination. Different institutions and even clinicians will have differing degrees of variations - the aim is the effectively identify medically relevant signs.


However, during OSCE assessments. Different medical schools, nursing colleges and other health professional courses will have their own preferred approach to a clinical evaluation - you should concentrate on THEIR marks schemes for your assessments.


The examination demonstrated here is derived from Macleods Clinical Examination - a recognised standard textbook for clinical skills.


Some people may experience an ASMR effect from watching this medical clinical examination

#ThyroidExamination #ClinicalSkills #DrGill #ASMR

Step in the Clinic with Dr. Pritesh Singh and get a practical insight into the Clinical Examination of Incisional Hernia.

Now Save Time with these Exam Relevant Clinical Videos & Waste None Studying Rare Cases.

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Blackheads are small bumps that appear on your skin due to clogged hair follicles. These bumps are called “blackheads” because the surface looks dark or black. Blackheads are a mild type of acne that usually form on the face, but they can also appear on the back, chest, neck, arms, and shoulders

Care must be taken to prevent stenosis at the anastomotic site. If the diameter of the anastomosis is less than 2 cm, the anastomosis should be taken down and resected. A classic end-to-end anastomosis should be performed to ensure adequate diameter to the intestine. If the posterior wall of the colon has been preserved, care should be taken to close the colostomy prior to opening the peritoneal cavity. This will reduce intraperitoneal contamination from the stoma site. Copious irrigation of the wound should be made prior to primary closure. If gross contamination has occurred, delayed closure of the wound should be considered.

An African traditional healer performing a brain surgery.

While an anal abscess is an infection within one or more of the anal spaces, an anal fistula (Choice B) is a tunneling between the anus or rectum and another epithelial lined space (eg, the skin overlying the drainage site). Fifty percent of patients with anal abscesses will go on to develop a chronic fistula from the involved anal gland to the overlying skin. Patients with fistulas typically present with an anal abscess that persists after incision and drainage, or with a pustule-like lesion in the perianal or ischiorectal area that continually drains. Surgical repair is usually necessary to eliminate the fistula while preserving fecal continence.

This is a surgical video that shows the removal of a volar ganglion cyst. This is a common surgical procedure and this video may help you better understand the steps that occur during the procedure.

This is a surgical video demonstrating the release and skin grafting of the middle and ring fingers. It demonstrates the marking, dissection, and repair of the fingers.

ROTIGS medical device by Honolulu inventor Dr. Brad NaPier makes difficult airway intubations easier for medical professionals.

This clip shows the basic steps of inserting V.T> tubes. This surgery is performed for the treatment of OME resistent to medical TTT.

A very interesting video showing how white blood cells (Neutrophil) are chasing bacteria (Diplococci). It also shows how the white blood cell engulf the bacteria. This is a real video.

he Allium Ureteral Stents are intended for temporary long or short-term use in malignant or benign chronic Ureteral Stenosis. Allium Ureteral Stents are mounted on a ready to use 8 or 10Fr delivery system. By using the appropriate delivery system their deployment procedure can be performed either retrogradely or percutaneously. Indicated for all chronic ureteral stricturesLarge caliber for intra-lumenal flowLong dwelling timeAntegrade or retrograde insertionEasy insertion and stent positioningExcellent patient comfortNo tissue in-growthAnti-reflux designEasy removal of the device