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TLH (R) with Segmental Rectal Resection & Partial Vaginectomy

TLH (R) with Segmental Rectal Resection &...

42 years old G:2 P:2 referred b/o debilitating pelvic and Rectal pain with sever dysparunia Recto-Vaginal exam indicated large nodule recto-vaginal space with involvement of posterior vaginal fornix Rectal Endometriosis arising from uterine adenomyoma with stricture was confirmed laparoscopically and treated with THL (R) S&O, Segmental Rectal resection with anastomosis and partial vaginectomy, post op course was uneventful, patient was discharged on 4th post Op day under satisfactory condition, at 3 month post Op patient was well satisfied with outcome and was pain free with no bowel symptom

Mechanism of Ovarian damage by Endometrioma

Mechanism of Ovarian damage by Endometrioma

This video vividly portrays the way that endometrioma inflicts irreparable damage on ovarian tissue by : 1) direct invasion of cortical tissue 2) thinning of cortical tissue and destruction of follicles which tends to be size dependent this all ends up to decreased ovarian reserve of different degrees prior to surgery even by expert surgeon Technique and expertise of surgeon in managing endometrioma is undoubtedly crucial but there is so much even very experienced surgeon can do for structure that is already badly damaged as you could witness in this video, this why, contrary to academic believe, the sooner laparoscopic surgery is performed more normal ovarian tissue could be saved with better ovarian reserve and future fertility provided that the resection of disease is global and not limited to ovary only.

ECG Case: Prolonged QT-interval

ECG Case: Prolonged QT-interval

Differential diagnosis for prolonged QT-interval: -Hypothermia -Hypokalemia (due to U-wave), Hypomagnesemia, & Hypocalemia -Acute coronary syndromes -Increased intracranial pressures -Drugs - f.ex. quinolone antibiotics, amiodarone, sotalol, indapamide, fluconazole -Congenital syndrome If the QT-interval is prolonged because of stretching the ST-segment the reason can be: -Hypothermia - Hypocalcemia

EXPAREL use in Shoulder Arthroplasty

EXPAREL use in Shoulder Arthroplasty

Dr. Richard Hawkins with the Steadman Hawkins Clinic of the Carolinas talks about the use of EXPAREL in his shoulder arthroplasty patients. EXPAREL is used as an opioid sparing care pathway and is injected at the time of surgery. In many cases this drug can be used in place of a nerve block and controls pain for up to 3 days. This allows patients to get moving quicker, lessens nausea, have shorter hospital stays, and saves the patient and the hospital cost.

Total Knee Arthroplasty

Total Knee Arthroplasty

Dr. Brayton Shirley with the Steadman Hawkins Clinic of the Carolinas and the Greenville Heath System performs total knee arthroplasty. A total knee replacement (TKR) is a complex procedure that requires an orthopedic surgeon to make precise measurements and skillfully remove the diseased portions of the bone, in order to shape the remaining bone to accommodate the knee implant. During the procedure we can hear detailed description of taken steps. Narration by Dr. David Vizurraga.

Anterior Hip Arthroplasty

Anterior Hip Arthroplasty

Dr. Brayton Shirley with the Steadman Hawkins Clinic of the Carolinas and the Greenville Heath System performs an anterior approach hip arthroplasty using the Hana table. Narration by Dr. David Vizurraga. Studies shows that patients treated with a minimally invasive direct anterior approach had a better perioperative outcome than patients treated with the lateral approach. The high-tech HANA table enables the physician to perform minimally invasive surgery resulting in a smaller incision, less tissue trauma and less pain, allows hyperextension and external rotation during hip replacement, decreasing the average hospital stay to two to four days compared to the conventional three to six days, and cuts recovery time to two to six weeks as opposed to two to four months. The movie contains images of the surgery and radiographs.

Robotic Assisted Laparoscopic Management of a Unicornuate Uterus

Robotic Assisted Laparoscopic Management of...

Laparoscopic excision of a rudimentary horn of a unicornuate uterus

Cervical Myoma

Cervical Myoma

Laparoscopic hysterectomy in a patient with cervical fibroid.

Laparoscopic Excision of Bowel Endometrioma

Laparoscopic Excision of Bowel Endometrioma

Bowel Endometrioma. The exact incidence of bowel endometriosis is unclear but may occur in 5-12% of all cases of endometriosis. The sites where endometriosis occurs are the rectum, the sigmoid, the appendix and the small bowels.

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