Surgical technique: A 3cm skin incision under spinal or general anesthesia, depending on the patients’ preference, starts half way the line between the superior anterior iliac spine towards the midline in a 30° angle to the pubic tubercle. Scarpa’s fascia is opened as well as the external obliq...ue aponeurosis. By using this skin line incision the internal ring will be immediately visualized. Although it is important to look for both direct and indirect hernias evaluating the groin, we do not taper the cord and directly evaluate the ring for indirect hernias. In case of an indirect hernia the sac is reduced or resected according to the preference of the surgeon and the preperitoneal space is entered bluntly through the dilated internal ring. In case of a direct hernia the approach slightly differs. One could prefer to open the transversalis fascia through the internal ring over a few centimeters or you can open the fascia more medially, at the site of the direct hernia. As primary point of concern the epigastric vessels should be identified and retracted softly upwards. Then a gauze can be introduced into the preperitoneal space and by doing so most of the space needed medially will be created. Then one can already palpate Cooper’s ligament and the pubic bone. Laterally to the internal ring more digital dissection is needed to create just the appropriate space for the mesh. By placing the mesh it is important not to introduce the mesh too medially. Laterally of the internal ring an adequate overlap of the mesh is necessary, especially in indirect hernias. No splitting of the mesh seems necessary. The patient will be asked to strain and push on the ring to control its place and to check adequate spreading of the mesh to cover the whole myopectineum of Fruchaud. One single stitch of vicryl 3/0 is placed taking both the fascia transversalis and the mesh.

Ultrasound-guided internal jugular cannulation

The kidneys are a pair of organs located in the back of the abdomen. Each kidney is about 4 or 5 inches long -- about the size of a fist. The kidneys' function are to filter the blood. All the blood in our bodies passes through the kidneys several times a day. The kidneys remove wastes, control the body's fluid balance, and regulate the balance of electrolytes. As the kidneys filter blood, they create urine, which collects in the kidneys' pelvis -- funnel-shaped structures that drain down tubes called ureters to the bladder. Each kidney contains around a million units called nephrons, each of which is a microscopic filter for blood. It's possible to lose as much as 90% of kidney function without experiencing any symptoms or problems.

Watch that Full Real Human Body Decomposition Process

Video demonstrates the action of the isolated lumbar multifidis muscle

Neuroanatomy of CSF Flow

David Beckham Medical Exam

How Hair can be retsored and transplanted? natural versus biofibers?
Dr. Mohamed El Ruby
Consultant of Plastic Surgery - Ain Shams University

تضخم الثدى عند الرجال من المشاكل المنشرة جدا بين الشباب و تسبب الكثير من المشاكل النفسية و الصحية
د. محمد الروبى
استشارى جراحات التجميل - جامعة عين شمس

A direct neck lift is an uncommon procedure in plastic surgery for the sagging neck. It is reserved for older patients who do not want a facelift or who do not want or can not go through a bigger facelift operation.

The brain is that part of the CNS contained within the cranial cavity (figure 13.1). It is the control center for many of the body's functions. The brain is much like a complex central computer but with additional functions that no computer can as yet match. Indeed, one goal in computer technology is to make computers that can function more like the human brain. The brain consists of the brainstem, the cerebellum, the diencephalon, and the cerebrum (table 13.1). The brainstem includes the medulla oblongata, pons, midbrain, and reticular formation. The structure of the brain is described in this chapter. Its functions are primarily discussed in chapter 14. Twelve pairs of cranial nerves, which are part of the PNS, arise directly from the brain. Two pairs arise from the cerebrum, nine pairs arise from the brainstem, and one pair arises from the spinal cord.

How to measure blood pressure

Frostbite is an injury caused by freezing of the skin and underlying tissues. First your skin becomes very cold and red, then numb, hard and pale. Frostbite is most common on the fingers, toes, nose, ears, cheeks and chin. Exposed skin in cold, windy weather is most vulnerable to frostbite. But frostbite can occur on skin covered by gloves or other clothing.

Purpose: To evaluate the results of LASIK and IntraLASIK treatment in myopic patients with nystagmus. Methods: Eight patients with congenital nystagmus (16 eyes), from 23 to 49 years of age, underwent LASIK surgery. Corneal flaps were created using either the Hansatome microkeratome or the Intral...ase femtosecond laser. The ablations were performed with the Bausch & Lomb excimer laser with an active tracking system. In some patients, the eyes were fixated with forceps or a fixation ring during the laser ablation. Results: The refractive errors were corrected in all cases. There was no decentration or loss of best corrected visual acuity greater than 1 line. In 56% of the eyes, the post-operative uncorrected visual acuity was better than the best spectacle corrected-visual acuity (BSCVA). 62.5% of the eyes improved their BSCVA. The overall visual performance was improved in all the patients. One patient that did not not drive before become eligible to get a driver license after the surgery. Conclusions: Selected patients with myopia and congenital nystagmus may benefit from laser refractive surgery. Laser refractive surgery may be safely and accurately performed by using either the Hansatome microkeratome or the Intralase femtosecond laser and an active tracking system with or without mechanical fixation. Certain patients improve their BSCVA post-operatively.

the technique of insertion of a tube into the pericardial sac to remove fluid or blood, improving cardiac function

A video showing the Vasa Previa which is an abnormality of the placenta

A video demonstrating the proper insertion of the Quicktrach emergency cricothyrotomy device.

Cosmetic facial plastic surgery is surgery performed to enhance visual appearance of the facial structures and features. Common procedures include facelifts, eye lifts, rhinoplasty, chin and cheek implants, liposuction, and procedures to correct facial wrinkles.

A prenatal ultrasound (also called a sonogram) is a noninvasive diagnostic test that uses sound waves to create a visual image of your baby, placenta, and uterus, as well as other pelvic organs. It allows your healthcare practitioner to gather valuable information about the progress of your pregnancy and your baby's health. During the test, an ultrasound technician (sonographer) transmits high-frequency sound waves through your uterus that bounce off your baby. A computer then translates the echoing sounds into video images that reveal your baby's shape, position, and movements. (Ultrasound waves are also used in the handheld instrument called a Doppler that your practitioner uses during your prenatal visits to listen to your baby's heartbeat.) You may have an early ultrasound at your practitioner's office at 6 to 10 weeks to confirm and date the pregnancy. Or you may not have one until the standard midpregnancy ultrasound between 16 and 20 weeks. That's when you may learn your baby's sex, if you like. (The technician will probably present you with a grainy printout of the sonogram as a keepsake.) You may also have a sonogram as part of a genetic test, such as the nuchal translucency test, chorionic villus sampling, or amniocentesis, or at any other time if there are signs of a problem with your baby. You'll have more frequent ultrasounds if you have diabetes, hypertension, or other medical complications.

Duhamel's Operation for Chagasic Megacolon