Ileocolectomy for Crohn's Disease

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.

The Mini Gastric Bypass (MGB) is a short, simple, successful and inexpensive laparoscopic gastric bypass weight loss surgery. The operation usually takes only 30 min., hospitalization less than 24 hours. The Mini Gastric Bypass is low risk, has excellent long term weight loss, minimal pain and can b...e easily reversed or revised.

Esophagomyotomy for Achalasia

A video showing how to draw blood for sampling

The challenge of position a patient with severe kyphosis for cataract extraction and lens implantation is met with a team effort and ingenuity.

To present a new device for fixating the fibro-optic probe during phacoemulsification

Meniscus allograft survival in patients with moderate to severe unicompartmental arthritis: a 2- to 7-year follow-up.PURPOSE: We present meniscus allograft survival data at least 2 years from surgery for 45 patients (47 allografts) with significant arthrosis to determine if the meniscus can survive ...in an arthritic joint. Type of Study: Prospective, longitudinal survival study. METHODS: Data were collected for 31 men and 14 women, mean age 48 years (range, 14 to 69 years), with preoperative evidence of significant arthrosis and an Outerbridge classification greater than II. Failure is established by previous studies as allograft removal. No patient was lost to follow-up. RESULTS: The success rate was 42 of 47 allografts (89.4%) with a mean failure time of 4.4 years as assessed by Kaplan-Meier survival analysis. Statistical power is greater than 0.9, with alpha = 0.05 and N = 47. There was significant mean improvement in preoperative versus postoperative self-reported measures of pain, activity, and functioning, with P = .001, P = .004, and P = .001, respectively, as assessed by a Wilcoxon rank-sum test with P = .05. CONCLUSIONS: Meniscus allografts can survive in a joint with arthrosis, challenging the contraindications of age and arthrosis severity. These results compare favorably with those in previous reports of meniscus allograft survival in patients without arthrosis. LEVEL OF EVIDENCE: Level IV.

PURPOSE: Laparoscopic partial nephrectomy (LPN) is an alternative modality of treatment for small sized renal cell carcinoma. Robot assisted laparoscopic partial nephrectomy (RLPN) has also been performed with an advantage in repairing resected surface after tumor resection. We compare the periopera...

tive data of patients treated with laparoscopic partial nephrectomy with those of RLPN undertaken patients. MATERIAL AND METHOD: From September 2006 to April 2008, 22 patients were treated with LPN and 22 were RLPN. 3 arms were used for RLPN; camera was inserted through the 12mm, umbilical trocar port. The laparoscopic Bulldog clamp was used for the clamping of renal hilum. We retrospectively compared each group about tumor size, operation time, estimated blood loss, warm ischemic time and hospital stay. RESULT: Operation time of LPN was shorter than that of RLPN (p=0.033). Tumor size, estimated blood loss and hospital stay was not significant different in each group. No case had conversion to open surgery. 1 patient of RLPN group, however, had conversion to radical nephrectomy due to severe bleeding. CONCLUSION: RLPN was safe and feasible in small sized renal cell carcinoma. Warm ischemic time was reasonable and morbidity associated with RLPN was also low. RLPN LPN p-value Tumor Size (cm) 2.5 2.1 0.605 Op time (min) 169.3 140.8 0.033 EBL (ml) 243.2 213.2 0.878 Warm Ischemic Time (min) 29.2 26.4 0.237 Transfusion (%) 4.5 4.5 0.756 Hospital stay (day) 4.4 5.5 0.053

bad breath odor

Ultrasonic Scaling

Repair of the umbilical hernia, and placing the omentum back in

Giant spigelian stranguled hernia with small bowel loop and omental flap inside. The omentum required resection, the bowel appears vital. After the handle of hernia sac and his content has been done, a overlapped prolene repair will be done.

Anatomy of the Prostate

Tattoo Removal from the skin

How diabetes effects the kidneys.

Laparoscopic Appendectomy Video

show your patients how to use an inhaler

Computer guided dental implant surgery

Stephen has sharing his experience with the others.