DoctorsVideos Search
Balloon Retention Facilitates Transgastric Laparoscopic Cysto-gastrostomy in Treatment of Pancreatic Pseudocyst
Aortic valve bypass surgery provides an alternative treatment option to traditional aortic valve replacement
Real time documentation of various retinal diseases
Real time documentation of various retinal diseases can be done with 4X magnification of video indirect ophthalmoscope or upto 40X magnification of photo-slitlamp with video attachment on beam-splitter with c-mount camera. The recordings can be labelled with "on-line" character generator.
Technique of Robotic-Assisted Laparoscopic Retroperitoneal Lymphadenectomy
Objectives: We highlight the technical aspects of robotically assisted right modified template retroperitoneal lymphadenectomy in a gentleman with mixed germ cell testicular cancer.
Methods and Procedures: The patient is a 20-year-old male with stage 1A mixed germ cell cancer of the right testicle. He was secured to the table in a right modified flank position. Once all ports had been inserted and the robot docked, the operation commenced with medial reflection of the ascending colon to expose the retroperitoneum. The vena cava was identified and exposed using sharp dissection to Kocherize the duodenum. The extent of our dissection was the right ureter laterally, the right renal artery superiorly, the anterior aorta medially, and the right common iliac artery inferiorly.
Results: The procedure time was 180 minutes. Blood loss was 150mL. Thirteen lymph nodes were obtained and were negative for cancer. The patient was discharged home on postoperative day 2 and recovered well with normal ejaculatory function.
Conclusion: Robotic-assisted retroperitoneal lymphadenectomy can be safely performed with reasonable operative time in appropriately selected patients. The improved visibility and dexterity offered by the robot allows for accurate dissection and prompt placement of hemostatic sutures during the procedure.
A New Endoscopic Treatment for Massive Rectal Bleeding Following Prostate Needle Biopsy
Objective: Immediate or delayed rectal bleeding following transrectal needle biopsy of the prostate has a reported incidence of 0% to 37%, and some cases can require emergency intervention. We describe a new method of treatment in these patients: colonoscopic hemoclip placement.
Methods and Results: A 79-year-old man with elevated prostate specific antigen level underwent transrectal needle prostatic biopsy with an 18-gauge needle. Several hours after the procedure, the patient sought medical attention for rectal bleeding, resulting in a 10-point drop in hematocrit. A flexible colonoscopy showed active arterial bleeding from the biopsy site in the anterior rectal wall. Endoscopic injection of 8mL epinephrine (1:10.000 dilution) was given. Bleeding continued. A clip was deployed (quick-clip) with excellent grasp of the mucosa surrounding the bleeding site. The patient did not require a blood transfusion and was discharged in stable condition after the urethral catheter was extracted.
Conclusions: When hemorrhage appears after prostate biopsy, different maneuvers can be performed: local pressure, transcatheter arterial embolization, proctoscopic thermocoagulation, colonoscopic injection of epinephrine or proctoscopic placement of a rubber band used for hemorrhoid treatment. If other maneuvers are not effective, endoscopic placement of a clip can be used as a treatment for this rare complication.
Treatment of Acute Cholecystitis Associated with Cholecystoduodenal Fistula and Common Bile Duct Stones
We present the case of a 77-year-old patient affected by acute cholecystitis associated with cholecystoduodenal fistula and common bile duct stones. Preoperative ultrasonography showed a distended, edematous gallbladder and pericholecystic fluid. MRCP confirmed a slight dilatation of the biliary tree with images of stones in the distal biliary duct. A cholecystoduodenal fistula was suspected. Four port sites were used; intraoperative transgallbladder cholangiography showed a stone in the distal biliary duct and the presence of the fistula. After stapling of the fistula, a transcystic extraction of common bile duct stones was performed by using a Dormia catheter. Intraoperative transcystic choledoscopy was performed to confirm clearance of the bile duct.
Between 10% to 18% of patients undergoing cholecystectomy for gallstones have common bile duct stones. Treatment options for these stones include pre- or postoperative endoscopy (endoscopic retrograde cholangiopancreatography), open surgery, or laparoscopic bile duct exploration. Laparoscopic cholecystectomy with simultaneous laparoscopic bile duct exploration seems to be as safe and as efficient as endoscopic retrograde cholangiopancreatography, and avoids an extra procedure.
115 years of X-rays Celebrity (Funnist X-Rays Of the World)
Smoking_Man in X-rays
Funny Memory X-Ray
Why I have Some Dysphagia
Coca Cola in The Bladder
helmet-head-x-ray
Top 20 Funniest X-ray Video
Some Bizarre X-rays