Medical Surgery

KIDNEY REMOVAL SERIES

2010-01-20T19:40:00.000-08:00

Normal anatomy

The kidneys are paired organs that lie posterior to the abdomen, in the area of the lower back. The kidneys make urine, which is transported from the kidneys to the bladder by the ureters.

indications

Nephrectomy may be recommended for:kidney deformities (birth defects: congenital abnormalities)injury (trauma)diseaseinfectionhypertensiontumorremoval of kidney from donor for kidney transplant

incisions

While the patient is deep asleep and pain-free (general anesthesia), an incision is made in the abdomen or in the side of the abdomen (flank).

procedure

The tube that carries urine from the kidney to the bladder (ureter) and the blood vessels are cut away from the kidney and the kidney is removed. The incision is then closed. This opoeration is called a nephrectomy.

aftercare

Patients are generally in the hospital after surgery for 3-5 days. The removal of one kidney generally has no health consequences as long as the remaining kidney is functioning well. Some centers are now performing nephrectomies using laparoscopic surgical techniques.

TURP SERIES

2010-01-20T19:36:00.000-08:00

Normal anatomy

The prostate gland is an organ that surrounds the urinary urethra in men. It secretes fluid that mixes with the sperm to make semen.

indication

An enlarged prostate gland compresses the urethra, causing problems with urination. Prostate enlargement is caused by prostate gland overgrowth (benign prostatic hypertrophy or hyperplasia) or in some cases, prostate cancer.

procedure

With an anesthetic (general anesthetic or spinal), a special kind of telescope, called a resectoscope is inserted through the urethra into the prostate. The resectosope is used to remove the blocking portions of the prostate. Transurethral resection of the prostate (TURP) is the most common type of surgical procedure for benign prostatic hyperplasia (BPH).

aftercare

TURP is typically successful at removing the symptoms of an enlarged prostate.

PROSTECTOMY SERIES

2010-01-20T19:32:00.000-08:00

normal anatomy

The prostate gland is an organ that surrounds the urinary urethra in men. It secretes fluid which mixes with sperm to make semen. The urethra carries urine from the bladder, through the prostate gland to the penis.

indication

With the exception of skin cancer, prostate cancer is the most common type of cancer among men in the United States. Early detection may result from a blood test called a PSA (prostate-specific antigen), and/or a digital rectal exam. The digital rectal exam checks the rear surface of the prostate gland for any abnormalities. A lump or hardness found during the exam might be a sign of prostate cancer.

incision

There are two main surgical methods used for removing the prostate gland. The first method is called the "perineal" method. An incision is made in the perineum, which is the area between the base of the scrotum and the anus.

The second surgical method of prostatectomy is called the "suprapubic" approach. An incision is made in the abdomen, just below the umbilicus, which extends downward to the pubic bone.

normal procedure

The suprapubic approach allows for removal of the lymph nodes and the ability to perform a nerve sparing modification that might prevent impotence post surgery.

aftercare

Patients with prostate cancer might require radiation therapy after their surgery. Results depend on the extent of their disease, and the response of the tumor to resection (removal) and radiotherapy.

KIDNEY TRANSPLANT SERIES

2010-01-20T19:30:00.000-08:00

normal anatomy

The kidneys are paired organs that lie posterior to the abdomen, in the area of the lower back. The kidneys make urine, which is transported from the kidneys to the bladder by the ureters, long muscular tubes which connect the kidneys with the bladder.

indication

Kidney transplant may be recommended for patients with kidney failure caused by:Severe, uncontrollable high blood pressure (hypertension)InfectionsDiabetes mellitusCongenital abnormalities of the kidneysOther diseases which cause renal failure, such as autoimmune diseaseDonor kidneys are obtained from either brain-dead organ donors, or from living relatives or friends of the recipient.

incision

While the patient is deep asleep and pain-free (general anesthesia), an incision is made in the lower right quadrant of the abdomen. The donor kidney is transplanted into the right lower pelvis of the recipient.

procedure

The new kidney is sutured into place. The vessels of the new kidney are connected to the vessels leading to the right leg (the iliac vessels), and the ureter is sutured to the bladder.

aftercare

In most cases, the recipient's native kidneys are left in place, and the transplanted kidney performs all the functions that both kidneys perform in healthy people. Kidney transplant recipients are required to take immunosuppressive medications for the rest of the lives, to prevent immune rejection of the transplanted organ.

site map

2010-01-06T11:35:00.000-08:00

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CATARACT SURGERY

2009-12-18T21:35:00.000-08:00

NORMAL ANATOMY

The lens of an eye is normally clear and perfect. A cataract is when the lens becomes cloudy when you get the older age.

INDICATION

Surgery is usually recommended for people who have vision problems or other major problems caused by the cataract and otherwise it is prohibited.

PROCEDURE,PART a

there are two procedures are used to treat cataracts of lens. In the manual extraction procedure, a small incision is made at the edge of the outer lining of the eye or a (cornea). by this procedure the lens is removed and replaced with an artificial lens.

PROCEDURE,PART b

the another procedure is called phacoemulsification.in this procedure phacoemulsification involves inserting a needle through a small incision on the eye. The end of the needle produces sound waves. The sound waves break up the lens, which is then sucked out through the needle. This procedure requires a smaller incision than the manual extraction procedure.

AFTERCARE

The Cataract surgery usually works very well. There are the few risks in operation like,the pain and recovery period are short, and your sight is usually greatly improved. Ninety-five percent or more of all cataract surgeries result in improved vision.

Tracheo -esophageal fistula repair series

2009-12-05T22:43:00.000-08:00

NORMAL ANATOMY

The trachea and esophagus pass next to each other through the chest cavity. The esophagus connects to the stomach, and carries food and saliva to the stomach. The trachea connects direct to the lungs and carries air to the lungs.

INDICATION

tracheo esophageal fistula is a congenital anomaly in which there is a connection between the trachea and the esophagus. This is a life-threatening problem requiring immediate intervention. Saliva and gastric secretions may be aspirated into the lungs through the abnormal opening in the trachea. Normal swallowing and digestion of food cannot occur with the abnormal esophagus.

PROCEDURE,PART 1

Although the surgical procedure varies depending on the location and type of fistula, in general, an incision is made in the right chest. The section of esophagus that contains the fistula is rejected.

PROCEDURE,PART 2

The ends of the esophagus are sutured back together. In many cases, infants are very ill, and therefore require a staged procedure. This involves placing a tube in the stomach (gastrostomy tube), in order to decompress the stomach and prevent fluid in the stomach from flowing up the esophagus, through the fistula and into the lungs. The infant is then cared for in an intensive care unit until he or she is well enough to undergo resection of the fistula and a definitive repair of the esophagus.

AFTERCARE

The baby will be cared for pre-operatively and post-operatively in a neonatal intensive care unit. He/she will be placed in an (incubator) to keep warm. He/she may require oxygen and/or mechanical ventilation. A chest tube may be in place to drain fluids. Intravenous fluids and pain medications will be given. Feedings will be started as soon as possible, depending on the extent of the repair. Length of the hospitalization varies, depending on the seriousness of the surgery and the baby's condition.

Coronary artery Balloon Angioplasty series

2009-12-05T22:28:00.000-08:00

NORMAL ANATOMY

The coronary arteries supply the blood to the heart muscle. The right coronary artery supplies both the left and the right heart portion; the left coronary artery supplies the left heart portion or the right coronary artery supplies the blood to the right portion of heart.

INDICATION

Fat and cholesterol accumulates on the inside of arteries (atherosclerosis). The small arteries of the heart muscle (the coronary arteries) can be narrowed or blocked by the accumulation of fat and cholesterol. If the narrowing is small, per cutaneous translational coronary angioplasty, or PT CA for short, may be the course for treatment. PT CA is a rear invasive procedure to open up blocked coronary arteries,or allowing blood to circulate unobstructed to the heart muscle. The indications for PT CA are Persistent chest pain (angina)Blockage of only one or two coronary arteries

PROCEDURE

When the patient is awake and pain-free (local anesthesia), a catheter is inserted into an artery at the top of the leg (the femoral artery). The procedure begins with the doctor injecting some local anesthesia into the groin area and putting a needle into the femoral artery, Once the needle is inserted, a guide wire is placed through the needle, into the blood vessel. Following this step, the guide wire is left in the blood vessel and the needle is to be removed. A large needle called an introduce is then placed over the guide wire and the guide wire is removed.

AFTERCARE,PART

This procedure would be greatly improved the blood flow through the coronary arteries and to the heart tissue approx 90% of patients and may eliminate the need for coronary artery bypass surgery. The outcome is relief from chest pain symptoms and an improved exercise capacity. In 2 out of 3 cases, the procedure is considered successful with complete elimination of the narrowing or blockage.Immediately after the procedure, a ten-pound sandbag may be placed over the femoral artery puncture site in the leg and remain there for 6 hours. This is done to help the artery heal.

EYE MUSCLE REPAIR

2009-12-05T22:06:00.000-08:00

NORMAL ANATOMY

The conjunctiva links the eyeball to the eye socket. The external muscles of the eye are found behind the conjunctiva.

The extra ocular muscles of the eye (external to the eyeball) control the positioning of the eyes. They coordinate of the eye movement between the eyes providing coordinated sight in all directions.

INDICATION

Strabismus (crossed eyes) is caused by a lack of muscle coordination between the eyes, it is causing the eyes to point in different directions. The eyes are unable to focus simultaneously on a single point or a site. Strabismus may be fromed problems with the extra ocular muscles (the six muscle pairs that move the eyes), problems with neurological control of the extra-ocular muscles, neuro-toxin, blindness, it is a mechanical problems in the eye, or we can say tha mechanical obstruction to vision in one eye during early life.

INCISION

A small incision is made on each side of the eyeball in the tissue between the eye and eyelid which is known by (conjunctiva).

PROCEDURE

One or more of the muscles of the eye are strengthened or weakened to allow proper position and movement of the eyeball.

AFTERCARE

Usual activities and exercise can usually be resumed shortly after surgery.

RADIAL KERATOMY FOR MYOPIA

2009-12-05T22:01:00.000-08:00

NORMAL ANATOMY

The cornea is composed of five layers and is one of the refractive elements. the clear covering over the colored iris and pupil of the eye. The cornea and lens of the eye help to focus light on the retina. so thats the way eye can be seen.

INDICATION

Radial keratotomy is used to correct nearsightedness, also called myopia. Myopia occurs when the cornea and lens focus light in front of, rather than on, the retina. Correction of myopia with radial keratotomy eliminates the need for corrective lenses (glasses or contact lenses).

PROCEDURE

While you are awake and pain-free (using local anesthesia), a series of delicate incisions are made around the cornea. This flattens the center of the cornea is used in order to change the focus of light rays on the retina. Each eye is operated on separately, and on different days.

AFTERCARE

An eye patch or dark glasses are worn for several days. The final outcome of your corrected vision can take up to several months.Advances in refractive surgery are being made rapidly. New procedures that are slowly replacing radial keratotomy are being used more frequentl.

CORNEAL TRANSPLANT

2009-12-05T21:40:00.000-08:00

NORMAL ANATOMY

The cornea is the composed of five layers.it is clear covering of the eye over the colored iris and the pupil.

INDICATION

Corneal transplantation is recommended for severe corneal infection,like injury, damage, or scarring corneas, that is no longer allow light to pass through (opaque), often secondary to lens surgery (see cataract surgery), the cornea is a infections or a inherited diseases.

INCISION

Corneal transplant is done when the patient awake and pain-free (local anesthesia). An incision is to be made around the outer edge of the cornea.

PROCEDURE

The damaged cornea is removed and the corneal graft is stitched in place. The corneal graft is a transplant from a brain dead donor maintained on life support.

AFTERCARE

It is expected that Transplanted corneas have a long life. The benefits of corneal transplant are significant, and it also include significant improvement in vision.

RETINAL DETACHMENT REPAIR

2009-12-05T21:28:00.000-08:00

NORMAL ANATOMY

The retina is the internal layer or a middle layer of the eye that receives and transmits images.and after that it passed through and been focused by the lens and cornea.

INDICATION

Retinal detachments are associated with a tear or hole in the retina,by this the internal fluids of the eye may leak, causing separation of the retina from the underlying tissues. This is most often caused by trauma, and the risk of retinal detachment after minor trauma, such a blow to the head, is increased in the elderly, and in patients with tumors or inflammation near the retina. In some cases, retinal detachment occurs in the absence of trauma. Symptoms of retinal detachment include bright flashes, "floaters", or loss of part of the visual field. Emergency retinal detachment surgery is necessary to prevent vision loss.

PROCEDURE,PART

The most common technique used to repair retinal detachment is called a sacral buckle. Prior to performing a sacral buckle procedure, breaks and tears in the retina are closed. There are two major methods used to close breaks and tears in the retina. Cryonics's, uses an intensely cold probe . This produces an inflammation that leads to formation of a scar which holds the retina to the underlying tissue

AFTERCARE

Sacral buckling for detachment may require a few days in the hospital. Keep the head elevated at all times. Patients should not bend over or strain with lifting or bowel movements. Vigorous exercise should be avoided for 3 to 4 weeks.

2009-12-02T08:55:00.000-08:00

NORMAL ANATOMY

The heart is the most powerful organ in the circulatory system it is located in the chest cavity, or thoracic cavity between the lungs slightly towards left. It pumps blood from the lungs to the rest of the body.

INDICATION

A heart transplant may be recommended for heart failure caused by coronary artery diseases (thickening of the heart walls)heart valve disease with congestive heart failure severe congenital heart disease Heart transplant surgery is not recommended for patients who have:kidney, lung, or liver disease insulin-dependent diabetes mellitus (IDEM)other life-threatening diseases

PROCEDURE

Heart transplants are the third most common transplant operations in the U.S. (over 1,500 cases per year). A healthy heart is obtained from a donor who has suffered brain death but remains on life-support. The healthy heart is transported in a special solution that preserves the organ. While the patient is deep asleep and pain-free ,an incision is made through the breast bone (sternum). The patients blood is re-routed through tubes to a heart-lung bypass machine to keep the blood oxygen-rich and circulating. The patients diseased heart is removed and the donor heart is stitched in place.

AFTERCARE

Heart transplant prolongs the life of a patient who otherwise would be died. About 80% of heart transplants are alive two years after the operation. The main problem, as with other transplants, is graft rejection. If rejection can be controlled, then survival can be increased up to 10 years or more. immunosuppressive drugs must be taken indefinitely.the major problems are the same all major organ transplants face:a shortage of donor hearts rejection of the transplanted heart cost of the surgery and post-operative care.

PULMONARY LOBECTOMY

2009-12-02T08:45:00.000-08:00

NORMAL ANATOMY

The lungs are comprised of lobes. The right lung has a superior lobe, middle lobe and inferior lobe. The left lung has a superior and inferior lobe.

PROCEDURE

If a cancer is within a lobe of the lung, removal of the involved lobe is indicated. Under general anesthesia with the patient deep asleep and pain free, an incision is made between the ribs to expose the lung. The chest cavity is examined and diseased lung tissue is removed. A drainage tube which is known as a (chest tube) is inserted to drain air, fluid, and blood out of the chest cavity and the ribs and skin are closed.

AFTERCARE

Hospital stay is usually 7 to 10 days. Deep breathing is important to help prevent pneumonia, infection, and re-expand the lung. The chest tube remains in place until the lung has fully re-expanded. Pain is managed with medications. The patient will be recovered fully in 1 to 3 months after the operation.

PNEUMOTHORAX

2009-12-02T07:48:00.000-08:00

NORMAL ANATOMY

The lungs are paired organs that lie in the thoracic cavity. The lungs extract oxygen from inhaled air and transport the oxygen to the blood. Surrounding the lungs is a very thin space called the pleural space. The pleural space is usually extremely thin, and filled with a small amount of fluid.

INDICATION

If air enters the pleural space, the lung will collapse. This is called a pneumothorax. If the chest wall is penetrated, which may occur as a result of an injury, air can enter the pleural space from the outside. Air can also enter from the inside, from the lung itself, if the lung is torn or ruptured. One of the most common causes of spontaneous non-traumatic pneumothorax is a pulmonary blab. This is a weakness and out-pouching of the lung tissue, which can rupture. This introduces air into the pleural space.

INCISION

Pneumothorax can be life-threatening. The immediate treatment for pneumothorax is tube thoracostomy, or the insertion of a chest tube. A long, flexible, hollow, narrow tube is inserted through the ribs into the pleural splice, and the tube is attached to a suction device. This allows the air to be evacuated from the pleural space, and allows the lung to re-expand. Chest tubes are generally inserted using local anesthesia. The chest tube is left in place until the lung leak seals on its own; this usually occurs within two to five days.

PROCEDURE

Pulmonary blabs can be rejected, preventing future pneumothorax. This is frequently done using a thoracoscopic surgical procedure. The patient is put to sleep using general anesthesia. Long, narrow instruments, including one with a camera on the end to allow for visualization of the interior of the thorax, are introduced through small incisions in the chest wall.

AFTERCARE

A stapling device is inserted into the chest during thoracoscopic surgery, and the segment of lung with blabs is stapled across and then removed. Most patients respond quite well to this procedure, and usually require one to three days in the hospital after surgery to recover. A chest tube is frequently left in place for one to two days after surgery to evacuate any residual air in the pleural space.

HEART LUNG TRANSPLANT

2009-12-02T07:43:00.000-08:00

NORMAL ANATOMY

The heart and lungs are located in the thoracic cavity, or chest cavity. The heart pumps blood from the body to the lungs, where the blood is oxygenated by lungs. It then returns the blood to the heart, which pumps the freshly oxygenated blood to the rest part of the body.

INDICATION

those person who has both cardiac or lungs disease who can be transplant their lung and heart.its transplantation known by heart lung transplantation. The most common reasons for a combined heart-lung transplant are pulmonary hypertension, cystic fibrosis, lung disease associated with damage to the right ventricle of the heart, and various congenital defects of the heart and lungs.

PROCEDURE

Heart-lung transplant operations have been performed since 1980 in the United States. The donated heart and lungs come from a human who has been declared brain-dead but remains on a life-support machine. A single recipient may receive one or both donor lungs. The tissues must be a match to help ensure that the patient does not reject the transplanted tissue. While the patient is deep asleep and pain-free, an incision is made through the breast bone (sternum). Tubes are used to re-route the blood to a heart-lung bypass machine that keeps the blood oxygenated and circulating during the surgery.

ALFA FETOPROTIEN SERIES

2009-12-02T07:34:00.000-08:00

INDICATION

Alpha fetoprotein (AFP) cause a protein produced by the liver and yolk sac of a fetus.there is no normal function in adults. The alpha fetoprotein test (AFP) is a blood testwhich is performed to measure or diagnose or monitor fetal distress or fetal abnormalities. It can also detect some liver disorders and some cancers in adults.During pregnancy, this test, along with the examination of amniotic fluid (amniocentesis), can help detect fetal spinal bifida or other defects of the fetus' neural tube.

PROCEDURE

The AFP test is used taking a blood sample. Blood is drawn from a vein, usually from the inside of the elbow or the back of the hand.Usually, there is little pain associated with a blood drawing. When the needle is inserted to draw blood, some people feel moderate discomfort, while others feel only a prick or stinging sensation. There are few risks with this test Excessive bleeding. Fainting or feeling light headed. Hematoma (blood accumulating under the skin). Infection (a slight risk any time the skin is broken). Multiple punctures to locate veins.

RESULT

Normal AFP levels for men for non-pregnant women are less than 300 nano grams per milliliter.Greater-than-normal levels of AFP in men and non-pregnant women may indicate cancer in testes, ovaries, biliary (liver secretion) tract, stomach, cancer malignant from hepatitis.

ARTERIAL BYPASS LEG SERIES

2009-12-02T04:56:00.000-08:00

NORMAL ANATOMY

Artery by pass leg series are those type of artery which supply blood to the leg originate from the aorta and iliac vessels.

INDICATION

These arteries can be become blocked with athero sclerotic plaque. Symptoms of such a blockage include pain, most frequently in the foot and calf, and ulcers and non-healing sores of the foot and leg.

INCISION

Peripheral arterial bypass surgery is required for atherosclerotic lesions in the arteries of the leg. This surgery involves using a vein graft ,taken from the same leg, and suturing the vein into the artery to bypass the blockage. While the patient is anesthetized ,an incision is made in the inside of the leg from the groin to below the knee.

PROCEDURE

The vein is freed from the surrounding tissue, and then sewn into place in the artery, above and below the atherosclerotic blockage.

AFTERCARE

Patients usually are able to walk within a few days of surgery, and often experience relief from pain immediately.

CSF OF OLIGOCLONAL BANDING

2009-12-02T03:42:00.000-08:00

NORMAL ANATOMY

The brain of man is situated in the region of head called cranium.it is surrounded by some layers,called meninges.the outer layer is thick ,hard and fibrous,known as durameter and inner layer is thin,called piameter.it contains blood capillaries which supply food or nutrients and oxygen to the cells of brain.in the upper and lower region of thin layer a fluid is found,called cerebro-spinal fluid.and collect waste products, as well as provide lubrication.

PROCEDURE

A sample of the CSF will be taken from the lumbar area of the spine. This is called a lumbar puncture. the position used during lumbar puncture may be uncomfortable, but you must remain in the curled position to avoid moving the needle and possibly injuring the spinal cord. There also may be some discomfort with the needle prick and the insertion of the lumbar puncture.Headache after the test.Bleeding into the spinal canal.Brain herniation (if performed on a patient with increased intracranial pressure), which can result in brain damage and/or death.Damage to the spinal cord (particularly ithe patient moves during the test).

GROWTH HORMONE STIMULATION TEST SERIES

2009-12-02T03:24:00.000-08:00

NORMAL ANATOMY

The growth hormone (GH) are the substances which are produced in particular cells or it is protein hormone released from the anterior pituitary gland under the control of the hypothalamus. In children, GH has growth-promoting effects on the body. It stimulates the secretion of somatomedins from the liver, which are a family of insulin-like growth factor (IGF) hormones. These, along with GH and thyroid hormone, stimulate linear skeletal growth in children. In adults, GH stimulates protein synthesis in muscle and the release of fatty acids from adipose tissue (anabolic effects). It inhibits uptake of glucose by muscle while stimulating uptake of amino acids. The amino acids are used in the synthesis of proteins, and the muscle shifts to using fatty acids as a source of energy. GH secretion occurs in a pulsatile (short, concentrated secretion) and sporadic manner. Thus, a single test of the GH level is usually not performed.

INDICATION

Why the test is performed: This test is typically performed on infants and children to identify human growth hormone (hGH) deficiency as a cause of growth retardation. It is also used to detect a pituitary tumor.

PROCEDURE

Because of the sporadic release of GH, the patient will have his blood drawn a total of five times over a few hours. Instead of the traditional method of blood drawing (veinipuncture), the blood is taken through an IV (angiocatheter).You should fast and limit physical activity for 10 to 12 hours before the test. If you are taking certain medications, your health-care provider may ask that you withhold these before the test, as some can affect results.You will be asked to relax for at least 90 minutes before the test, as exercise or increased activity can alter hGH levels. Inform your health-care provider if you or your child has had a radioactive scan performed within a week of this test, as radioactive scans can affect test results.when the needle is inserted, some people feel moderate pain, while others feel only a prick or stinging sensation. Afterward, there may be some throbbing.What the risks are:Risks associated with venipuncture are slight:excessive bleeding fainting orfeeling lightheaded hematoma (blood accumulating under the skin)infection (a slight risk any time the skin is broken)multiple punctures to locate veinsclinical signs and symptoms of hypoglycemia if IV Insulin is adminstered.

RESULT

A diminished amount of GH indicates a problem either in the hypothalamus or the pituitary. Additional testing can illustrate the exact site of the deficiency. In children, a deficiency of GH results in dwarfism. In adults, it may be associated with panhypopituitarism.

COMPLETE BLOOD COUNT SERIES

2009-12-02T03:17:00.000-08:00

INDICATION

The complete blood count (CBC) is a screening test. it is used to diagnose and manage numerous diseases. It can reflect problems with fluid volume (such as dehydration) or loss of blood. It can show abnormalities in the production, life span, and destruction of blood cells. the CBC test isolates and counts the 7 types of cells found in the blood: eosinophil, neutrophil, basophil, lymphocyte, monocyte, red blood cell, and platelets.

PROCEDURE

A CBC requires a small blood specimen. Blood is taken from a vein, usually from the inside of the elbow or the back of the hand.The skin should be cleaned with alcohol or iodine before the test. The patient should be seated comfortable or recleaning.When the needle is inserted to taken blood, some people feel moderate pain, while others feel only a prick or stinging sensation. After the blood is taken, there may be some throbbing.Although the CBC test is very safe, any blood taking has a slight risk of complication, including:Oozing of blood from the puncture site Fainting or feeling lightheaded Hematoma (blood accumulating under the skin)Multiple punctures to locate veins Infection (a slight risk any time the skin is broken)

RESULT

Normal values vary with altitude and gender,low numbers of red blood cells may indicate anemia which has many causes including:Blood lossIron deficiency Deficiencies of vitamin B12 or folic acid Bone marrow failure (for example, from radiation, toxin, fibrosis, tumor)Erythropoietin deficiency.

High numbers of red blood cells may indicate:Cigarette smoking Low oxygen tension in the blood Congenital heart disease .Pulmonary fibrosis Dehydration (such as from severe diarrhea)Emphysema.

VENUS THROMBOSIS SERIES

2009-12-02T02:50:00.000-08:00

NORMAL ANATOMY

Venus thorambosis are those arteries which supply blood to the leg originate from the aorta and iliac vessels.

INDICATION

These arteries can be become blocked with atherosclerotic plaque. Symptoms of such a blockage include pain, most frequently in the foot and calf, and ulcers and non-healing sores of the foot and leg.

PROCEDURE

Peripheral arterial bypass surgery is required for atherosclerotic lesions in the arteries of the leg. This surgery involves using a vein graft (saphenous vein), taken from the same leg, and suturing the vein into the artery to bypass the blockage. While the patient is anesthetized using general or spinal anesthesia, an incision is made in the inside of the leg from the groin to below the knee

The vein is freed from the surrounding tissue, and then sewn into place in the artery, above and below the atherosclerotic blockage.

AFTERCARE

Patients usually are able to walk within a few days of surgery, and often experience relief from pain immediately.

STROKE SERIES

2009-12-02T02:37:00.000-08:00

NORMAL ANATOMY

The CNS of a vertebrate develops in the embryo from the dorsal,hollow nerve cord.in the initial stage,nerve cord is simply a tube filled with CSF. Much of the brain is supplied blood by the internal carotid arteries.

The internal carotid arteries branch at the base of the brain in an area called the circle of Willis.

PART NO 3

A blood clot (thrombus) may form in the body, break-off, and travel to the brain through a carotid artery and the circle of Willis.

PART NO 4

The blood clot may block the passage of blood through a brain artery, depriving nearby tissue of oxygen and nutrients. The result is a stroke

CRANIOTOMY SERIES

2009-11-29T21:31:00.000-08:00

NORMAL ANATOMY

The brain is located inside the cranium. The cranium is a set of bones which makes up the skull, and protects and holds the brain.the brain divided into three irregular vesicals,the fore brain,mid brain ,and hind brain.

INDICATION

Brain surgery may be needed to treat brain tumors bleeding (hemorrhage) or blood clots (hematomas) from injuries (subdural hematoma or epidural hematomas)weaknesses in blood vessels (cerebral aneurysms)damage to tissues covering the brain (dura)pockets of infection in the brain (brain abscesses)severe nerve or facial pain (such as trigeminal neuralgia or tic douloureux)epilepsy

PROCEDURE

The hair on part of the scalp is shaved. An incision is made through the scalp and a hole is drilled through the skull. A piece of the skull may be removed while the brain is being operated on and replaced before the skin is stitched closed. The surgery in which the brain is accessed through the skull is called "craniotomy".

AFTERCARE

The results depend on the source, severity, and location of the problem.

BREAST REDUCTION (MASTOPEXY) SERIES

2009-11-29T21:11:00.000-08:00

INDICATION

Breast reduction is usually performed for enlarged breasts (macromastia), but may also be indicated by cystic breast infections (polycystic mastitis)back pain, neck pain, shoulder pain, breast pain, or headachesloss of sensation in the breasts, arms, or fingerssleeping problems or poor posture resulting from large breasts pigmented bra-strap groovestriae (scarlike lines) on the breasts Mammograms (breast X-rays) and a routine breast exam are required before surgery.

INCISION

Breast-revision surgery is performed while you are deep asleep and pain-free (using general anesthesia), in either an outpatient facility or in the hospital.

PROCEDURE

Incisions are made along the natural creases in the breast and around the dark pink skin surrounding the nipple (areola). A keyhole-shaped incision above the areola is also made to define the new location of the nipple. Skin is then removed from the lower section of the breast. The areola, nipple, and underlying breast tissue are moved up to a higher position. The nipple is moved and incisions are closed with stitches (sutures).

RESULT

For a reduction in breast-size, some of the breast tissue is removed and the nipples are relocated higher on the breasts for cosmetic reasons. After surgery, a bulky gauze dressing is wrapped around the breasts and chest. There may be temporary loss of sensation in the breast skin and nipples after surgery. This condition improves with time. Within two weeks of surgery, stitches (sutures) are removed.and the pain will be remove by the meditation.

ABDOMINOPLASTY SERIES

2009-11-29T21:02:00.000-08:00

INDICATION

abdominoplasty disease related to abdomen disease.it is occur by the enlarge amount of fat can collect in the belly. In abdominoplasty, some of the fat is removed by the surgery.

PROCEDURE,PART 1

The surgeon will make a cut in the fold under the belly. This is the "bikini line." Skin is also cut around the belly button. A large area of fat and skin are then pulled away from the muscle.the surgeon are to tighten the abdominal muscles in the belly.The skin is also stretched downward. after that Extra skin and fat are trimmed away. A new hole will be cut for the belly button. The opening will then be closed with stitches.

RESULT

After surgery, there may be some pain and discomfort. This may last for several days. Resting with the legs and hips bent will put less stress on the belly. The remaining scar will fade with time.

LIPOSUCTION SERIES

2009-11-29T20:52:00.000-08:00

INDICATION

in the human body "Fat" are "settle" in certain parts of the body. Women get fat mostly in the stomach, buttocks, hips, and thighs. Men, on the other hand, can get fat in the belly and waist. Liposuction procedure may help people who want to do less fat in these parts of their body. But this procedure is not for those people who are very overweight.

PROCEDURE

A special machine and tools are used in this procedure. The person will be given medicine and fall asleep. The surgeon will push small suction tools through the skin into the fat pockets or those places where fats are present. The tools will break up the fat and suck it out. Small tubes may be placed in the area to help drain fluids for the first few days after the surgery.

AFTERCARE

The person can be wearied special clothing over the area to help cut down on swelling and bleeding. The clothing presses on the skin and tissue underneath. It will also help the skin shrink and fit the new body shape.

FACELIFT SERIES

2009-11-29T20:49:00.000-08:00

INDICATION

Sagging or wrinkled skin occurs naturally with increasing age. Folds and fat deposits appear around the neck, and deep flexion creases form between the nose and mouth. The jawline grows jowly and slack. Heredity, poor diet, smoking, or obesity may contribute to early or severe skin problems. A facelift can help repair some of the visible damage to skin, fat, and muscles and can restore a younger look. A facelift can be done alone or with nose reshaping, a forehead lift, or eyelid surgery.

INCISION

While the patient is sleepy (sedated) and pain-free (local anesthesia) or deep asleep and pain-free (general anesthesia), the plastic surgeon makes incisions above the hairline at the temples, behind the earlobe, to the lower scalp. The surgeon removes some of the fat tissue and loose skin, then stitches (sutures) the incisions closed.

RESULT

Usually there is not much discomfort after surgery and pain medication can relieve it. Some numbness of the skin is normal and will disappear in a few weeks or months. The head will be elevated on two pillows (or at a 30 degree angle) for a couple of days after surgery to keep the swelling down. The drainage tube will be removed 1 to 2 days after surgery if one was inserted. Bandages are usually removed after 1 to 5 days. The face will look pale, bruised, and puffy, but in 4 to 6 weeks it will be looking normal. Most of the stitches will be removed in 5 days. The stitches or metal clips in the hairline could be left in a few days longer if the scalp takes longer to heal.

BREAST AUGMENTATIOM SERIES

2009-11-29T20:44:00.000-08:00

NORMAL ANATOMY

The breasts consists of a framework of connective tissue and a system of glands and ducts that produce milk. Fat makes up the majority of the breast tissue. Behind the breast tissue are the Pectoralis muscles.

INCISION

Incision sites are made as inconspicuous as possible, either in the armpit, around the areola, or under the breast.

PROCEDURE,PART 1

The implant may be placed beneath the breast tissue.

PROCEDURE,PART 2

The implant may be placed beneath the pectoralis muscle and the breast tissue.

AFTERCARE

A woman's decision to have breast augmentation varies from person to person, which may include increasing feelings of confidence and self-esteem.

HUMANGIOMA EXCISION

2009-11-29T20:37:00.000-08:00

INDICATION

Hemangiomas are the most common type of benign blood-vessel growths that occur in infants and children. They are frequently located on the face, but can occur anywhere. Most appear within the first few weeks of birth, and most regress within a few years. Large or disfiguring hemangiomas, or hemangiomas that fail to regress, require surgical removal.

PROCEDURE

While the infant is deep asleep and pain-free (using general anesthesia), the hemangioma is removed. If the hemangioma is large, the site is covered with a skin graft.

AFTERCARE

Cosmetic repair depends on the size of the lesion and the surgeon's skill. Generally, the long-term prognosis is quite good. The hospital stay is two to five days, depending on the extent of surgery. Complete healing takes up to six weeks.

VERTIBROPLASTY SERIES

2009-11-29T20:20:00.000-08:00

NORMAL ANATOMY

The spine is made up of bones (vertebrae) separated by soft cushions (intervertebral discs).

INDICATION

Vertebral fractures occur in thousands of people each year. The main cause of these fractures is osteoporosis. Osteoporosis causes bone to lose strength and become weak and susceptible to fractures.

PROCEDURE

Using a special x-ray machine, a bone needle is guided through the skin and into the fractured vertebra. A cement-like material called polymethylmethacrylate acrylic cement (PMMA) is injected into the vertebra. The needle is removed and the cement hardens, stabilizing the vertebra.

AFTERCARE

Vertebroplasty is a relatively new procedure. It helps to stabilize the vertebral fracture which in turn helps reduce or eliminate the patient's pain.

ANKLE SPRAIN SERIES

2009-11-29T20:15:00.000-08:00

NORMAL ANATOMY

The ankle joint connects the foot with the leg. The ankle joint allows the foot to move upward and downward and in an inward and outward motion. Muscles, tendons, and ligaments surround the ankle providing the stability the ankle joint needs for walking and running.

TYPE I ANKLE SPRAIN

The most common way the ankle can be injured is by an ankle sprain. When an ankle is sprained ligaments on the ankle are either stretched, partially torn or completely torn. The most common type of sprain is an inversion injury, where the foot is rotated inward. Ankle sprains can range from mild, to moderate, and severe. Type 1 ankle sprain is a mild sprain. It occurs when the ligaments have been stretched or torn minimally.

TYPE Ii ANKLE SPRAIN

Type II ankle sprain is a moderate level of sprain. It occurs when some of the fibers of the ligaments are torn completely.

TYPE Iii ANKLE SPRAIN

Type III ankle sprain is the most severe ankle sprain. It occurs when the entire ligament is torn and there is great instability of the ankle joint.

SPINAL FUSION

2009-11-29T20:06:00.000-08:00

NORMAL ANATOMY

The vertebrae are the bones that make up the spinal column, which surrounds and protects the spinal cord. The intervertebral disks are soft tissues that sit between each vertebrae and act as cushions between vertebrae, and absorb energy while the spinal column flexes, extends, and twists. Nerves from the spinal cord exit the spinal column between each vertebra.

INDICATION

Spinal fusion is a surgical technique in which one or more vertebrae are fused together to stop the motion between them.Spinal fusion may be recommended for:Abnormal curvature of the spine (scoliosis or kyphosis)Injury to the spinal vertebraeProtrusion of the cushioning disk between vertebrae (slipped disk, herniated nucleus pulposus)Weak or unstable spine caused by infections or tumors

INCISION

Different incisions are made depending on the area to be treated. The approach can be made either from the front (anterior), from the back (posterior), or both.

PROCEDURE,

In a posterolateral gutter fusion procedure, the spine is approached from the back. Bone graft is taken from the pelvis and laid out in the posterolateral portion of the spine that is to be fused. The back muscles hold the graft in place until it fuses with the vertebrae. A fusion will setup within three months and will continue to get stronger for one to two years.

INTERBODY CAGE FUSION

Interbody cage fusion uses a hollow threaded titanium or carbon fiber cylinder to fuse two vertebrae together. The diseased disk is removed and two interbody cages are placed in the opening where the diseased disk has been removed. The cages are filled with bone graft. The bone grows through the holes in the cages fusing the vertebrae.

AFTERCARE

2009-11-29T19:04:00.000-08:00

NORMAL ANATOMY

Bone-marrow is a soft, fatty tissue found inside of bones that produces blood cells (red blood cells, white blood cells, and platelets). Red blood cells carry oxygen throughout the body. White blood cells act to ward off infection. Platelets aid in blood-clotting.

INDICATION

Bone-marrow transplants are performed for:deficiencies in red blood cells (aplastic anemia) and white blood cells (leukemia or lymphoma)aggressive cancer treatments (chemotherapy or radiation therapy)inherited (genetic) diseases (such as thalassemia)immune-system disorders (such as congenital neutropenia and severe-combined immunodeficiency syndrome)

PROCEDURE

While you are awake and pain-free (using local anesthesia), bone marrow is removed from the top of the hip bone (iliac crest). The bone marrow is filtered, treated, and transplanted immediately. Other times it's frozen and stored for later use. The bone marrow is then transfused through a vein (IV line). It naturally transports itself back into the intended bone cavities, where it grows quickly to replace the old bone marrow.

AFTERCARE

Bone-marrow transplants prolong the life of patients who might otherwise die. As with all major organ transplants, however, it is difficult to find bone-marrow donors, and the cost of surgery is very high. The donor is usually a sibling with compatible tissue. The more siblings you have, the better the chance of finding the right match. Occasionally, unrelated donors act as a source for bone-marrow transplants. The hospitalization period is three to six weeks. During this time, you are isolated and under strict monitoring because of the increased risk of infection. Attentive follow-up care is required for two to three months after discharge from the hospital. It takes about six months to a year for the immune system to fully recover from this procedure. Relatively normal activities are resumed after consulting with your doctor.

CARPAL TUNNEL REPAIR

2009-11-29T08:44:00.000-08:00

NORMAL ANATOMY

The tendons and nerve to the hand (median nerve) passes between strong ligaments (carpal ligaments) in the wrist and the wrist bones (carpal tunnel).

INDICATION

When the nerves or tendons inside the carpal tunnel swell or become inflamed (carpal tunnel syndrome), pressure on the nerve causes pain, numbness, tingling, or weakness in the fingers and wrist.The nerve most commonly affected in carpal tunnel syndrome is the median nerve, which provides motor and sensory function to the hand.Most physicians recommend trying non-surgical treatments (such as: splinting the wrist, using anti-inflammation medications) before recommending surgery.

PROCEDURE

Carpal tunnel repair is done while the patient is awake or sleepy and pain-free (local or regional anesthesia) or deep asleep and pain-free (general anesthesia). Through an incision on the inside of the wrist, the carpal ligament is cut open to relieve the pressure on the nerve. The incision is stitched (sutured) closed.

AFTERCARE

The surgery is usually very successful in relieving symptoms. Numbness or tingling that continues after surgery is usually due to damage to the nerve. A splint may be used to reduce wrist motion. The surgery is usually done as an outpatient. Complete recovery takes about 4 weeks.

BONE FRACTURE REPAIR

2009-11-29T08:34:00.000-08:00

INDICATION

Fractures of the bones are classified in a number of ways. A simple fracture involves a single fracture line through a bone. A comminuted fracture is one in which the bone has been fractured into two or more fragments. An open fracture is one in which the fractured bone penetrates the skin.

PROCEDURE

The three main treatment options for bone fractures are:CastingOpen reduction, and internal fixation- this involves a surgery to repair the fracture-frequently, metal rods, screws or plates are used to repair the bone, and remain in place, under the skin, after the surgery. This procedure is recommended for complicated fractures not able to be realigned (reduced) by casting, or in cases in which the long-term use of a cast is undesirable.Open reduction, and external fixation- this involves a surgery to repair the fracture, and placement of a external fixation device on the limb with the fracture. This device is an external frame which supports the bone and hold it in the correct position while it is healing. This technique is generally applied to complex fractures that cannot be repaired using open reduction, and internal fixation.

PROCEDURE

While the patient is pain-free (general or local anesthesia), an incision is made over the fractured bone. The bone is placed in proper position and screws, pins, or plates are attached to or in the bone temporarily or permanently. Any disrupted blood vessels are tied off or burned (cauterized). If examination of the fracture shows that a quantity of bone has been lost as a result of the fracture, especially if there is a gap between the broken bone ends, the surgeon may decide that a bone graft is essential to avoid delayed healing. If bone grafting is not necessary, the fracture can be repaired by the following methods:a) one or more screws inserted across the break to hold it.b) a steel plate held by screws drilled into the bone.c) a long fluted metal pin with holes in it, is driven down the shaft of the bone from one end, with screws then passed through the bone and through a hole in the pin.In some cases, after this stabilization, the microsurgical repair of blood vessels and nerves is necessary. The skin incision is then closed in the usual fashion.

AFTERCARE

The advantage of internal fixation is that it often allows early mobility and faster healing. Unless the internal fixation causes problems, it is not necessary or desirable to remove it. The long-term prognosis is excellent. The length of the hospital stay depends on factors such as the condition of the bone, the presence of infection, the state of the blood and nerve supply, and presence of other injuries. Children's bones heal rapidly, usually in 6 weeks time.

BLEPHAROPLASTY SERIES

2009-11-29T07:56:00.000-08:00

INDICATION

Eyelid surgery (blepharoplasty) is used to correct "puffy bags" below the eyes and drooping upper lids that make the patient look older and tired or that interferes with vision. Eyelid surgery will not remove wrinkles around the eyes, lift sagging eyebrows, or eliminate dark circles under the eyes.

INDICATION

Sagging eyelids are a normal part of aging. Fat deposits may increase as skin thins and wrinkles.

INCISION

Incisions are made in the natural creases or folds of the eyelids. Underlying fat may be removed, excess skin is trimmed along the natural fold in the eyelid.

AFTERCARE

After healing, the scars fade and are unnoticeable.

BREAST RECONSTRUCTION SERIES

2009-11-29T04:13:00.000-08:00

INDICATION,PART1

The normal female breasts are paired structures that contain fat and glandular tissue designed to secrete milk. Cancer of the breast is one of the more common cancers in women. Risk factors include a family history of breast cancer, early age at first period, and late menopause.

INDICATION,PART2

Breast removal (mastectomy), is performed most frequently for cancer of the breast. Occasionally, in patients with a strong family history of breast cancer and genetic abnormalities that predispose them to breast cancer, bilateral prophylactic mastectomies are performed to prevent the future occurrence of breast cancer.

INCISION

Reconstruction of the breast after mastectomy is performed in select patients who have very small tumors, or who undergo prophylactic (preventative) bilateral mastectomy. First, tissue from the lower abdomen, including skin, muscle, and blood vessels, is removed. This is called a TRAM flap.

PROCEDURE,PART 1

The flap is then transferred under the skin between the two sites, and sutured into place.

PROCEDURE,PART2

Alternatively, a saline filled prosthesis can be implanted under the skin and muscle after mastectomy. Over the next few weeks and months, the prosthesis is slowly filled with increasing amounts of saline by injection, which expands the overlying skin and creates a breast mound.

AFTERCARE

The final step is nipple reconstruction. One method involves taking a partial graft from the remaining nipple to create a new one. In another method, the surgeron raises a small area of skin on the reconstructed breast and tattoos it at a later date. The overall results of breast reconstruction, while not perfect, are usually excellent. Nevertheless, patients should discuss their expectations with their surgeon at length prior to surgery.

CLEFT LIFT REPAIR

2009-11-29T03:07:00.000-08:00

NORMAL ANATOMY

A cleft lip is an abnormal opening in the middle of the upper lip. A cleft palate is an opening in the roof of the mouth (palate).

INDICATION

Cleft lip repair and cleft palate repair are indicated for:repair of physical deformitynursing, feeding, or speech problems resulting from cleft lip or palate

PROCEDURE

While the baby is anesthetized and asleep (general anesthesia), the tissues around the defect are trimmed and sewn together with several layers of stitches (absorbable sutures). The skin is sewn together with very small, fine stitches (sutures) to make the scar as small as possible. In cleft palate repair, tissue from the back of the mouth (pharynx) may be taken to add tissue to the deficient soft palate (this is called a pharyngeal flap). Occasionally more than one surgery is required for complete palate closure.

AFTERCARE

Most babies heal without complications. The cosmetic result often depends on the severity of the deformity and is usually quite good.

CHIN AUGMENTATION

2009-11-29T03:03:00.000-08:00

NORMAL ANATOMY

The mandible, or lower jaw, determines much of the facial profile and the alignment of the upper and lower teeth. The teeth must be properly aligned for a normal dental bite.

INDICATION

The best candidates for chin augmentation or genioplasty are patients with weak or receding chins (microgenia), but with a normal dental bite. Expectations of looking and feeling better after surgery should be discussed with the plastic surgeon before any surgery, keeping in mind that the desired result is improvement, not perfection. The facial profile can be balanced by extending the chin in relationship to the nose. Reconstructive genioplasty to correct bite dysfunction can be performed in conjunction with jaw surgery. Thousands of genioplasties are performed successfully each year. Surgery may be performed in the surgeon’s office-based facility, a hospital, or an outpatient facility.

INCISION

One surgical approach is to make an incision inside the mouth along the inferior sulcus (a landmark inside the jaw) to gain access to the chin bone. There is no incision made on the skin.

PROCEDURE

A horizontal cut (called an osteotomy) is made through the jaw bone (mandible) with a bone saw or chisel. The lower portion of the separated bone is moved forward to the desired position and wired in place. The neurological nerves are carefully protected. The incision is closed with sutures and an external pressure dressing is applied. There is no visible scarring since the surgery is performed through an incision inside the mouth.

AFTRECARE

2009-11-29T02:37:00.000-08:00

INDICATION

Dermabrasion may be offered to patients with:Facial scars from acne, accidents, and previous surgeryFine facial wrinkles, such as around the mouthPrecancerous growths (keratoses)

PROCEDURE

Dermabrasion is usually done while you are awake. You will receive local anesthesia. This means the doctor will numb the area to be worked on.A surgical instrument is used to gently and carefully "sand" the scar tissue off down to normal, healthy skin. The healing tissue is treated with ointments (such as petroleum jelly or antibiotic ointments) to reduce scab formation (crusting) and therefore reduce scar formation.

AFTERCARE

The skin may be treated with ointment and a wet or waxy dressing. After surgery, your skin will be quite red and swollen. Eating and talking may be difficult. You may have some aching, tingling, or burning for a while after surgery. Your doctor can prescribe medicine to help control any pain.Swelling usually goes away within 2 - 3 weeks. New skin starts to itch as is grows. If you had freckles, they may temporarily disappear.If the treated skin remains red and swollen after healing has started, this may be a sign that abnormal scars are beginning to form. Talk to your doctor. Treatment may be available.The new layer of skin will be a little swollen, sensitive, and bright pink for several weeks. Most patients can go back to normal activities in about 2 weeks. You should avoid any activity that could cause injury to the treated area. Avoid sports that involve balls, such as baseball, for 4 - 6 weeks.Protect the skin from the sun for 6 - 12 months until your skin coloring has returned to normal.

SKIN GRAFT

2009-11-29T02:33:00.000-08:00

NORMAL ANATOMY

Skin grafting involves the taking a thin (split thickness) layer of skin from another part of the body and placing it over the injured area. Skin flap surgery involves moving an entire thickness (full thickness) of skin, fat, nerves, blood vessels, and muscle from a healthy part of the body to the injured site. These techniques are planned when a considerable amount of skin has been lost in the original injury, when a thin scar will not heal, and when improved function (rather than aesthetic reasons) are the primary concern. Secondary procedures may later be necessary to achieve appropriate aesthetic results.

INCISION

The skin covers the entire body, and acts as a protective barrier. Skin grafts may be recommended for:extensive woundsburnsspecific surgeries that may require skin grafts for healing to occur.The most common sites of harvest for skin grafts are the buttocks and inner thigh, areas which are usually hidden and therefore cosmetically less important.

PROCEDURE

While the patient is awake, sleepy (sedated), or deep asleep and pain-free (local anesthesia or general anesthesia), healthy skin is taken from the selected donor site on the patient's body using a dermatome (skin-cutting instrument).

AFTERCARE

The graft is carefully spread on the bare area to be covered. It is held in place either by gentle pressure from a well-padded dressing or by a few small stitches. The raw donor area is covered with a sterile nonadherent dressing for 5-7 days to protect it from infection. The donor area heals on its own within 2-3 weeks.

Skin grafts usually heal with little scarring, and often look similar to surrounding normal skin.

SCAR REVISION

2009-11-29T02:30:00.000-08:00

NORMAL ANATOMY

Skin covers the entire body, and acts as a protective barrier. Scar tissue forms as skin heals after an injury (such as an accident) or surgery. The amount of scarring may be determined by the size, depth, and location of the wound; the age of the person; heredity; and skin characteristics including color (pigmentation). No scar can be removed completely. The degree of improvement will depend on variables such as the direction and size of the scar, the age of the person, skin type and color, and hereditary factors that may precondition the extent of the healing process.

INDICATION

Scar removal and revision is best performed after months or years of healing. Medications (topical corticosteroids, anesthetic ointments, and antihistamine creams) can reduce the symptoms of itching and tenderness during this time. Scars shrink and becomes less noticeable as they age, therefore, immediate surgical revision is delayed until the scar lightens in color, which is usually several months or even a year after a wound has healed. A keloid is an abnormal scar that is thicker, different color and texture, extends beyond the edge of the wound, and has a tendency to recur. It often creates a thick, puckered effect simulating a tumor. Keloids are removed at the point where it meets normal tissue. The skin is then sutured closed. Keloids often recur at the site of scar revision.

PROCEDURE,PART 1

Surgery to revise scars is done while the patient is awake, sleeping (sedated), or deep asleep and pain-free (local anesthesia or general anesthesia). Massive injuries (such as burns) can cause loss of a large area of skin and may form hypertrophic scars. A hypertrophic scar can cause restricted movement of muscles, joints, and tendons (contracture). Surgical repair includes removing excessive scar tissue and a series of small incisions on both sides of the scar site, which create V-shaped skin flaps (Z-plasty) may be used. The result is a thin, less noticeable scar because the wound closure following a Z-plasty more closely follows the natural skin folds.

PROCEDURE,PART 2

OBSTETRICS

2009-11-29T02:18:00.000-08:00

ANTERIOR VAGINAL REPAIR
D&C
EPISIOTOMY
HYSTERECTOMY
TUBAL LIGATION
C SECTION SERIES
BREECH SERIES
ANNIOCENTERIES SERIES
CHORIONIC VILLUS SAMLING
EPIDURAL SERIES
PERCUTANEOUS UMBILICAL CORD BLOOD SAMPLING
ULTRASOUND SERIES

PEDIATRICS SERIES

2009-11-29T02:02:00.000-08:00

MENINGOCDE REPAIR SERIES
INTESTINAL OBSTRUCTION SERIES
EXCHANGE TRANSFUSION
PATENT DUCTUS ARTERIOSIS
OMPHALOCADE REPAIR
PECTUS EXCEVATUM REPAIR
GASTROSCHISIS HERNIA REPAIR

OPHTHALMOLOGY

2009-11-28T07:41:00.000-08:00

VASCULAR SERIES

2009-11-27T00:16:00.000-08:00

CORONARY ARTERIAL BY PASS LEG SERIES
VENUS THROMBOSIS SERIES
STROKE SERIES

UROLOGY SERIES

2009-11-26T23:44:00.000-08:00

KIDNEY TRANSPLANT
PROSTATECTOMY
TURP
KIDNEY REMOVAL
BLADDER AND URETHRAL REPAIR
HYDROCODE REPAIR SERIES
TESTICULAR TORSION REPAIR SERIES
OSMOLALITY URINE SERIES
PATENT URACHUS REPAIR

NEUROLOGY SERIES

2009-11-26T23:43:00.000-08:00

CRANIOTOMY SERIES

HEAMATOLOGY

2009-11-26T23:38:00.000-08:00

THORACIC SURGERY

2009-11-26T23:31:00.000-08:00

Heart lung transplant
Pneumothorax
Coronary artery Balloon Angioplasty series
Heart volve surgery series
Heart bypass surgery
Chest tube insertion
Heart transplant
Tracheo-esophageal fistula repair series
Pulmonary lobertomy

2009-11-26T20:14:00.000-08:00

NORMAL ANATOMY

The nose is made up of bone and cartilage. The size and relationship of the bone and cartilage which make up the nose determine the size and shape of the nose.

INDICATION

Nose surgery (rhinoplasty) offers improvement in the appearance in cases in which the nose is cosmetically unappealing. Age may also be a consideration. Many surgeons prefer not to perform cosmetic (elective) rhinoplasties until the growth of the nasal bone is completed (around 14 or 15 for girls, a bit later for boys).

PROCEDURE

With local anesthesia, the nose and the surrounding area is numbed. The patient will usually be lightly sedated but awake during the surgery, and relaxed and insensitive to pain. The surgery is usually done through the incision inside the nostrils. Instruments inserted through the nostril, are used to reshape the bones which make up the nose.

AFTERCARE

The results of surgery are variable, depending on the initial shape of the nose, but rhinoplasty offers significant improvement in appearance in many cases.

EAR,NOSE,AND,THORAT SURGERY

2009-11-25T08:45:00.000-08:00

COLON CANCER SERIES

2009-11-25T04:32:00.000-08:00

NORMAL ANATOMY
The colon, or large intestine, is a muscular tube that begins at the end of the small intestine and runs to the rectum. The colon absorbs water from liquid stool that is delivered to it from the small intestine.

INDICATION NO 1
Diverticula are out-pouchings of the wall of the colon. They are thought to be the result of a diet low in fiber. By the age of 60, over half of all Americans have colonic diverticula.
INDICATION NO 2
In most cases, diverticula go unnoticed. However, in a small percentage of patients, diverticula can cause problems. The most common problem is diverticulitis, which occurs when a small, hard piece of stool is trapped in the opening of the diverticula. This leads to inflammation and death of the segment of colon containing the diverticula.
INDICATION NO 3
Diverticula can also bleed and cause significant blood loss from the gastrointestinal tract. Vessels overlying a diverticula are stretched until they break, causing bleeding into the colon. Blood is usually passed in the stool.
INCISION
Treament of diverticulitis and diverticular bleeding involves surgical removal of the segment of colon containing the diverticula. While the patient is deep alseep and pain free (general anesthesia), an incision is made in the midline of the abdomen.
PROCEDURE
After the diseased area is removed, the healthy ends of the colon are sewn back together. Occasionally, especially in cases of diverticulitis, where there is significant inflammation, a colostomy is performed. After the inflammation has resided, the colostomy is removed and the healthy ends of the colon are sewn back together.

BILIARY OBSTRUCTION REPAIR

2009-11-25T04:25:00.000-08:00

NORMAL ANATOMY

Bile is a digestive fluid secreted by the liver and stored in the gallbladder which normally is released into the duodenum portion of the small intestine through the sphincter of Oddi. Bile, released after a meal containing fats, aids in absorption and digestion of the fat.

INDICATION

Biliary obstruction occurs when the duct which transports bile from the liver to the small intestine (duodenum) is blocked by a stone, a tumor, an injury or inflammation of any of the ducts. A tumor in the pancreas may press in on the ducts, causing a backup of bile in the gallbladder. Blood tests may indicate a high level of bilirubin, a waste product of the liver, or diagnosis may come from an endoscopic examination.

PROCEDURE

One method of relieving a blockage of the bile duct due to pancreatic tumors is the placement of a stent, a device designed to hold tube-shaped structures open. An endoscope (an instrument placed down the throat into the esophagus, through the stomach to the duodenum of the small intestine) helps the surgeon to see the blockage and to place the stent in the correct position. Dye may be injected and X-ray images taken to insure the stent is correctly placed and the flow of bile is restored.
AFTERCARE

Once the flow of bile is restored, the threat of infection and inflammation is decreased. However, the prognosis may not be significantly altered if the pancreatic carcinoma is otherwise untreatable. Reoccurrence of the blockage (restenosis) may also occur, requiring further surgery or replacement of the stent.

LAPAROSCOPIC SURGERY

2009-11-25T04:02:00.000-08:00

INCISION

Laparoscopic surgery is a surgical technique in which short, narrow tubes (trochars) are inserted into the abdomen through small (less than one centimeter) incisions. Through these trochars, long, narrow instruments are inserted. The surgeon uses these instruments to manipulate, cut, and sew tissue.

PROCEDURE NO 1

Carbon dioxide gas is infused through one of the trochars into the patient's abdomen. This pushes the anterior abdominal wall upward, and makes room for the surgeon to work. A camera, inserted through one trochar, is linked to a video monitor. This allows the surgeon to view the abdominal contents.

PROCEDURE NO 2

Clamps, scissors, and sutures on the end of long, narrow instruments are inserted through the other trochar.
AFTERCARE
A number of different procedures can be performed laparoscopically, including gallbladder removal (laparoscopic cholecystectomy), esophageal surgery (laparoscopic fundoplication), colon surgery (lapraoscopic colectomy), and surgery on the stomach and spleen. One advantage of laparoscopic surgery is that patients recover much more quickly than they do from standard "open surgery" in which a large incision is used. Because the surgeon creates only a few small incisions, rather than one large incision, post-surgery pain is generally reduced.

INTESTINAL OBSTRUCTION REPAIR

2009-11-25T03:42:00.000-08:00

NORMAL ANATOMY

The intestine is made up of the small intestine and the large intestine (colon). The small intestine runs from the stomach to the large intestine. The colon runs from the end of the small intestine to the anus. The intestine absorbs nutrients and water from the diet.

INDICATION Part 1

Obstruction of the intestine occurs when food and water cannot pass through the intestine. The area of intestine nearest to the obstruction becomes dilated and non-functioning. If the obstruction is not relieved, it can lead to intestinal gangrene and perforation.

INDICATION Part 2

The most common causes of intestinal obstruction in adults are adhesions, hernias, and colon cancer. Adhesions are scars that form between loops of intestine, usually caused by prior surgery, which causes such scar formation. Hernias are areas of weakness in the abdominal wall, through which loops of intestine can slip and become trapped. Colon cancer is one of the most common forms of cancer. While each reason for intestinal obstruction requires a different treatment, all intestinal obstructions are potentially life-threatening.

INCISION

In most cases, surgery is necessary. While the patient is deep asleep and pain-free (general anesthesia), an incision is made in the midline of the abdomen. In the case of adhesions, the adhesion is removed, thus relieving the obstruction. In the case of a hernia, the hernia is repaired. If colon cancer is present, cancerous areas are removed, which also relieves the obstruction. .

PROCEDURE

In all cases, the intestine involved in the obstruction is examined. If any parts of the intestine look unhealthy from lack of blood flow during the period of obstruction, they are removed and the healthy ends are reconnected. A patient's recovery depends on several factors, including the cause of the intestinal obstruction and the length of time prior to relief of the obstruction.

medical surgeries

2009-11-25T01:56:00.000-08:00

EAR,NOSE,AND,THORAT SURGERY

2009-11-24T11:00:00.000-08:00

Ear tube insertion
Nose surgery
Adenoid removal
Ear surgery
Mastoidetomy
Emergency airway puncture
Thyriodectomy
Layagoscopy

INFLATABLE ARTIFICIAL SPHINCTER

2009-11-23T02:30:00.000-08:00

NORMAL ANATOMY

Urinary continence is maintained by a muscular sphincter that surrounds the urethra as it exits the bladder

PROCEDURE,Part 1

An artificial urinary sphincter is used to treat stress incontinence in men that is caused by urethral dysfunction such as after prostate surgery. Additionally this procedure may be performed in men and women with sphincter dysfunction related to spinal cord injury or multiple sclerosis. Most experts advise their patients to try medication and bladder retraining therapy first before resorting to this treatment. Alternatives to this procedure are the pubovaginal sling in women or the periurethral injection of collagen in men and women.
PROCEDURE,Part 2
An artificial sphincter consists of three parts:a cuff that fits around the bladder necka pressure regulating balloona pump that inflates the cuff.To treat urinary incontinence, the cuff is placed around the bladder neck so that when it is inflated, the urethra will close tightly. The pressure regulating balloon will be placed under the tissues of the lower abdomen. The balloon is filled with a liquid (occasionally, an iodine-based solution will be used so that it will be visualized when x-ray procedures are performed). The control pump mechanism is placed in the labia for women, and in the scrotum for men. To use the sphincter, the person will compress (squeeze) the pump to divert fluid from the urethral cuff to the balloon. This action will allow the sphincter to relax so that the person can urinate. The cuff will then re-inflate on its own in 3 to 5 minutes .
PROCEDURE,Part 3

When inflated, the cuff constricts the urethra and blocks passage of any urine. When deflated, the cuff reduces pressure on the urethra and allows for free passage of urine.

AFTERCARE

If you had an artificial urinary sphincter placed, you will return from surgery with a foley catheter in place, which will be remove prior to discharge. The artificial sphincter cuff will be not be inflated immediately after surgery to allow the tissues to heal. About 6 weeks after surgery you will be taught how to activate your pump to inflate the artificial sphincter.

PANCREAS TRANSPORT

2009-11-22T08:55:00.000-08:00

NORMAL ANATOMY

The pancreas resides in the back of the abdomen. It functions to produce digestive enzymes which are delivered to the small intestine (duodenum) and various hormones, which are delivered to the bloodstream. One of the most important hormones produced by the pancreas is insulin. Insulin is produced by specialized cells of the pancreas called islets of Langerhans. Insulin regulates blood sugar levels.

INDICATION

One of the most common diseases which affects the pancreas is insulin dependent diabetes, or type 1 diabetes. Type 1 diabetes is the result of an autoimmune attack on the islet cells which produce insulin. The resultant lack of insulin leads to excess blood sugar levels in the blood and a variety of health problems including visual disturbances (diabetic retinopathy), heart disease, nerve disorders (diabetic neuropathy), and kidney disease (diabetic nephropathy). Diabetic patients must take insulin everyday

INCISION

Pancreas transplant is a procedure in which a donor pancreas, obtained from a brain-dead organ donor who is maintained on life support, is surgically implanted into a diabetic patient. This operation is most often done in combination with kidney transplant in a patient who have diabetes and kidney failure as a result of their diabetes. The recipient's own diseased pancreas is left in place and the donor pancreas transplanted through a midline abdominal incision.

PROCEDURE,

The vessels of the donor pancreas are attached to the vessels in the groin that supply the leg.
AFTERCARE

Attempts have been made to isolate only the insulin producing islets from the donor pancreas and infuse these iselts directly into the bloodstream of diabetic patients, where they would lodge in the tissues and produce insulin. While still an experimental procedure, "islet transplantation" may someday offer a treatment for diabetes that, unlike pancreas transplant, does not require a major surgery

GASTROSTOMY TUBE PLACEMENT

2009-11-22T08:05:00.000-08:00

NORMAL ANATOMY
the stomach connect direct to th esophagus to the small intestine,and acts as an reservoir means(as a source of food supplyer),firstly its deliver the food to the small intestine,
INDICATION
there are various reason to insert the tube of gastrostomy.it may be needed temporarily or perminently.gastrostomy tube insertion may be acceptable for birth's defects of the mouth,esophagus,or stomach(esophageal atresia or tracheal esophageal fistula)problems with sucking and/or swallowing,for example in patients debilitated by stroke or dementia.
INCISION
While the patient is deep asleep and pain-free (general anesthesia), a small incision is made on the left side of the abdomen.
PROCEDURE,PART 1
A small, flexible, hollow tube (catheter) with a balloon or flared tip is inserted into the stomach. The stomach is stitched closed around the tube and the incision is closed.
PROCEDURE,PART 2
Alternatively, gastrostomy tubes can be placed under endoscopic guidance, using a much smaller incision (percutaneous endoscopic gastrostomy tube placement, or PEG). PEG tube placement can generally be performed under local anesthesia rather than general anesthesia. An endoscope is passed into the mouth, down the esophagus, and into the stomach. The surgeon can then see the stomach wall through which the PEG tube will pass. Under direct visualization with the endoscope, a PEG tube passes through the skin of the abdomen, through a very small incision, and into the stomach. A balloon is then blown up on the end of the tube, holding in place. PEG gastrostomy tubes avoid the need for general anesthesia and a large incision.
AFTERCARE
the stomach and abdomen may be heals in 5to7 days.a little bit pain can be managed by the medication.the patient will be intravenously(VI) for at least.

PELVIC LAPAROSCOPY SERIES

2009-11-22T07:47:00.000-08:00

NORMAL ANATOMY

pelvic is the organ of female reproductive system.the fallopian tubes connect to the ovaries of the uterus.
INDICATION

Pelvic laparoscopy is used both for diagnosis and for treatment and may be recommended for pelvic pain due to uterine tissue found outside the uterus in the abdomen (endometriosis) infection pelvic inflammaatory disease not responsive to drug therapy suspected twisting (torsion) of ovary ovarian cystscar tissue (adhesions)in pelvis puncture through the uterus (uterine perforation) following D&C or by IUD evaluation of infertility sterilization (tubal ligation)evaluation of a pelvic mass that was confirmed previously by abdominal ultrasound.

INCISION

while the patient is deep sleep and pain free (general anesthesia),a one half inch incision is made in the skin below the navel.

PROCEDURE

air is pumped into the abdomen to make the organ of the abdominal cavity more easily visible.The laparascope is inserted through the scope to obtain tissue samples or to perform certain surgical procedure.air is pumped into the abdomen to make the organ of the abdominal cavity more visible.

AFTERCARE

Patients are usually able to go home within 24 hours of surgery.

pancreatitis

2009-11-22T07:32:00.000-08:00

NORMAL ANATOMY

The pancreas is a gland which is located posterior to the abdomen. It is act as both exocrine and endocrine gland.it is actually an exocrine gland and it is contains cells that secrete the hormone insulin, and cells that secrete digestive enzymes that aid in the breakdown of food in the gastrointestinal tract. The pancreas secretes these enzymes into the pancreatic duct, which joins the common bile duct from the liver and drains into the small intestine.

INDICATION

Inflammation of the pancreas, or pancreatitis, is a serious condition that is most commonly caused by either alcohol toxicity or gallstones. Gallstones can lodge in the common bile duct and block the flow of pancreatic enzymes out of the pancreas into the intestine. the patient will not be allowed to eat for three to five days, to prevent secretion of enzymes by the pancreas. He will also receive pain medication to control the pain caused by pancreatic inflammation.

PROCEDURE

if pancreatitis is due to gallstones, most often the responsible gallstone passes into the intestine spontaneously, and the pancreatitis goes away. Less commonly, a minor surgical procedure is necessary to extract a gallstone that is blocking the pancreatic duct where it drains into the small intestine. An endoscope, with a camera on its end, is passed down the esophagus, through the stomach, and into the small intestine. The entrance of the pancreatic duct into the small intestine can be viewed through the endoscope. A special instrument on the end of the endoscope can then be passed into the pancreatic duct and the gallstone is extracted. Very rarely pancreatitis is severe enough to require surgery, which is usually performed when the pancreas becomes infected. Dead pancreatic tissue is removed, and the area around the pancreas is washed clean. Patients who require such treatment usually have prolonged hospital stays and are seriously ill.

General Surgery

2009-11-22T06:45:00.000-08:00

pancreatitis
pelvic laparoscopy series
gastrostomy tube placement
pancreas transplant
Inflatable Artificial Sphincter
Intestinal Obsruction Repair
laparoscopic Surgery
Biliary Obstruction Repair
Colon Cancer Series
Diagnostic peritoneal lavage series
Anal fissure Series
Gi Bleeding Series
Inflammatory Bowel Disease
Endoscopic Retrograde Cholangio Pancreatography Series
Gastroesophageal Reflux Series
COLON DIVERTICULA SERIES

MEDICAL TOURISUM

2009-11-21T23:52:00.000-08:00

Medical Procedure Destination
Medical tourism are providing an alternative source of medical treatment for people who are not able to get appropriate and convenient medical treatment due to long waiting lists. And it allows people to undergo elective medical procedures that they otherwise could not afford. There is much to consider before experiencing a successful medical retreat. One of the first issues to investigate would be the quality and safety of health care abroad. You can perform a quick search on the internet and find a host of foreign hospitals, doctors, even government organizations marketing directly the worldwide consumer with hopes of attracting them to their country. The more popular worldwide destinations for medical travel are Hong Kong, Hungary, India, Singapore, Malaysia, Philippines, Thailand and Colombia.so by this medical tourism those people who can not afford who can easily get the benefits by the medical tourism.

Sternal precautions

2009-11-20T20:27:00.000-08:00

Sternal precautions Patients undergoing coronary artery bypass surgery will have to avoid certain things for eight to 12 weeks to reduce the risk of opening the incision. These are called sternal precautions. First, patients need to avoid using their arms excessively, such as pushing themselves out of a chair or reaching back before sitting down. To avoid this, patients are encouraged to build up momentum by rocking several times in their chair before standing up. Second, patients should avoid lifting anything in excess of 5-10 pounds. A gallon (U.S.) of milk weighs approximately 8.5 pounds, and is a good reference point for weight limitations. Finally, patients should avoid overhead activities with their hands, such as reaching for sweaters from the top shelf of a closet or reaching for plates or cups from the cupboard.