Background: The number of patients demanding endoscopic neck surgery is rising. The access trauma of the axillary, breast and chest approaches is bigger than in open or video assisted surgery. We tested the feasibility of he sublingual transoral access which is in our opinion the only real minimally...-invasive extracollar endoscopic access to the thyroid gland Methods: We performed an experimental investigation in a porcine model. In 10 pigs we made 10 endoscopic transoral thyroidectomys with a modified axilloscope with the help of ultrasonic scissors and a neuro-monitoring system for identification of the recurrent laryngeal nerve. Results: The average operation time from the introduction to the removal of the obturator just above the larynx was 57 seconds. The mean operation time was 43 minutes. With the help of the neuro-monitoring system we proved in all cases the function of the recurrent laryngeal nerve on both sides. The pigs were observed for another two hours after operation. During and after the operation no complications appeared. Conclusions: We could show that the endoscopic transoral thyroid resection in pigs is possible and save. Our results might be useful for using this access for endoscopic thyroid resection in humans.

Biliary and Pancreatic Sphincterotomies for Sphincter of Oddi Dysfunction

This 43 year old woman has severe recurrent RUQ pain post cholecystectomy. Liver and pancreatic chemistries and duct size are normal, but pancreatic manometry is abnormal. The plan is to perform dual biliary and pancreatic sphincterotomy. The pancreatic duct is cannulated with a 3.9 French tip tr...iple lumen papillotome loaded with a 0.025 inch Jagwire. Contrast is injected to outline the course of the duct. The wire is passed to the tail. Notice the knuckling of the wire into the tail. This provides a safety loop, but is only safe in a small duct with use of a smaller caliber wire. Then with the wire securely in PD, papillotome is used to cannulate the bile duct. Placement of the wire in PD guarantees access for pancreatic stent placement, which is mandatory in these patients to reduce risk, it also facilitates difficult biliary cannulation. Here is the fluoroscopic view as the papillotome is passed deep into bile duct. This shows wires in the CBD and PD. Now a biliary sphincterotomy is performed, with the pancreatic guidewire in place beside the papillotome. The scope is pushed into a longer position to orient up the middle of the papilla. The sphincterotomy is done in very careful stepwise fashion to avoid perforation. Now the biliary wire is removed and the papillotome passed over the pancreatic wire for pancreatic sphincterotomy. The incision is aimed back up towards the biliary sphincterotomy to ensure the septum only is cut. Note the large pancreatic orifice. Last, a 4 French 9cm unflanged soft material pancreatic stent is placed. We always use single pigtail design to avoid inward migration of the stent. The long unflanged design allows spontaneous passage within a few weeks.

Animated video about Cardiac Arrhythmia

Avideo showing suturing of the uterus and abdominal wall after c-section

Scleral Buckling: Slinging Muscles & Marking Breaks VR1 Basic Techniques

Off-Pump CABG in Dextrocardia; A New Challenge for a New Era

Axillary Cannulation: Antegrade Flow and Brain Protection

Repair of Anomalous Left Coronary Artery from the Pulmonary Artery (AlCAPA) in an Adult

Aortic Valve-Sparing Operation in a Patient with Aortic Root Aneurysm using a new Prosthesis for Anatomical Reconstruction of the Sinuses of Valsalva

Endoscopic Atraumatic Coronary Artery Bypass EndoACA

Arterial Coronary Off-Pump Revascularization

Sentinel Lymph Node removal in breast Cancer en Français

A video-animation presentation about sentinel lymph node biopsies for breast cancer diagnosis. 3D graphics are used to explain the process. Topics include the lymphatic system and the methods used. This video is part of the breast cancer education series produced by CancerQuest at Emory University

An animation showing what PCO is

Polycystic ovary syndrome (PCOS, also known clinically as Stein-Leventhal syndrome), which is an endocrine disorder that affects 5--10% of women. It occurs amongst all races and nationalities, is the most common hormonal disorder among women of reproductive age, and is a leading cause of infertility. The symptoms and severity of the syndrome vary greatly between women. While the causes are unknown, insulin resistance (often secondary to obesity) is heavily correlated with PCOS.

Pectus excavatum (hollow chest) deformity is not uncommon (sometimes mild and other times severe in its form). The chest deformity is often the source of self-consciousness for the patients while growing up. Several surgical techniques (Nuss procedure, Ravitch procedure, etc) are available.

Needle fasciotomy (aponeurotomy) is usually a 15-Minute in-office procedure for Dupuytren's contracture. Performed under local anesthesia, in the office, by board-certified plastic surgeon Reza Momeni, MD. This is a minimally invasive treatment for Dupuytren's.

UltraSound-guided Sciatic nerve block by supra popliteal approach

Technique for Popliteal/Peroneal Nerve Block

Ultra Sound-Guided Interscalene Block