“Love is like the human appendix. You take it for granted while it's there, but when it's suddenly gone you're forced to endure horrible pain that can only be alleviated through drugs.”
― Reverend Jen,
“Love is like the human appendix. You take it for granted while it's there, but when it's suddenly gone you're forced to endure horrible pain that can only be alleviated through drugs.”
― Reverend Jen,
An abdominal surgery is a surgical repair, resection, or reconstruction of organs inside the abdominal cavity. These surgical wounds made over the abdomen are known as abdominal incisions.
These power-point presentation is precisely made to cover all the aspects of surgical incision required in physiotherapy.
An abdominal surgery is a surgical repair, resection, or reconstruction of organs inside the abdominal cavity. These surgical wounds made over the abdomen are known as abdominal incisions.
These power-point presentation is precisely made to cover all the aspects of surgical incision required in physiotherapy.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
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2. The operation for opening the
abdominal cavity is called
laparotomy.
They can be classified into
longitudinal
transverse
oblique
combined
3. Accesses to the abdominal cavity organs: 1 - Kocher's for liver and gallbladder surgery;
2 - according to Fyodorov; 3 - the transrectal to put in a gastrostoma; 4 - for sigmoid
colon surgery; 5 - the superior median laparotomic; 6 - the pararectal by Lennander; 7 -
according to Volkovych-Dyakonov for appendectomy; 8 - the inferior median
laparotomic
4. Longitudinal incisions
The median laparotomy is the most
wide spread: superior and inferior
median laparotomy.
The cut is done along the linea alba.
This approach gives free access to
almost every organ without crossing
muscles, large vessels and nerves
of the abdominal wall.
5. A disadvantage of the technique
is a potential post-operational hernia,
especially after the superior laparotomy
where the linea alba is broad and thin.
6. Make an incision in the upper
abdomen to expose:
The gallbladder
Stomach
Duodenum
Spleen
Liver.
7. Use a lower abdominal incision
for patients with:
Intestinal obstruction
Pelvic problems.
Make an incision from the upper
to lower abdomen to:
Evaluate all abdominal organs
in a trauma laparotomy.
8. Longitudinal incisions drawn through the
rectus sheath (transrectal) include
a paramedian cut, lead along the projection of
the internal border of the rectus muscle;
the anterior lamina of its sheath is cut, the
rectus muscle is pulled outwards with a hook
the posterior lamina of the sheath is incised
together with the parietal peritoneum.
performed for operations in the superior
compartment
9. the pararectal incision is
performed parallel to the
external border of the rec-tus
muscle while the muscle is
pulled inwards.
- performed for organs which
localized in the inferior
compartment (mostly in
appendectomy).
10. Oblique incisions
oblique incisions are applied in surgeries
for the liver and gall bladder or for the
spleen;
the cut is done through all the layers
parallel to the costal arch.
to access the vermiform process or
sigmoid colon, oblique cuts are made
parallel to the inguinal ligament;
11. transverse cuts crossing or dilating
the rectus muscles are applied mostly
for gynecologic interventions;
they provide a comfortable access to
the organs of the inferior compartment
of the abdominal and lesser pelvic
cavity;
but they are used less frequently than
others due to difficulties in dilating the
access during an operation and in
suturing the rectus muscles as well;
12. Combined cuts
combined cuts (thoracoabdominal)
provide a broad access to the
abdominal cavity organs including
those situated over the costal arches;
they are applied in stomach resection,
splenectomy, liver resection, removal
of the adrenal gland, and other
operations;
14. At the end of the operation, close
the wound in layers. Use several
pairs of large artery forceps to hold
the ends and edges of the
peritoneal incision. Close the
peritoneum with a continuous 0
absorbable suture on a round-
bodied needle
15. Close the linea alba with
interrupted No. 1 polyglycolic
acid or continuous
monofilament nylon on a round
or trocar needle
16. Penetrating injuries
Penetrating injuries follow gunshot wounds
and wounds induced by sharp objects such as
knives or spears
Laparotomy with intra-abdominal
exploration is indicated when the abdomen
has been penetrated, regardless of the
physical findings
Signs of hypovolaemia or of peritoneal
irritation may be minimal immediately
following a penetrating injury involving the
abdominal viscera.
17. Blunt injuries
Blunt injuries result from a direct
force to the abdomen without an
associated open wound; they most
commonly follow road traffic
accidents or assaults
Following blunt injury, exploratory
laparotomy is indicated in the
presence of:
Abdominal pain and rigidity
18. RUPTURED SPLEEN
Technique
1.Place the patient supine on the operating
table with a pillow or sandbag under the left
lower chest. Open the abdomen through a
long midline incision. Remove clots from the
abdominal cavity to localize the spleen. If
bleeding continues, squeeze the splenic
vessels between your thumb and fingers or
apply intestinal occlusion clamps
19. 2.Make the decision whether to
remove or preserve the spleen.
If the bleeding has stopped, do
not disturb the area. If a small
tear is bleeding, try to
control it with 0 absorbable
mattress sutures
20. 3.To remove the spleen, lift it
into the wound and divide the
taut splenorenal ligament with
scissors.
21. 4.Ligate the short gastric
vessels well away from the
gastric wall. Dissect the
posterior part of the hilum,
identifying the tail of the
pancreas and the splenic
vessels
22. 5. If there is excess bleeding,
drain the bed of the spleen with
a latex drain brought out
through a separate stab wound.
Remove the drain at 24 hours, if
possible
23. LACERATION OF THE LIVER
Technique
1.Through a midline incision, examine the liver
and gallbladder. Small wounds may have stopped
bleeding by the time of operation and should not
be disturbed.
2.For moderate wounds or tears that are not
bleeding, do not suture or debride the liver. If a
moderate wound is bleeding, remove all
devitalized tissue and suture the tear with 0
chromic mattress stitches on a large round-
bodied needle
24. The intestinal suture is a basic element of most
operations for the gastroenteric tract.
the suture must be firm, i.e. after the suture has
been put in, the edges of the sutured organs should
not loosen;
the suture is to be hermetic in two meanings of the
term: mechanically hermetic so that no drop of an
organ's contents leak of its lumen, and biologically
hermetic so that no microflora ooze from an organ's
cavity;
the suture must provide good hemostasis;
the intestinal suture should not narrow the lumen of
a hollow organ;
the suture should not hamper the peristalsis.
26. The intestinal suture going through the
mucous and submucous layers is called
transfixed (Czerny's suture);
27. the two-row suture by Albert
The first row of sutures passes through all
the layers of the intestinal wall ensuring
firmness and mechanical hermeticity.
The second row of sutures, the serous-
muscular Lembert's suture, adds to its
biological her-meticity.
28. SMALL INTESTINE
Reducing the wound of the small intestine
If the intestinal wall has a small defect (up to 1
cm long), a one-row purse-string suture is put
in around the
In such case non-resoluble
suture material is used, and a
ligature is drawn only through
serous and muscular layer of
the intestinal wall.
29. A needle should be inserted into serous
membrane, drawn through the muscular
membrane and taken out from serous one.
the forceps is smoothly removed and the first
knot is completed. Then it is fixed by the
second (fixing) knot.
30. Resection
1 Determine the extent of the loop to be
resected, including a small margin of
healthy gut on either side. Hold up the
loop so that you can see the mesenteric
vessels against the light. Plan to divide
the mesentery in a V-fashion or separate
it from the intestinal wall, depending
upon the length of the mesentery.
31. 2.Isolate the mesenteric vessels by
making blunt holes in the
mesentery on either side of the
vessel. Doubly ligate each vessel
and then divide it between the
ligatures. Continue dividing the
mesentery until you have isolated
the section of gut to be resected.
32. 3.Apply crushing clamps to
both ends of the isolated loop
and gently "milk" the normal
bowel above and below the loop
to move contents away from the
planned point of resection
33. 4.Under the loop of bowel, place
a swab that has been
soaked in saline and wrung
out. Holding the knife blade
against one of the crushing
clamps, divide the gut.
34. 5.Clean the exposed part of the
lumen and discard the used
swab. Temporarily release the
occlusion clamp and check to
see whether the cut ends of the
bowel bleed freely
35. Intestinal anastomoses
Joining crossed areas of the intestine
is known as intestinal anastomosis.
These anastomoses are put in end-to-
end, side-to-side, end-to-side, and
side-to-end.
36. In a side-to-side anastomosis, two
completely closed stumps are first
made. To attain it, the free end of
the intestine is ligated and buried
into the purse-string suture. The
stumps are situated
isoperistaltical in relation to one
another; openings are made on
adjoining surfaces by a scalpel
and sutured by two rows
37. The side-to-side intestinal anastomosis after the small intestine resection. а - an
intestinal stump treatment: the ligated stump is buried into the purse-string suture; b -
suturing the anastomosis posterior lips with continuous blanket stitches; c - the initial
moment of suturing the anastomosis anterior lips; d - a glover's (Schmieden's) suture
put in to the anterior lips; e - the second row of Lembert's sutures put in the anterior
lips; f - the general view of the side-to-side anastomosis; repairing the edges of the
crossed mesocolon
38. an end-to-end anastomosis joins the ends
of hollow organs directly by two-row Albert's
suture.
the first row is transfixed, continuous or
interrupted suture with catgut; the second
row is interrupted serous-muscular
Lembert's sutures.
for the large intestine a three-row suture is
used, the third row is of Lembert's sutures.
such an anastomosis is more physiologic
and thus is widely applied in various
surgeries.
39. An end-to-side anastomosis is
applied when joining segments of the
gastroenteric tract of various
diameters - in the resection of the
stomach and joining the small
intestine with the large one
40. COLON
Treatment of colon injuries is dependent upon the
location:
Treat transverse colon injuries with exteriorization of
the site of injury as a colostomy
Treat left (descending) colon injuries with
exteriorization of the injury site through a colostomy;
drain the paracolic gutter and the pelvis
Treat right (ascending) colon injuries with resection of
the entire right colon; make an ileostomy and transverse
colostomy - do not attempt to repair the injury directly
An alternative in the treatment of colonic injury or
perforation is to defunction the lesion by creating a
colostomy or an ileostomy upstream from the lesion,
and placing a large latex drain near that lesion
Patients with colonic trauma require antibiotics.
41. Selecting the type of colostomy
Normally, a loop colostomy is the
easiest (Figure 6.48A)
If you have to resect a piece of
colon, perform a double-barrelled
colostomy with the two free ends
(Figures 6.48B)
palpation: it should admit the tip of
the thumb and finger (Figure 6.47).
Close the laparotomy incision.
42. Techniques
Determine the site for the
colostomy at surgery. Make an
incision separate from the main
wound in the quadrant of the
abdomen nearest to the loop to
be exteriorized. Use the greater
omentum as a guide to locate
the transverse colon.
43. Double-barrelled colostomy
1.Resect the gangrenous loop
of colon as described for
resection of the small intestine.
Mobilize the remaining colon so
that the limbs to be used for the
colostomy lie without tension.
44. 2.Bring the two clamped ends of bowel out
through a stab wound or gridiron incision
and keep them clamped until the
laparotomy incision has been closed
(Figure 6.53). Then remove the clamps and
fix the full thickness of the gut edge to the
margin of the stab wound. Approximate
mucosa to skin edge with interrupted 2/0
absorbable suture (Figures 6.54, 6.55). If a
bag is not available, cover the colostomy
with generous padding.
45. Witzel's gastrostomy: 1 - constructing the serous-muscular tunnel and burying the
tube into the purse-string suture; 2 - Position of a gastrostomic tube in the stomach
the tube are grabbed by the tool and drawn to the anterior abdominal wall through
the made-up opening. The tube is fixed to the skin by the threads brought o
46. The stomach resection by Billroth I (schematic) fact
excludes the possibility of peptic ulcers of the
gastroenterostomy. But it is not that easy to draw a
gastric stump to the duodenum. There must be no strain
of the ends while making an anastomosis because it
leads to lacerated sutures and to anastomotic leak.
47. The stomach resection by Billroth-II; 2 - the stomach
resection by Billroth-II in Hoffmeister-Finsterer's
modification
48. 1 - horizontal-bar stitches in liver ruptures
through an omentum; 2 - horizontal-bar
stitches with a blunt needle throughout an
omentum onto the liver's edge
49. . Cholecystectomy from the neck aspect: 1 - separating and ligating the vesical artery
and vein; 2 - separating the gallbladder out of its bed; 3 - the gallbladder's bed
peritonization target is to access the vascular pedicle and to compress the splenic
artery.