" DoctorsVideos: March 2011

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Adrenergic Physiology and Pharmacology for Medical Students Lecture

Robotic partial nephrectomy-Vloc renorrhaphy

Trans Urethral Resection of Prostate (TURP)

Transoral Robotic Surgery: Base of Tongue Resection

da Vinci Robotic Hysterectomy

Inframammary Access for breast resection

Endoscopic Endonasal Transsphenoidal Resection of Pituitary Adenoma

Ahmad Valve in Glaucoma surgery

SILS Sigmoid Colon Resection

Sugical resection of a tuberculum sella meningioma after anterior clinoidectomy

Sebaceous cyst neck excision

Otitis Media with effusion

Single port laparoscopic spleen resection

New Endoscopic Thyroid Surgery Technique

laparoscopic management of liver hydatid cyst

Diagnostic laparoscopy with removal of bullet

Robot Assisted anterior and low anterior resection

Celiac Disease

Laparoscopic Anterior Resection for cancer

Liver Transplant: LDLT Left or Right?

Arthroscopic PCL Repair with Repair of Meniscal Root Avulsion

Anatomic Total Shoulder Arthroplasty

Blocked Coronary Artery with Balloon Angioplasty and Stent Repair

Transciliary filtration in acute glaucoma

Phaco mulsification , IOL and Glaucoma

Surgical Treatment of Emphysema

Rhinoplasty and Beyond Aesthetic and Functional Surgery of the Nose

Laparoscopic fundoplication

Botox injections into the bladder

Laparoscopic salpingo-oophorectomy

Laparoscopic Lysis of Abdominal Adhesions Animation

Total laparoscopic hysterectomy Instructional Video

Laporoscpic Pheochromocytoma

SILS Hiatal Hernia Repair with Transoral Fundoplication

Lap Vagotomy and Gastrojejunostomy

Robotic Assisted Microsurgical Sub Inguinal Varicocelectomy

Transanal Endoscopic Microsurgery for rectal cancer

Prophylactic Prepubic Urethrectomy During Radical Cystoprostatectomy

Cataract Surgery

Carbon Dioxide Pyeloscopy During Robot-Assisted Pyeloplasty

Retroperitoneal And Transperitoneal Robotic Assisted Pyeloplasty In Adults: Techniques And Results

Laparoscopic Pyeloplasty with Autonomy Articulating Scissors

Laparoscopic Nissen Fundo for large Hiatal Hernia with GERD

Laparoscopic Ventral Hernia with Autonomy Laparo-Angle Scissor

Laparoscopic Gastric sleeve plication

Occlusion and late Dentistry implant failure

SILS Hysterectomy-McClelland Technique

Transoral Robotic Surgery: Radical Tonsillectomy

Gastric imbrication and laparoscopic ventral hernia repair

Laparoscopic Incisional Hernia Rpair

Placental Site Trofoblastic Tumor

Laparoscopic Strassman Metroplasty for Bicornuate uterus in 24 years lady with history of 2 successive 2nd trimister pragnancy losses.

Male Breast Reduction Gynecomastia Surgery

Straumann Bone Level implants surgery in atrophic maxillar

Transoral Robotic Surgery: Supraglottic Laryngectomy

Hallux Valgus Surgery

Clinically Implantable Glaucoma Diagnostic and Therapeutic

Single incision laparoscopic Cholecystectomy ( SILS)

ATP: Adenosine Triphosphate

HIV Replication 3D Medical Animation

Dental implant surgery training video

Robotic Assisted Radical Prostatectomy

Robotic Assisted Prostate Surgery using the da Vinci Surgical System – During a procedure, the Side cart is positioned next to the operating table with the da Vinci Robotic arms arranged to provide entry points into the human body and prostate. EndoWrist instruments, and the Da Vinci Insight Vision System, are mounted onto the robot’s electromechanical arms representing the surgeon’s left and right hands and provide functionality to perform complex tissue manipulation through the entry points, or ports. Endowrist instruments include forceps, scissors, electrocautery, scalpels and other surgical tools. Endowrist instruments are selected and changed during the robotic prostatectomy. If the surgeon needs to change an Endowrist, as is common during a robotic prostatectomy procedure, the instrument is withdrawn from the surgical system using controls at the console. Typically, an operating room nurse standing near the patient physically removes the EndoWrist instruments and replaces them with new instruments. The surgeon performs the robotic prostatectomy while sitting comfortably at the console, manipulating the hand controls and viewing the operation live through the da Vinci Robot’s InSight vision system. This is more comfortable for the surgeon and reduces operating fatigue, a known hindrance in open surgery. The robotic assisted prostate surgery is completed with the removal of the da Vinci prostatectomy instruments and closure of the small incisions in the abdomen with sutures. Dr. Samadi’s patient testimonials and media coverage attest to his robotic prostatectomy expertise. Dr. Samadi has performed >over 3,200 robotic prostatectomy procedures. The majority of Dr. Samadi’s da Vinci Robotic Prostatectomy patients are discharged within 24- hours of their surgery. Many patients leave the same day, and often walk out of the hospital within hours of their robotic prostatectomy surgery. For most patients, Dr. Samadi’s use of the da Vinci Prostatectomy provides superior benefits over traditional open or laparoscopic prostatectomy, including*: * Quicker return to normal activity * Shorter hospitalization (most patients go home the next day) * Reduced risk of incontinence and impotence * Less blood loss and transfusion * Reduced pain

Lumbar Laminectomy

Upper GI Endoscopy: A case of Cancer stomach

Laparoscopic Extended Subtotal Gastrectomy with LHA prevention

Robotic-Assisted Laparoscopic Intracorporeal Urinary Diversion

Robotic Partial Nephrectomy For Complex Renal Tumors: Surgical Technique

Single Incision Laparoscopic Appendicectomy

Laparoscopic Ovarian Drilling

FNA liver Metastasis

DiabetesMine Design Challenge 2011

Laparoscopic Neosalphingostomy

Bilateral Becker breast Implants Inflation and valve removal

ERCP Precut with needle knife

Abdominoplasty Explained (Tummy Tuck Surgery)


Reasons for an Abdominoplasty (Tummy Tuck) 
A flat, well-toned abdomen is something that many people strive to have. Health conscious people may have tried dieting and exercise for years, but still cannot achieve results in the abdominal region. Sometimes stomach muscles that have become stretched out due to pregnancy may have trouble getting back into shape. An abdominoplasty can help. Due to aging, a person’s body may respond less favorably to dieting and exercise. A tummy tuck may be a viable option. People who have had significant fluctuations in weight may not ever be able to get a well-toned abdomen without undergoing cosmetic plastic surgery. Heredity is a reason why some people may never be able to achieve results even when adhering to a healthy diet and exercise regimen. These individuals would make good candidates for an abdominiplasty (tummy tuck). Prior surgery may make it difficult for people to attain a flat abdominal region. A tummy tuck may be a good option for people who fall into this category as well.

Realistic Expectations for Potential Abdominoplasty Patients 
As with any other cosmetic plastic surgery procedure, abdominoplasty is no different. Potential tummy tuck patients must have realistic expectations. While the results of a tummy tuck are technically permanent, the results can be greatly diminished by significant future weight gains. A tummy tuck should not be chosen as a solution to stretch marks. A tummy tuck may be able to improve the appearance of stretch marks if they are located on the areas of excess skin to be excised.

Tube Feeding Placement Video

Minimally Invasive Procedure for Hemorrhoids


Benefits of minimally invasive procedures
Not only do these procedures usually provide equivalent outcomes to traditional "open" surgery (which sometimes require a large incision), but minimally invasive procedures (using small incisions) may offer significant benefits as well: * Quicker Recovery – Since a minimally invasive procedure requires smaller incisions than conventional surgery (usually about the diameter of a dime), your body may heal much faster. * Shorter Hospital Stays – Minimally invasive procedures help get you out of the hospital and back to your life sooner than conventional surgery. * Less scarring – Most incisions are so small that it's hard to even notice them after the incisions have healed. * Less pain – Because these procedures are less invasive than conventional surgery, there is typically less pain involved.

Wound Repair - Multiple Ulceration (Learn How to?)

CO2 laser stapedectomy procedure

Innovations In Breast Cancer Detection: 3D Mammography Approved by FDA

Approved by the FDA February 11, 2011, breast tomosynthesis, a new imaging technology pioneered by the MGH Breast Imaging Program under the leadership of Elizabeth Rafferty, MD, director of Breast Imaging at MGH, produces a 3D image of the breast and gives doctors a clearer view through the overlapping structures of breast tissue.

Sentinel Lymph Node removal in breast Cancer

Single Incision Laparoscopic Right Colectomy

The patient's right colon was removed to treat a 6cm carcinoma of the cecum. The laparoscopic resection was accomplished with only a small incision at the umbilicus through which the ports were placed. In performing the surgery, Dr. Julio Teixeira maintained sound oncologic principles and a curative resection was achieved. The patient had an uneventful recovery.

Techniques of Ossiculoplasty - Incus Transposition

After elevating tympanomeatal flap, drilling of attic area was done. Remnant incus removed. With a diamond burr and acetabulum made in the body which accomodates head of stapes. underlaying of the temporalis fascia graft done.

Video Assisted Robotic Valve Repair Surgery

Minimally invasive cardiac surgery has not enjoyed a standard nomenclature. The terms minimally invasive or limited-access cardiac surgery have referred to the size of the incision, the avoidance of a sternotomy, use of a partial sternotomy, or abstention from cardiopulmonary bypass. However, the development of MIHVS may be considered analogous to an Everest ascent, embarking from a conventional or "base camp" operation and advancing progressively toward less invasiveness through experience and acclimatization

Breast Ductal System Excision

Excision of the major ductal system of the breast as described by Hadfield in 1960 is associated with several complications, such as loss of sensation in many women, nipple retraction in 10% and necrosis of aerola-nipple complex. In order to reduce such complications, we have modified the classical Hadfield technique. The basic difference is advancement of the aerola-nipple complex as a flap into a new bed immediately above the incision across the upper half of aerola-skin junction. The results of 46 operations performed for 33 patients (13 patients had bilateral operation) were satisfactory. After a mean follow up of 3.5 years, loss of sensation occurred in two patients (4%) epithelial necrosis of the upper half of the aerola in one patient (2%) and recurrence of discharge in another patient (2%). No episodes of wound infection or nipple retraction were reported in this study. The results demonstrate the effectiveness of this technique as an appropriate alternative to classical Hadfield operation

supracricoid laryngectomy for larynx cancer

Supracricoid partial laryngectomy-cricohyoidoepiglottopexy (SCPL-CHEP) and supracricoid partial laryngectomy-cricohyoidopexy (SCPL-CHP) provide useful and effective alternatives to total laryngectomy (TL). These organ preservation surgery techniques are useful for laryngeal lesions that have extended beyond the traditional indications for VPL and SGL. Unlike attempts to extend the resection margins of VPL and SGL, SCPL-CHEP and SCPL-CHP provide reliable oncologic outcomes and reproducible functional results from a fixed reconstruction technique. A spectrum of procedures exists from smallest to largest, corresponding to a spectrum of lesions from smallest to largest. A spectrum exists for both supraglottic and glottic carcinoma. This spectrum is a useful tool for preoperative planning for organ preservation surgery. On the top of the spectrum, every other laryngeal schematic is blank. The clinician can then draw the lesion they are seeing into the appropriate point on the spectrum. The examples that are given in the spectrum are linked with the surgical procedures below. Some lesions are associated with 2 surgical procedures. This is because controversies remain in the literature concerning which is the most appropriate technique for a given lesion. Understanding these spectra helps the surgeon to see the role of the SCPLs relative to other useful organ preservation techniques.

Chest Wall Fibrosarcoma

Recurrent chest wall faibrosarcoma in a 30 year old man treated by chest wall excision and reconstruction by latissmus dorsi flap.

Modified Radical Mastoidectomy- " The Inside out technique"

ENT An operation to eradicate disease of the middle ear cavity and mastoid process, in which the mastoid and epitympanic spaces are converted into an easily accessible common cavity by removing the posterior and superior external canal walls

Robotic Radical Prostatectomy Surgery

The basic technique for performing minimally invasive radical prostatectomy is the same regardless of the technology used. Candidates for this approach include patients in whom the diagnosis and staging support organ-confined prostate cancer and in whom the appropriate metastatic workup results are negative. The goal of minimally invasive radical prostatectomy is to laparoscopically resect the prostate and its capsule, along with the seminal vesicles. The procedure can be performed either extraperitoneally or, more commonly, transperitoneally. The two most reported techniques for performing minimally invasive radical prostatectomy are robotic (robotic radical prostatectomy) and laparoscopic (laparoscopic radical prostatectomy). Laparoscopic radical prostatectomy The laparoscopic approach involves 2-dimensional monitors and conventional laparoscopic instruments (5 or 10 mm) with a 10-mm 0° and/or 30° telescope. The camera may be operated by a one-armed camera holder or by an assistant. The use of a single voice-operated robotic arm has also been described as an adjunct to the laparoscopic approach. A camera-holding device provides stability and prevents camera shake that can result from holding it by hand (ie, by an assistant).

Average Salaries Of Doctors In USA


Internal medicine doctor Average Salary

New York: $170,000
Los Angeles: $165,000
Houston: $152,000
Seattle: $155,000



Primary Care doctor Average Salary

New York = $170,000
Los Angeles = $165,000
Houston = $152,000
Seattle = $155,000

pediatrics doctor Average Salary
New York $163,000
Houston $145,0o0
Los Angeles $157,000
Seattle $148,000


USA Resident Average Salary

Resident - The Bottom of The chain
1st Year (PGY1): $34,000 - $45,000
2nd Year (PGY2): $37,000 - $47,000
3rd Year (PGY3): $38,000 - $49,000


CARDIOLOGY

Cardiologist (Medicine) doctor Average Salary


New York $278,000
Los Angeles $268,000
Houston $247,000
Seattle $252,000


Cardiologist (Interventional) doctor Average Salary


New York $313,000
Los Angeles $302,000
Houston $279,000
Seattle $285,000


NEUROLOGIST (Medicine and Surgery) Average Salary


Neurology (Medicine) doctor Average Salary

New York = $204,000
Los Angeles = $197,000
Houston = $182,000
Seattle = $186,000

Neurology (Surgery) doctor Average Salary

New York = $396,000
Los Angeles = $ 382,000
Houston = $352,000
Seattle = $360,000

Endometriosis resection

Dorsal dartos flap for fistula prevention in snodgrass hypospadias repair

Anatomic Bladder Neck Preservation During Robotic-Assisted Laparoscopic Radical Prostatectomy

Cochlear Implant to Benefit the Deaf

part 1 part 2 part 3

Laparoscopic Nissen Fundoplication Surgery for the Treatment of Acid Reflux

Part 1 Part 2

Supra-ampullar Cystectomy And Ileal Neobladder

Modified Posterior Reconstruction Of The Rhabdosphincter After Robot-Assisted Radical Prostatectomy

Totally Laparoscopic Pancreaticoduodenectomy

Tension And Energy-free Robotic Assisted Laparoscopic Radical Prostatectomy

Laparoscopic Extended Pelvic Lymph Node Dissection For Prostate Cancer

WORLD'S FIRST ROBOTIC ASSISTED DOUBLE VALVE REPLACEMENT HEART SURGERY

History of Multiple Sclerosis

SILS Gastric Bypass

Trabeculectomy

Incisional Hernia Repair


Definition
Incisional hernia repair is a surgical procedure performed to correct an incisional hernia. An incisional hernia, also called a ventral hernia, is a bulge or protrusion that occurs near or directly along a prior abdominal surgical incision. The surgical repair procedure is also known as incisional or ventral herniorrhaphy.
Purpose
Incisional hernia repair is performed to correct a weakened area that has developed in the scarred muscle tissue around a prior abdominal surgical incision, occurring as a result of tension (pulling in opposite directions) created when the incision was closed with sutures, or by any other condition that increases abdominal pressure or interferes with proper healing.

Glaucoma Lecture

Elevated pressure in the eye is the main factor leading to glaucomatous damage to the eye (optic) nerve. Glaucoma with normal intraocular pressure is discussed below in the section on the different types of glaucoma. The optic nerve, which is located in back of the eye, is the main visual nerve for the eye. This nerve transmits the images we see back to the brain for interpretation. The eye is firm and round, like a basketball. Its tone and shape are maintained by a pressure within the eye (the intraocular pressure), which normally ranges between 8 mm and 22 mm (millimeters) of mercury. When the pressure is too low, the eye becomes softer, while an elevated pressure causes the eye to become harder. The optic nerve is the most susceptible part of the eye to high pressure because the delicate fibers in this nerve are easily damaged. The front of the eye is filled with a clear fluid called the aqueous humor, which provides nourishment to the structures in the front of the eye. This fluid is produced constantly by the ciliary body, which surrounds the lens of the eye. The aqueous humor then flows through the pupil and leaves the eye through tiny channels called the trabecular meshwork. These channels are located at what is called the drainage angle of the eye. This angle is where the clear cornea, which covers the front of the eye, attaches to the base (root or periphery) of the iris, which is the colored part of the eye. The cornea covers the iris and the pupil, which are in front of the lens. The pupil is the small, round, black-appearing opening in the center of the iris. Light passes through the pupil, on through the lens, and to the retina at the back of the eye. Please see the figure, which is a diagram that shows the drainage angle of the eye.

Step by step otoplasty (ear pinning) surgical procedure

This is a video about otoplasty, auriculoplasty in prominent ears by sutures without incisions. The suture is placed through skin perforations without incisions and without scars. The effect is immediate, immediate return to work and social life.

Preauricular Ear Sinus Infection

Tube Surgery Ear, Surgery for Kids

laparoscopic cholecystectomy with lap. assisted vaginal hysterectomy done simultaneously

Robotic Assisted Radical Prostatectomy





Upon completion of radical prostatectomy, the surgeon needs to reconstruct the urinary system. More specifically, the urologist must reattach the open bladder neck to the urethra. This reconnection of 2 tubular structures is referred to as an anastamosis. The anastamosis is routinely performed with suture, either in a continuous or interupted manner. In the recent years, self-retaining sutures have been developed to help prevent back-slipping of suture and thus a loss of tissue tension. The novel engineering of the suture with unidirectional barbs helps maintain suture position in soft tissues. With conventional suture, there is often a loss of tension which may lead to urine leakage at the anastamosis. One of such self-retaining sutures (SRS) is called VLoc and made by Covidien. It is also unique in that it is an absorbable suture and has its own self-anchoring loop, thus eliminating the need for knot tying. We have now incorporated the VLoc suture in our robotic radical prostatectomy cases. It has helped reduce anastamosis time and facilitated the anastamosis process for our nursing team. The following video demonstrates robotic reconstruction with the VLOC suture. Since the last 2 cm are not being used (there are no more barbs 2cm from the needle), there is no need for knot tying to secure tension. The barbs are sufficient enough. A 300mL water bladder test (cystogram) is always performed prior to case completion to ensure that there is absolutely no leakage. This allows our patients to have their Foley catheters removed on the 4-5th day after surgery.

Hand Assisted aparoscopic Sigmoid Resection and Rectopexy

LapBand Removal Converted to Mini-Gastric Bypass

Robotic Surgery: Training Curriculum

Understanding Embryonic Stem Cells


The controversial topic of embryonic stem cells, or ES cells. ES cells are cells that can be isolated from early embryos, before they differentiate into specific types of cells. Because stem cells have the potential to generate fresh, healthy cells of nearly any type, there is interest in exploring their use to treat and cure various diseases. The societal controversy regarding human ES cells relates primarily to their derivation from very early embryos. In addition, certain stem cell lines are developed using a cloning technique called somatic cell nuclear transfer, which can generate cells that are an exact genetic match to a patient.

Robotic surgery to remove a kidney tumor

How stem cells work and develop

da Vinci robotic, laparoscopic radical prostatectomy

Ten steps of Laparoscopic Sleeve Gastrectomy for morbid obesity

Part 1 Part 2

Erectile Dysfunction

Erectile dysfunction, sometimes called "impotence," is the repeated inability to get or keep an erection firm enough for sexual intercourse. The word "impotence" may also be used to describe other problems that interfere with sexual intercourse and reproduction, such as lack of sexual desire and problems with ejaculation or orgasm. Using the term erectile dysfunction makes it clear that those other problems are not involved. Erectile dysfunction, or ED, can be a total inability to achieve erection, an inconsistent ability to do so, or a tendency to sustain only brief erections. These variations make defining ED and estimating its incidence difficult. Estimates range from 15 million to 30 million, depending on the definition used. According to the National Ambulatory Medical Care Survey (NAMCS), for every 1,000 men in the United States, 7.7 physician office visits were made for ED in 1985. By 1999, that rate had nearly tripled to 22.3. The increase happened gradually, presumably as treatments such as vacuum devices and injectable drugs became more widely available and discussing erectile function became accepted. Perhaps the most publicized advance was the introduction of the oral drug sildenafil citrate (Viagra) in March 1998. NAMCS data on new drugs show an estimated 2.6 million mentions of Viagra at physician office visits in 1999, and one-third of those mentions occurred during visits for a diagnosis other than ED. In older men, ED usually has a physical cause, such as disease, injury, or side effects of drugs. Any disorder that causes injury to the nerves or impairs blood flow in the penis has the potential to cause ED. Incidence increases with age: About 5 percent of 40-year-old men and between 15 and 25 percent of 65-year-old men experience ED. But it is not an inevitable part of aging. ED is treatable at any age, and awareness of this fact has been growing. More men have been seeking help and returning to normal sexual activity because of improved, successful treatments for ED. Urologists, who specialize in problems of the urinary tract, have traditionally treated ED; however, urologists accounted for only 25 percent of Viagra mentions in 1999.

Chest Pain USMLE Algorithm

Chest pain may be a symptom of a number of serious conditions and is generally considered a medical emergency. Even though it may be determined that the pain is non-cardiac in origin, this is often a diagnosis of exclusion made after ruling out more serious causes of the pain. Differential diagnosis Of Acute Chest Pain The causes of chest pain range from non-serious to life threatening.DiagnosisPro lists more than 440 causes. Cardiovascular * Acute coronary syndrome o Unstable Angina Pectoris - requiring emergency medical treatment but not primary intervention as in a myocardial infarction. o Myocardial infarction ("heart attack")[3] * Aortic dissection * Pericarditis and cardiac tamponade * Arrhythmia - atrial fibrillation and a number of other arrhythmias can cause chest pain. * Stable angina pectoris - this can be treated medically and although it warrants investigation, it is not an emergency in its strictest sense Pulmonary * Pulmonary embolism * Pneumonia * Hemothorax * Pneumothorax and Tension pneumothorax * Pleurisy - an inflammation which can cause painful respiration GI * Gastroesophageal reflux disease (GERD) and other causes of heartburn * Hiatus hernia * Achalasia, nutcracker esophagus and other neuromuscular disorders of the esophagus * Functional dyspepsia Chest wall * Costochondritis or Tietze's syndrome - a benign and harmless form of osteochondritis often mistaken for heart disease * Spinal nerve problem * Fibromyalgia * Chest wall problems * Radiculopathy * Precordial catch syndrome * Breast conditions * Herpes zoster commonly known as shingles * Tuberculosis

Penile Prosthesis Surgery for Erectile Dysfunction

Plummer Vinson Syndrome in Iron Deficiency Anemia

Surgery to remove a distal wedge of scar tissue from around a mandibular second molar

Knee Arthroscopy with All-Inside Lateral Meniscus Repair

Diagnosing Low Back Pain

External DACRYOCYSTORHINOSTOMY (DCR)

DCR or dacryocystorhinostomy operations are done to relieve a watery, sticky eye caused by a blockage between the tear sac at the corner of the eye and the tear duct into the nose. The aim of surgery is to make a new passage from the tear sac into the nose. This bypasses the blockage and allows the tears to drain normally again. DCR surgery is worth undertaking if the watering is bad enough to interfere with patient's daily life. It is also recommended if patient has had an attack of acute dacryocystitis (infection in the tear sac) as a result of a blocked tear duct; otherwise patient may have repeated attacks of a red, painful swelling at the corner of the eye. The surgery can be performed in two ways: · Externally -- through the skin · Endoscopically -- from within the nostril. External DCR: A small cut (1-2 cm) is made on the side of the nose, approximately where a pair of glasses rests. A piece of bone between the tear sac and the nose is removed to make a new channel for the tears. Some surgeons use (Not shown in this video) a soft silicone tube or cord to keep the tear passage open during healing. This tube is not usually noticeable and is removed in clinicabout 12 weeks after the operation. The operation takes about 1-1.5 hours, so is NOT a minor procedure. The success rate for this operation is 85-90%. Success means that the watering stopscompletely or only happens in very windy weather. Surgery stops you having a watery eye that needs wiping all the time. For cure of infection (acute dacryocystitis) the success rate is over 95% - patient will no longer have a painful swelling at the corner of your eye and need frequent courses of antibiotics. Endonasal DCR: This is performed together with an Ear, Nose and Throat specialist. The tear sac is approached from inside the nose using an endoscope. This instrument allows the surgeon to see inside the nose and make an opening between the tear sac and the lining of the nose, without using stitches. There is no cut in the skin for this operation and the operation is usually quicker. Silicone tubing is often used at the time of surgery to keep the tear passage open during healing. Which surgery is better? There is no scar with endonasal DCR, but the scar from external DCR is often invisible after a few months. External DCR is better if the tiny tear ducts in the eyelids (canaliculi) are blocked, as well as the bigger duct in the nose. Endonasal surgery may be better if patient has sinus or other nasal problems -- these may be dealt with at the same time as the tear duct operation. What type of anaesthetic is used? The operation will be done under local anaesthesia. Most patients stay in hospital overnight but some can go home the same day. After the operation: Patient may have some bleeding from your nose after the operation. Usually, this is only a trickle and more serious bleeding is rare. If there is bleeding at the end of surgery, the surgeon may pack the nostril and the pack is removed the next day. If patient has a nosebleed after he/she has left hospital, it is helpful to pinch the soft part of the nose for at least 10 minutes and place an ice pack on the bridge of the nose. If the bleeding continues it is better to contact the surgeon. The patient should not blow nose hard for two weeks after the operation as this may cause bleeding. After external DCR patient will have a dressing on the side of nose which will be removed next day. Patient may find it difficult to wear your glasses until the dressing is removed. There will be stitches in the cut on the side of nose that will absorb away by themselves.

Flexible bronchoscopy

Bronchoscopy is a technique of visualizing the inside of the airways for diagnostic and therapeutic purposes. An instrument (bronchoscope) is inserted into the airways, usually through the nose or mouth, or occasionally through a tracheostomy. This allows the practitioner to examine the patient's airways for abnormalities such as foreign bodies, bleeding, tumors, or inflammation. Specimens may be taken from inside the lungs. The construction of bronchoscopes ranges from rigid metal tubes with attached lighting devices to flexible optical fiber instruments with realtime video equipment.

Sciatic Nerve Block

ANATOMY The sciatic nerve is the largest nerve in the human body, originating from the lumbosacral plexus (L4-5 and S1-3) and providing sensory and motor innervation to the lower extremity. The sciatic nerve exits the pelvis via the greater sciatic foramen below the piriformis muscle. In the gluteal region, the sciatic nerve courses between muscle layers. The nerve is deep (anterior) to the gluteus maximus muscle and is superficial (posterior) to the inner muscle layers (superior and inferior gemellus muscles, obturator internus muscle, quadratus femoris muscle). It courses down the midline of the posterior thigh and branches into the tibial and common peroneal nerves usually in the popliteal fossa. Sciatic nerve block is most commonly performed for foot or ankle surgery

Single Incision Laparoscopic Cholycystectomy


The procedure is identical to traditional laparoscopic gallbladder removal, a procedure called a cholecystectomy, except that the surgeon makes just one tiny incision instead of four. In traditional laparoscopic cholecystectomy, incisions are made in the abdomen — one on the rim of the navel (umbilicus), one beneath the navel and two beneath the navel and to the right side. A laparoscope (optical instrument) and surgical instruments are passed into the interior of the abdomen to aid the surgeon in removal of the gallbladder. In single-incision surgery, the laparoscope and all of the instruments are inserted through one 1.5-2 cm incision within the navel. Thus, the patient recovers with a single, almost invisible scar in the umbilical area. As with all laparoscopic surgeries, patients also generally experience less pain and blood loss, and a shorter recovery time, than with open surgery.

Sex Change Surgery-Male transform to Female Gender

Laparoscopic TEP Repair of Left Inguinal Hernia - A Step-by-Step Approach

Part I Part II

Mechanism of Botulinum Toxin

laparoscopic gastrojejunostomy

Robotic Mitral Valve Repair Surgery Animation

How To Do Central Line Procedure?

Modification of Renal Entrapment Device for Morcellation

Dietary Managment of liver disease

Concurrent Inguinal Hernia Repair With Mesh During Robotic Assisted Radical Prostatectomy