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Trabeculectomy, also called Filtration Surgery, is a surgical procedure performed for treatment of glaucoma. The treatment involves removing part of the trabecular meshwork and creating a new escape route for the aqueous humor. When successful, it allows the aqueous fluid to drain from the eye into an area underneath the conjunctiva where it is subsequently absorbed by the body's circulatory system or filtered into tears.
In this procedure:
- A conjunctival pocket is created and maybe treated with Mitomycin or other antimetabolites for a few minutes. These drugs are used to prevent scarring of the operation site. Scarring, if occurs, may clog the new drainage canal, and is therefore the major reason the procedure may fail.
- A half thickness flap is then made in the sclera and is dissected all the way to the clear cornea.
- A block of scleral tissue including part of the trabecular meshwork and Schlemm's canal is then removed to make a hole into the anterior chamber of the eye.
- As the iris may plug up this hole from the inside, a piece of the iris maybe removed at this time. This is called iridectomy.
- The scleral flap is then sutured loosely back in place. These sutures can be released gradually during a couple of weeks after surgery. This allows adjustment of the aqueous flow in order to achieve target pressure and to avoid the complication of having a too low intraocular pressure.
- The conjunctiva is sewn back in place to cover the area.
After surgery, aqueous humor drains into a filtering area called a "bleb" under the conjunctiva. Since the surgery is usually performed near the top of the eye, the bleb can easily be concealed behind the upper eyelid.
Gastrostomy tube is placed when a patient is not able to eat on his/her own as a result of neurological or other dysfunction. There are many different types of gastrostomy tubes but in general there are two bigger categories. The classic one and the low profile one. The gastroplexy technique is used preferably to avoid accidental pulling of the gastrostomy tube from an agitated or confused patient.
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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.
The camera sends images to an external monitor so the doctor can study the inside of your colon. The doctor can also insert instruments through the channel to take tissue samples (biopsies) or remove polyps or other areas of abnormal tissue. A colonoscopy typically takes about 20 minutes to an hour.
Heartburn is a burning pain in your chest, just behind your breastbone. The pain is often worse when lying down or bending over. Occasional heartburn is common and no cause for alarm. Most people can manage the discomfort of heartburn on their own with lifestyle changes and over-the-counter medications. Heartburn that is more frequent or interferes with your daily routine may be a symptom of a more serious condition that requires medical care
Nosebleeds common. Most often they are a nuisance and not a true medical problem. But they can be both. Nosebleed care Sit upright and lean forward. By remaining upright, you reduce blood pressure in the veins of your nose. This discourages further bleeding. Sitting forward will help you avoid swallowing blood, which can irritate your stomach. Pinch your nose. Use your thumb and index finger to pinch your nostrils shut. Breathe through your mouth. Continue to pinch for five to 10 minutes. Pinching sends pressure to the bleeding point on the nasal septum and often stops the flow of blood. To prevent re-bleeding, don't pick or blow your nose and don't bend down for several hours after the bleeding episode. During this time remember to keep your head higher than the level of your heart. If re-bleeding occurs, blow out forcefully to clear your nose of blood clots and spray both sides of your nose with a decongestant nasal spray containing oxymetazoline (Afrin, Mucinex Moisture Smart, others). Pinch your nose again as described above and call your doctor. When to seek emergency care The bleeding lasts for more than 20 minutes The nosebleed follows an accident, a fall or an injury to your head, including a punch in the face that may have broken your nose
Sanjeev Dutta, MD, FACS discusses the fascinating new world of surgical technology. The pediatric general surgeon shares how medicine and technology have combined to achieve less invasive procedures and healthier outcomes for surgical patients.
Dr. Dutta is a pediatric general surgeon at Lucile Packard Children's Hospital. He is also an Associate Professor of Surgery at Stanford School of Medicine and Surgical Director of the Multidisciplinary Initiative for Surgical Technology Research.
Learn more about Stanford Children's Health. http://www.stanfordchildrens.org.