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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.
The primary goal of treatment for each patient is to help relieve pain and other symptoms resulting from the herniated disc. To achieve this goal, each patientโs treatment plan should be individualized based on the source of the pain, the severity of pain and the specific symptoms that the patient exhibits.
Anatomy Tutorial During Trans Nasal Endoscopy
Parasitic twins: boy carrying dead twin inside him, giant tumor removed - tumors compilation
This is a minimally invasive surgical technique using an endoscope to remove any type of lumbar disc herniation - prolapsed, sequestrated or migrating discs. This technique does not employ any specialist instruments.The procedure involves two 5 mm portals employed beside the midline at the appropriate level of disc prolapse and the approach is interlaminar. The success rate of this technique in my hands is more than 90%
Ovarian cancer warning signs include ongoing pain or cramps in the belly or back, abnormal vaginal bleeding, nausea, and bloating. Depending on the cancer stage, ovarian cancer treatment includes surgery and chemotherapy.
Shingles is a painful skin rash camera.gif. It is caused by the varicella zoster virus. Shingles usually appears in a band, a strip, or a small area on one side of the face or body. It is also called herpes zoster. Shingles is most common in older adults and people who have weak immune systems because of stress, injury, certain medicines, or other reasons. Most people who get shingles will get better and will not get it again. But it is possible to get shingles more than once.
Low potassium (hypokalemia) refers to a lower than normal potassium level in your bloodstream. Potassium is a chemical (electrolyte) that is critical to the proper functioning of nerve and muscles cells, particularly heart muscle cells. Normally, your blood potassium level is 3.6 to 5.2 millimoles per liter (mmol/L). A very low potassium level (less than 2.5 mmol/L) can be life-threatening and requires urgent medical attention.
A Medical Video showing an overview of the endocrine and gland system of the human body
symptoms of liver dysfunction. Remember, the body doesn't work in isolation. Where there is dysfunction in one area of the body, be rest assured that dysfunction is happening throughout the body.
One of a series of films we produced to help patients, their families and carers learn more about some of the most common tests and procedures used to diagnose and treat blood diseases. Patients who have previously undergone these tests helped us to design the videos. Each film clearly explains what the procedure involves and addresses common issues and concerns including: Why your doctor recommended this procedure What you need to do to prepare What you can expect during the procedure What you need to do afterwards Not every patient will be referred for all of these tests and practice may differ slightly depending on where you are treated.
The procedure of Suprapubic Cystostomy
50 Orgasms A Day
Gallbladder cancer is cancer that begins in the gallbladder. Your gallbladder is a small, pear-shaped organ on the right side of your abdomen, just beneath your liver. The gallbladder stores bile, a digestive fluid produced by your liver. Gallbladder cancer is uncommon. When gallbladder cancer is discovered at its earliest stages, the chance for a cure is very good. But most gallbladder cancers are discovered at a late stage, when the prognosis is often very poor. Gallbladder cancer is difficult to diagnose because it often causes no specific signs or symptoms. Also, the relatively hidden nature of the gallbladder makes it easier for gallbladder cancer to grow without being detected. Symptoms ShareTweet Aug. 07, 2014 References Products and Services Book: Mayo Clinic on Digestive Health Give today to find cancer cures for tomorrow See also Abdominal pain Can you recommend a diet after gallbladder removal? Chemo Targets Chemotherapy Chemotherapy and hair loss: What to expect during treatment Chemotherapy and sex: Is sexual activity OK during treatment? Chemotherapy nausea and vomiting: Prevention is best defense Show more Advertisement Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission. Advertising & Sponsorship PolicyOpportunitiesAd Choices Mayo Clinic Store Check out these best-sellers and special offers on books and newsletters from Mayo Clinic. NEW! โ The Mayo Clinic Diet, Second Edition Relief for America's epidemic of indigestion Keeping your bones healthy and strong Manage blood pressure for better health The Mayo Clinic Diet Online
A video showing the phases of normal wound healing
Watch that video of 232 Teeth Removal From Indians' Boy Mouth
The cardiac conduction system is a group of specialized cardiac muscle cells in the walls of the heart that send signals to the heart muscle causing it to contract. The main components of the cardiac conduction system are the SA node, AV node, bundle of His, bundle branches, and Purkinje fibers.
Priapism is a prolonged erection of the penis. The persistent erection continues hours beyond or isn't caused by sexual stimulation. Priapism is usually painful. Although priapism is an uncommon condition overall, it occurs commonly in certain groups, such as people who have sickle cell anemia. Prompt treatment for priapism is usually needed to prevent tissue damage that could result in the inability to get or maintain an erection (erectile dysfunction). Priapism is most common in men in their 30s.