Laparoscopy in acute bowel obstruction following previous surgery is a difficult procedure and avoided by most of the surgeons due to the difficulty in obtaining pneumoperitoneum, port placement, lack of working space, adhesions and risk of bowel injury.
Here is a patient who had a previous laparotomy for trauma with a midline incision from xyphysternum to pubis; after unsuccessful conservative management he underwent a laparoscopy; a prior CT scan showed adhesions in the left side and a distal-mid small bowel obstruction. The pneumoperitoneum was obtained with the Visiport placed in the right lower quadrant; although the abdomen was grossly distended, under significant tension and distended loops of small bowel were occupying most the peritoneal cavity, with muscle relaxation there is usually enough space to perform a thorough inspection of the abdominal cavity. Port placement has to be done with special care as there is no room to push and usually a blunt trocar directed away from the bowel is employed in my practice. The collapsed loops of small bowel point quickly to the site of obstruction -- it is better to avoid manipulating the distended bowel as it is heavy, oedematous and prone to be lacerated with the instruments; once the pathology is identified, in this case the obstructive band, light packing is performed in order to expose the working space and protect the bowel from instruments like scissors or diathermy. In this case the band adhesion was slightly more difficult to separate from the bowel and required a combination of sharp and gentle blunt dissection.
Once the obstruction is release and the transit of contents is confirmed in the collapsed bowel the procedure is terminated. No abdominal drainage is usually necessary.

This is an amazing device designed to transport body organs and blood long distances. The inventor of this life-saving device is Randal Miller.

Herniated or Ruptured Disc: Between each of the vertebre of the spine is a disc which is filled with a gel type material to cushion the connection between the vertebre. With age or injury these intervertebral discs can rupture or herniate. This herniation causes them to push against the adjacent nerves which come from the spinal cord. This can frequently cause pain, numbenss and tingling. This animated video reviews herniated disc.

Infant CPR Video Demonstration

The BMHR uses the same socket (hydroxyapatite-coated metal uncemented cup) and bearing(metal on metal) as the BHR. The modular head component fits onto a hydroxyapatite proximal porous coated cobalt chrome stem. It is an uncemented short stemmed prosthesis. It was invented by Prof. Dereck Mc.Minn a year ago and is performed by very few surgeons the world over. In India it is being done only at the Asian Regional Center for Hip Resurfacing in Chennai.

Cosmetic surgery-mammoplasty-breast surgery-tummy

After losing control of his entire right side from a massive stroke, a teenager overcomes a long, difficult, and uncertain recovery with courage, grit, and determination. ~ Detroit Medical Center

DMC Orthopaedic Specialists are the state leaders in a unique new procedure to resurface the knee joint, preserving more bone for the patient. ~ Detroit Medical Center

A positive Speed's test result is usually thought to suggest inflammation or lesions related to the biceps/labral complex. The specificity, sensitivity, and positive and negative predictive values are determined for the Speed's test.

Kathleen Carr, MD performs a full shoulder exam for the musculoskeletal program at the University of Wisconsin Department of Family Medicine.

esophago-gastro- duodinoscopy
Gastroduodinoscopy requires special training and considerable experience but affords valuable information.
By its implement the whole of the interior of the stomach as well as esophagus, the first part and the proximal section of the second part of the duodenum and both efferent and afferent loops of the gastrojujenostomy if present can be scrutinized.
Gastroscopy is valuable in the diagnosis of gastric ulcers, in checking the results of medical treatment of chronic gastric ulcer. Gastroduodinoscopy is valuable in differential diagnosis between chronic peptic ulcer and gastric carcinoma, in diagnosis of small gastric neoplasm, in the detection of certain forms of gastritis, in examination of a stoma, in cases of gastrojujenostomy, in cases of duodinitis and duodenal ulcer.
Now its' the Era of
VIDEOGASROSCOPE
Direct means of diagnosis of upper G.I. diseases
Continuous Video recording of the entire procedure is there by which
we can review the whole procedure by playing the Video.
We are doing final diagnosis of upper G.I. lesions with biopsy.
Treatment becomes easy and to the point.
Early detection of pre malignant and malignant lesions is appreciable.

The video will describe what is the purpose of a very important blood test known as ABGs. Please see my website for disclaimer.

A discussion and demonstration of suturing techniques with Lee Dresang, MD from the University of Wisconsin Department of Family Medicine

In this video, Dr. Joe Bresee, with the CDC Influenza Division, describes swine flu - its signs and symptoms, how it's transmitted, medicines to treat it, steps people can take to protect themselves from it, and what people should do if they become ill.

Umbilical Hernia Repair using the new device echnique Ventral Patch

DMC Sports Medicine Specialist Dr. Scott Lemos helps a young football start get back in the game after an ACL injury. ~ Detroit Medical Center

The video will describe what is miliary tuberculosis. Please see my website for disclaimer.

Video demonstrates the action of the isolated lumbar multifidis muscle

The video will describe what is Tree in bud sign on CT scan of Chest. Please see disclaimer on my website www.academyofprofessionals.com

peptic ulcer