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Mini-Laparoscopic Cholecystectomy with Intraoperative Cholangiogram for Symptomatic Cholelithiasis (Gallstones) - Standard
Authors: Brunt LM1, Singh R1, Yee A2
Published: September 26, 2017
AUTHOR INFORMATION
1 Department of Surgery, Washington University, St. Louis, Missouri
2 Division of Plastic and Reconstructive Surgery, Washington University, St. Louis, Missouri
DISCLOSURE
No authors have a financial interest in any of the products, devices, or drugs mentioned in this production or publication.
ABSTRACT
Minimal invasive laparoscopic cholecystectomy is the typical surgical treatment for cholelithiasis (gallstones), where patients present with a history of upper abdominal pain and episodes of biliary colic. The classic technique for minimal invasive laparoscopic cholecystectomy involves four ports: one umbilicus port, two subcostal ports, and a single epigastric port. The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) has instituted a six-step strategy to foster a universal culture of safety for cholecystectomy and minimize risk of bile duct injury. The technical steps are documented within the context of the surgical video for (1) achieving a critical view of safety for identification of the cystic duct and artery, (2) intraoperative time-out prior to management of the ductal structures, (3) recognizing the zone of significant risk of injury, and (4) routine intraoperative cholangiography for imaging of the biliary tree. In this case, the patient presented with symptomatic biliary colic due to a gallstone seen on the ultrasound in the gallbladder. The patient was managed a mini-laparoscopic cholecystectomy using 3mm ports for the epigastric and subcostal port sites with intraoperative fluoroscopic cholangiogram. Specifically, the senior author encountered a tight cystic duct preventing the insertion of the cholangiocatheter and the surgical video describes how the author managed the cystic duct for achieving a cholangiogram, in addition to the entire technical details of laparoscopic cholecystectomy.
Colon polyp facts Colon polyps are growths on the inner lining of the colon and are very common. Colon polyps are important because they may be, or may become malignant (cancerous). They also are important because based on their size, number, and microscopic anatomy (histology); they can predict which patients are more likely to develop more polyps and colon cancer. Changes in the genetic material of cells lining the colon are the cause of polyps. There are different types of colon polyps with differing tendencies to become malignant and abilities to predict the development of more polyps and cancer. It is important to recognize families with members who have familial genetic conditions causing polyps because some of these conditions are associated with a very high incidence of colon cancer, and the cancer can be prevented or discovered early.
Osteochondroma. Osteochondromas (osteocartilaginous exostoses), the most common benign bone tumors, may arise from any bone but tend to occur near the ends of long bones. ... Enchondroma. ... Chondroblastoma. ... Chondromyxofibroma. ... Osteoid osteoma. ... Nonossifying fibroma (fibrous cortical defect) ... Benign giant cell tumor of bone.
These are a few common types of benign bone tumors: Osteochondroma is the most common benign bone tumor. ... Giant cell tumor is a benign tumor, typically affecting the leg (malignant types of this tumor are uncommon). Osteoid osteoma is a bone tumor, often occurring in long bones, that occurs commonly in the early 20s.
A bone marrow biopsy is part of a bone marrow test that takes a sample of your solid bone tissue. This test looks for abnormalities in your blood cells and signs of any diseases. You can request anesthesia or a sedative before the biopsy, and manage any pain afterward with over-the-counter medications.
Graft-versus-host disease (GVHD) is a common complication after an allogeneic transplant, a transplant in which cells from a family member, unrelated donor or cord blood unit are used. In GVHD, the immune cells from the donated marrow or cord blood (the graft) attack the body of the transplant patient (the host).
Microscopic polyangiitis (MPA) is vasculitis of small vessels. It was initially considered as a microscopic form of polyarteritis nodosa (PAN). In 1990, the American College of Rheumatology developed classification criteria for several types of systemic vasculitis but did not distinguish between polyarteritis nodosa and microscopic polyarteritis nodosa. [1] In 1994, a group of experts held an international consensus conference in Chapel Hill, North Carolina, to attempt to redefine the classification of small vessel vasculitides. [2, 3]
The syndrome of inappropriate antidiuretic hormone (ADH) secretion (SIADH) is defined by the hyponatremia and hypo-osmolality resulting from inappropriate, continued secretion or action of the hormone despite normal or increased plasma volume, which results in impaired water excretion.
To learn more about robotically assisted heart surgery, please visit https://cle.clinic/2Y6aHXH
Robotically assisted heart surgery is a minimally invasive option most often used for mitral valve repair. Cleveland Clinic cardiothoracic surgeons explain how it works and what to expect.
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Nurses often prime IV lines with the hopes that there are no air bubbles. In this video, I will share a couple of tips to help reduce the risk or frequency of air bubbles during line priming. I will also talk about how to troubleshoot the air bubbles when they appear during an infusion
Providing patient care and influencing safe patient outcomes requires that registered nurses and licensed practice nurses maintain air free IV lines. Learn the strategies and tips to decrease the risk of air bubbles appearing in your primary or secondary medication line as well as troubleshooting tips to remove those alarming bubbles. Your patients will thank you!
Whether you are providing normal saline, a medication, or a combination, ensure that all fluids are compatible.
Supplies used in this video include the Alaris Primary Infusion line, alcohol swabs and a sterile 10 cc syringe ... and a nail in the wall :)
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โค๏ธ ~ You may also be interested in watching ~ โค๏ธ
PICC line assessment https://youtu.be/tnKClpU-J1g
How To Access a PICC line https://youtu.be/SCF6bmk8KWc
Putting on Sterile Gloves https://youtu.be/xNwkKLqDJn4
Organizational Plans for Nursing https://youtu.be/_NATxwPwHzc
Medication Conversions https://youtu.be/TCPBXg2TYCs
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Children are special patients, and their medical needs are unique, including their surgical needs. At UNC Hospitals, an expert and experienced team of physicians treat children in a kid-friendly and family-centered environment. UNC Pediatric Surgeon Dr. Timothy Weiner explains
NTIS refers to a syndrome found in seriously ill or starving patients with low fT3, usually elevated RT3, normal or low TSH, and if prolonged, low fT4. It is found in a high proportion of patients in the ICU setting, and correlates with a poor prognosis if TT4 is <4ug/dl. The patho-physiology includes suppression of TRH release, reducedT3 and T4 turnover, reduction in liver generation of T3, increased formation of RT3, and tissue specific down-regulation of deiodinases, transporters, and TH receptors. Although long debated, tissue TH levels are definitely reduced, and tissue hypothyroidism is presumably present. This is often not clinically evident because of the brief duration, and reduced but not absent tissue levels of TH. Although recognized for nearly 4 decades, interpretation of the syndrome is contested, because of lack of data. Some observes, totally without data, argue that it is a protective response and should not be treated. Other observers (as in this review) present available data suggesting, but not proving, that thyroid hormone replacement is appropriate, not harmful, and may be beneficial. The best form of treatment (TRH,TSH,or T3+T4) and possible accompanying treatments (GHRH, Cortisol, nutrition, insulin) lack consensus. In this review current data are laid out for readerโs review and judgment.
A glucagonoma is a rare tumor of the alpha cells of the pancreas that results in the overproduction of the hormone glucagon. Alpha cell tumors are commonly associated with glucagonoma syndrome, though similar symptoms are present in cases of pseudoglucagonoma syndrome in the absence of a glucagon-secreting tumor.
Guest surgeon Dr. Nicole Callan gives us an introduction to hernias. She discusses what a hernia is, the different types of hernias, and an introduction to treatment.
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How to Check Cervical Mucus
CPAP, or continuous positive airway pressure, is a treatment that uses mild air pressure to keep the airways open. CPAP typically is used by people who have breathing problems, such as sleep apnea. CPAP also may be used to treat preterm infants whose lungs have not fully developed.
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In our Nursing Skills course, we show you the most common and most important skills you will use as a nurse! We included everything from bed baths, to inserting a foley, to advanced skills like chest tube management.
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There are 3 major parts of the respiratory system: the airway, the lungs, and the muscles of respiration. The airway, which includes the nose, mouth, pharynx, larynx, trachea, bronchi, and bronchioles, carries air between the lungs and the body's exterior.