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Coronary Artery Grafting With Bilateral Internal Mammary Arteries Using Composite Y-Graft Technique

Coronary Artery Grafting With Bilateral Internal...

This video demonstrates the technique of coronary artery bypass grafting with bilateral internal mammary arteries using composite Y-graft technique. The right internal mammary artery (RIMA) is harvested first as a skeletonized free graft and then the left internal mammary artery (LIMA) is harvested as a skeletonized pedicled graft. Before going on bypass when the heart is full and not arrested the precise marking of the Y-graft anastomosis site is possible. This site is marked on the LIMA at the level of the left atrial appendage. The composite Y-graft is constructed by anastomosing the proximal end of the RIMA to the marked site of the LIMA (end-to-side anastomosis) using 8-0 continuous running Prolene suture. The flow in the composite graft is checked and measured to make sure that it is 2 - 3 times more than the LIMA flow (measured before) to be able to provide enough blood to 2 and more coronary arteries to be bypassed. The cardiopulmonery bypass is started and the heart is arrested. LIMA to Diagonal and LAD sequential graft and RIMA to OM and PDA sequential grafts were done for this particular patient. Composite Y-graft function and patency is checked 3 months after surgery by 64 slice contrast CT scan. LIMA stem flow is checked after surgery by Dupplex investigation. Good flow is noted with predominant diastolic component. Good function and patency of the composite Y-graft is also seen on the angiogram 5 years after surgery. This operation let us avoid vein grafts and perform arterial revascularisation providing good and stable long-term results which is very important especially for the younger patients.

Circumferential Supracrestal Fiberotomy (CSF)

Circumferential Supracrestal Fiberotomy (CSF)...

Circumferential supracrestal fiberotomy(CSF) in rotated teeth after finishing orthodontic treatment by Dr Amr Asker. Video by Dr Amr Asker.

Endarterectomy in Aortoiliac Occlusive Disease

Endarterectomy in Aortoiliac Occlusive Disease

Recording of a endarterectomy with aortoiliac occlusive disease (Leriche syndrome). The patient was shown severe calcific also has diabetes, is moderately obese and quit smoking in 1991. Presented by Patrick J. O'Hara, MD and Tara M. Mastracci, MD, Department of Vascular Surgery Cleveland Clinic Foundation, Cleveland, Ohio.

 Hysteroscopy: Myoma tipe1 and Endometrial Polyps

Hysteroscopy: Myoma tipe1 and Endometrial...

42 yo, 0G presenting diagnosis of infertility, To ultrasound pelvic shows the presence of endometrial thickening (submucosus myoma), takes offive hysteroscopy.

Hyperplasia Complex with Atypias

Hyperplasia Complex with Atypias

64 yo patient, treated with tamoxifen for 3 years for breast cancer. Ultrasound pelvic show endometrial thickening (6 mm).

Thoracoscopic Esophagectomy For Cancer Of  Esophagus

Thoracoscopic Esophagectomy For Cancer Of...

Video shows thoracoscopic dissection of esophagus for cancer of the middle portion of esophagus. Video by Dr Hemant Bhansali

Minimally Invasive Esophagectomy

Minimally Invasive Esophagectomy

Lectures from the 2014 General Thoracic Surgical Club about minimally invasive esophagectomy. Video by dr Dawn Jaroszewski.

Esophageal cancer surgery, Radical Esophagectomy

Esophageal cancer surgery, Radical Esophagectomy

Minimaly invasive esophagectomy is currently a new approach to radical esophagectomy that avoids big incisions especially the thoracic incision and yet has an excellent oncological result especialy regarding the mediastinal lymphadenectomy. Video by Dr Sanjay Sharma:

Canine Exposure With Diathermy (Electrocautary) And Orthodontic Traction

Canine Exposure With Diathermy (Electrocautary)...

In this video Dr. Amr Asker performs upper canine exposure with diathermy, bonding and puts a ligature wire. Video by Dr. Amr Asker

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Adenocarcinoma adenoma Animation banding bleeding cancer colon colonoscopy duodenum echocardiography endoscopy esophagus gastric gastroenterology gastroscopy GIST gynecology HEART Histopathology laparoscopy laryngology oncology polyp polypectomy rectum stomach surgery TUMOR ulcer varices

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Testimonials

Being focused on new endoscopic techniques in medicine (ESD - endoscopic submucosal dissection), I understand well the need to promote the latest innovation and discoveries. I recommend MEDtube video sharing website for doctors as tool to disseminate techniques and technologies improving doctors' skills and awareness globally. Good luck.

Takuji Gotoda,
MD, PhD

Tokyo Medical University Hospital

I was excited to discover MEDtube during my online research for video content in ortopedics. Such project was missing. Professional medical education requires more open and innovative approach. I will use the platform in my teaching activities and publish own content. I look forward to joint projects with MEDtube and promise my personal support in Hong Kong and continental China. Good luck!

Shekhar Kumta,
MD, PhD

Orthopaedic Surgeon, Dir. of the Teaching & Learning Resource Centre, The Chinese University of Hong Kong, China

I have devoted my long professional career to technology harvesting of innovation in medicine and new technologies in surgery. One of the most difficult barriers to innovation has been the real-time access to information about the rapidly emerging new technologies. It is this inefficiency in the timely availability of announcements of new discoveries that has slowed the diffusion of new technologies and impaired their early adoption.. MEDtube is a powerful new platform that provides healthcare professionals a much more immediate exposure to such new technologies. MEDtube is a welcome addition of rapid access to trusted healthcare knowledge and early discovery which is as much of a game-changers as the innovations which they report.

Richard Satava,
MD, PhD

Department of Surgery, University of Washington