As we enter in the Modern day, we are witnessing dawn of the new trend in which closed body operating procedures are more often being performed through minimal access. This development is the consequence of vision and work of many dedicated individuals. They include early pioneers of endoscopy who planted the seed and lastly the current pioneers who pushed and expanded these frontiers to give rise the birth of modern laparoscopy. Therapeutic laparoscopic surgery was introduced into the surgical practice recently and within a short span of time, it has become established as defacto standard for the treatment of chronic cholelithiasis and many advanced laparoscopic procedures can be performed safely. Laparoscopic surgery, what we should witness today, may be the culmination of over a hundred years of painstaking efforts from the number of pioneers within the fields of optics, instrumentation and video laparoscopic camera. Few advances in medicine occur in isolation. The innate human curiosity to peer within the body cavities can be traced back to ancient times. However, due to primitive technology and crude instruments, several ambitions were not realized. It is probably safe to say that first laparoscopy would not have been performed had it not been for the efforts of many physicians in 1800s to develop endoscope. The device developed by Theodore Stein in mid 1880 contains all the aspects of the current endoscopic documentation system. There was a crude endoscope and a high intensity light source. Illumination was made by continuously feeding a magnesium wire into an ignition chamber utilizing a clockwise mechanism. Light from this combustion was reflected to the tube utilizing a mirror. Finally the look was focused on to some photographic plate through coupling optics.
The document describes the history and development of endoscopy from its origins with Bozzini's "Lichtleiter" in 1806 to modern innovations. Key developments include:
- Desormeaux introducing Bozzini's device into patients and coining the term "endoscope" in 1853.
- Czerny constructing the first rigid endoscope in 1880 and using Edison's light bulb, allowing angling and air insufflation.
- Kelling pioneering laparoscopy in 1901 after being introduced to endoscopy by Mikulicz-Radecki.
- Hopkins inventing the rigid rod-lens system for scopes in 1959, allowing their widespread adoption after partnering with
Laparoscopy involves using small incisions and a camera to perform abdominal surgeries. It was pioneered in the early 1900s and has since been used for procedures like cholecystectomy and appendectomy. Advantages include less pain, scarring and faster recovery compared to open surgeries. Proper patient positioning, insufflation, trocars and energy devices are required. Complications can include injuries from access and cautery. Recent advances include natural orifice translumenal endoscopic surgery and single-incision laparoscopic surgery.
Entry technique with veress needle in LaparoscopyDrVarun Raju
The document summarizes the Veress needle technique for establishing pneumoperitoneum during laparoscopic surgery. It describes how Janos Veress first developed the spring-loaded needle in 1932 for tuberculosis treatment. Modern Veress needles are 12-15 cm long and have a blunt inner stylet and sharp outer cannula. Placement is typically at the umbilicus using various tests like aspiration and insufflation pressure to confirm intraperitoneal placement before trocar insertion. Complications can occur if not properly positioned.
This document discusses the evolution of laparoscopic surgery and laparoscopic instruments from ancient times to modern times. It describes some of the early pioneers who developed early endoscopic instruments in the 18th-19th centuries like Philip Bozzini and Maximilian Nitze. It then discusses the development of modern laparoscopy in the early 20th century with pioneers like Jacobaeus coining the term "laparoscopy" and Veress developing pneumoperitoneum. The document highlights the crucial inventions of the rod lens system by Harold Hopkins in the 1950s and videolaparoscopy by Camran Nezhat in the 1980s that enabled complex laparoscopic surgery. It also discusses some of the challenges
This document discusses various laparoscopy equipment used in minimally invasive surgeries. It describes key components like laparoscopes, trocars, insufflators, and various surgical instruments. A laparoscopic surgeon needs to be technically proficient in operating the equipment and understanding the principles of the instruments being used, as the procedures are technologically dependent and any emergency requires quick problem-solving skills without overreliance on technical support.
This document discusses the basic principles of laparoscopy. It describes the key differences between laparoscopic and open surgery for both patients and surgeons. For patients, laparoscopic surgery results in less pain, faster recovery times, and quicker return to normal activities due to smaller incisions. For surgeons, laparoscopy provides a magnified view but with altered tactile response and two-dimensional images. The document outlines the typical laparoscopic setup including the endoscope, light source, camera, monitor, insufflator, trocars and various instruments. It also lists some common laparoscopic procedures that can be used for diagnostic and operative purposes.
This document provides an overview of laparoscopic instrumentation used in minimally invasive surgery. It discusses the key components needed, including optical devices like telescopes and cameras, equipment for insufflation, trocars and other instruments for accessing the surgical site. A variety of operative instruments are described, such as graspers, dissectors, scissors, and bowel/lung clamps. Energy sources like electrosurgery, ultrasonic devices, and staplers are also covered. The document concludes with a discussion of instruments for tissue approximation and hemostasis, including clip appliers and mechanical staplers, as well as some miscellaneous tools.
1. The document discusses the basics of laparoscopy including the laparoscopic tower setup, ergonomics, port placement, entry techniques, energy devices, and complications.
2. Key aspects of ergonomics include following the straight line principle with the tower, monitor, and instruments, proper table height, and triangulating or sectoring port placement depending on whether the surgeon stands ipsilateral or contralateral.
3. Safe entry techniques include closed insertion with a Veress needle or open insertion with direct trocar placement, with Palmer's point being an alternative to umbilical entry.
The document describes the history and development of endoscopy from its origins with Bozzini's "Lichtleiter" in 1806 to modern innovations. Key developments include:
- Desormeaux introducing Bozzini's device into patients and coining the term "endoscope" in 1853.
- Czerny constructing the first rigid endoscope in 1880 and using Edison's light bulb, allowing angling and air insufflation.
- Kelling pioneering laparoscopy in 1901 after being introduced to endoscopy by Mikulicz-Radecki.
- Hopkins inventing the rigid rod-lens system for scopes in 1959, allowing their widespread adoption after partnering with
Laparoscopy involves using small incisions and a camera to perform abdominal surgeries. It was pioneered in the early 1900s and has since been used for procedures like cholecystectomy and appendectomy. Advantages include less pain, scarring and faster recovery compared to open surgeries. Proper patient positioning, insufflation, trocars and energy devices are required. Complications can include injuries from access and cautery. Recent advances include natural orifice translumenal endoscopic surgery and single-incision laparoscopic surgery.
Entry technique with veress needle in LaparoscopyDrVarun Raju
The document summarizes the Veress needle technique for establishing pneumoperitoneum during laparoscopic surgery. It describes how Janos Veress first developed the spring-loaded needle in 1932 for tuberculosis treatment. Modern Veress needles are 12-15 cm long and have a blunt inner stylet and sharp outer cannula. Placement is typically at the umbilicus using various tests like aspiration and insufflation pressure to confirm intraperitoneal placement before trocar insertion. Complications can occur if not properly positioned.
This document discusses the evolution of laparoscopic surgery and laparoscopic instruments from ancient times to modern times. It describes some of the early pioneers who developed early endoscopic instruments in the 18th-19th centuries like Philip Bozzini and Maximilian Nitze. It then discusses the development of modern laparoscopy in the early 20th century with pioneers like Jacobaeus coining the term "laparoscopy" and Veress developing pneumoperitoneum. The document highlights the crucial inventions of the rod lens system by Harold Hopkins in the 1950s and videolaparoscopy by Camran Nezhat in the 1980s that enabled complex laparoscopic surgery. It also discusses some of the challenges
This document discusses various laparoscopy equipment used in minimally invasive surgeries. It describes key components like laparoscopes, trocars, insufflators, and various surgical instruments. A laparoscopic surgeon needs to be technically proficient in operating the equipment and understanding the principles of the instruments being used, as the procedures are technologically dependent and any emergency requires quick problem-solving skills without overreliance on technical support.
This document discusses the basic principles of laparoscopy. It describes the key differences between laparoscopic and open surgery for both patients and surgeons. For patients, laparoscopic surgery results in less pain, faster recovery times, and quicker return to normal activities due to smaller incisions. For surgeons, laparoscopy provides a magnified view but with altered tactile response and two-dimensional images. The document outlines the typical laparoscopic setup including the endoscope, light source, camera, monitor, insufflator, trocars and various instruments. It also lists some common laparoscopic procedures that can be used for diagnostic and operative purposes.
This document provides an overview of laparoscopic instrumentation used in minimally invasive surgery. It discusses the key components needed, including optical devices like telescopes and cameras, equipment for insufflation, trocars and other instruments for accessing the surgical site. A variety of operative instruments are described, such as graspers, dissectors, scissors, and bowel/lung clamps. Energy sources like electrosurgery, ultrasonic devices, and staplers are also covered. The document concludes with a discussion of instruments for tissue approximation and hemostasis, including clip appliers and mechanical staplers, as well as some miscellaneous tools.
1. The document discusses the basics of laparoscopy including the laparoscopic tower setup, ergonomics, port placement, entry techniques, energy devices, and complications.
2. Key aspects of ergonomics include following the straight line principle with the tower, monitor, and instruments, proper table height, and triangulating or sectoring port placement depending on whether the surgeon stands ipsilateral or contralateral.
3. Safe entry techniques include closed insertion with a Veress needle or open insertion with direct trocar placement, with Palmer's point being an alternative to umbilical entry.
laparoscopy is recent advancing area in the field of general surgery. the identification and underlying mechanism of action of each laparoscopic instrument is necessary for their handling ans use.
Laparoscopy involves using small incisions and a camera to visualize the inside of the abdomen. It has several advantages over open surgery such as less pain, shorter hospital stays, and quicker recovery times. Some of the key equipment used in laparoscopy include rod lens systems and fiber optic cables for optics, trocars for abdominal access, and insufflators to inflate the abdomen with gas. Potential risks include injuries from trocars or pneumoperitoneum as well as effects of the pneumoperitoneum on respiratory and renal systems. Common procedures now performed laparoscopically include cholecystectomy, appendisectomy, hernia repair, and some cancer staging.
Laparoscopy, also known as keyhole surgery, allows surgeons to examine the abdominal organs through small incisions using a laparoscope. It was developed in the early 1900s and is now commonly used to diagnose and treat conditions of the appendix, gallbladder, intestines, and other abdominal organs. The key advantages of laparoscopy over open surgery are reduced pain, scarring, and recovery time for patients. However, it requires more technical skill from surgeons due to limited movement and vision within the abdominal cavity. Complications can include injuries from trocar insertion or electrical burns, but the risks of laparoscopy are generally low when performed by an experienced surgeon.
This document provides guidelines for laparoscopic entry techniques. It discusses positioning the patient and various methods for primary and secondary port entry. The preferred primary entry is through the umbilicus using a closed Veress needle technique. Guidelines are provided for Veress needle insertion including abdominal pressure, saline testing, and insufflation. Alternatives like Palmer's point or open Hasson technique should be considered if umbilical entry fails or is risky due to adhesions. Secondary ports should be inserted under direct vision at specific locations and angles to avoid injury.
Laparoscopic surgery uses small incisions and cameras to perform operations inside the abdomen. It has several advantages over open surgery like less pain, quicker recovery, and smaller scars. The core principles involve insufflating the abdomen with gas, visualizing and identifying structures, and triangulating surgical tools. Safety issues include potential injuries from trocar insertion and risks of bleeding. New advances in laparoscopy include single-incision techniques, robotic surgery, and natural orifice approaches.
The document discusses complications that can occur during and after laparoscopic surgeries. Some common complications discussed include:
1. Anaesthetic complications such as inadequate muscle relaxation during the procedure, hyperventilation prior to surgery, and possible air embolism from carbon dioxide used for pneumoperitoneum.
2. Complications due to pneumoperitoneum such as respiratory acidosis, increased pressure on veins, and possible effects on renal function from increased abdominal pressure.
3. Surgical complications such as injuries to organs like the stomach, bowel, bladder from trocars or instruments. Thermal injuries from diathermy are also discussed.
4. Other complications mentioned include bleeding, infections, inc
This document discusses the principles and techniques of laparoscopic surgery. It begins with an introduction to minimal access surgery and its aims of reducing somatic and psychological trauma while allowing for shorter hospital stays and faster recovery. The document then covers the categories of minimally invasive procedures and diagnostic and therapeutic applications of laparoscopic surgery. It provides details on preoperative evaluation and preparation, creating pneumoperitoneum, intraoperative equipment and techniques, postoperative care, and examples of common laparoscopic procedures like cholecystectomy, hernia repair, and fundoplication. Throughout it includes diagrams to illustrate surgical anatomy and procedure steps.
It has not changed the nature of disease
The basic principles of good surgery still apply,including appropriate case selection, excellent exposure,adequate retraction and a high level technical expertise
If a procedure makes no sense with conventional access, it will make no sense with a minimal access approach
The cleaner and gentler the act of operation, the less the patient suffers, the smoother and quicker his convalescence,the more exquisite his healed wound.
We actually do not know what is there stored for us, but we believe that laparoscopy is trending towards advancement and nano and robotic technology is going to replace in future.
3D cameras have come into existence and various newer technologies are being invented.
Carbon dioxide is commonly used for insufflation during surgery due to its endogenous and non-combustible properties. KARL STORZ offers the THERMOFLATOR® and ENDOFLATOR® insufflators, which provide precise pressure monitoring and safety features like overpressure detection. Both devices can be integrated into intelligent operating rooms and controlled via endoscopic camera systems. The THERMOFLATOR® additionally offers heated insufflation to prevent patient hypothermia.
energy devices are d most important part of an operation theator and surgery. in this presentation i have briefly described various energy devices used in general surgery and laparoscopy.
All about C-Arm system and how it workds
Copy this link to know more about Carm system -https://thetrend4u.blogspot.com/2022/10/what-is-c-arm-system-download-power.html
Minimally invasive surgery uses small incisions and miniaturized imaging systems to perform major operations with less trauma than traditional open surgery. The techniques were developed starting in the early 1900s and improved with advances like rod lens endoscopes, flexible instruments, and fluoroscopic imaging. Laparoscopic surgery involves inflating the abdominal cavity with gas to provide space to see and operate. Thoracoscopy may require deflating one lung. Other minimally invasive techniques provide access through subcutaneous tissues or body cavities without requiring incisions into organs. Endoluminal and intraluminal procedures operate from within lumens like blood vessels or the digestive tract.
Laparoscopy involves using small incisions and a camera to perform surgery in the abdomen or pelvis. It requires specialized instruments including trocars for instrument insertion, graspers and forceps for tissue manipulation, scissors and staplers for cutting and sealing, and electrosurgical devices. Key components of laparoscopy are insufflation of carbon dioxide gas, optical devices for visualization, and various instruments tailored for intra-abdominal use and manipulation of delicate tissues during minimally invasive procedures.
Electrosurgery devices use electrical energy to cut, coagulate, and ablate tissue. Common devices include monopolar and bipolar electrosurgery, which use radiofrequency energy. Ultrasonic devices like the Harmonic scalpel use ultrasonic vibrations for cutting and coagulation without electricity. Other technologies for tissue effects include vessel sealing devices, lasers which use light energy, cryosurgery using extreme cold, and microwave ablation. Proper use and monitoring of electrosurgical devices is important to prevent unintended tissue damage and burns.
This presentation will help u know with the history,present and coming up trends in laparoscopy .Also it is an acquaintance presentation regarding laparoscopy.
This document provides an overview of minimal access surgery (MAS). It defines MAS as applying modern technology to minimize surgical trauma without compromising exposure or safety. The history of MAS is traced from early laparoscopic procedures in the 1900s to developments like natural orifice transluminal endoscopic surgery (NOTES) and single incision laparoscopic surgery (SILS) more recently. The advantages of MAS include reduced pain, wounds, and recovery time compared to open surgery. Potential complications include injuries and those related to pneumoperitoneum such as arrhythmias. A variety of endoscopic, laparoscopic, and catheter-based minimal access procedures across several specialties are described in the document.
The document discusses various energy devices used in surgery including electrical, ultrasonic, laser, and mechanical sources. It provides details on electrosurgery, physics of electrosurgery, types of electrosurgical circuits including monopolar and bipolar. Effects of electrosurgery such as cutting, coagulation, and dessication are explained. Newer energy devices like harmonic scalpel, ligasure, and microwave ablation are introduced along with their advantages. Complications of electrosurgery and newer generation electrosurgical units with improved efficiency are also summarized.
This presentation of introduction of laparoscopic surgery made by Dr. R.K. Mishra Director and chief surgeon World Laparoscopy Hospital. Dr. Mishra in this presentation has explained present pas and future of laparoscopic surgery. Laparoscopy is a surgical procedure which uses a special surgical instrument called a laparoscope to look inside the body, or to perform certain operations. World Laparoscopy Hospital is the center of excellence for laparoscopic and da vinci robotic surgery training and considered as one of the best institute in the world. For more detail about laparoscopic surgery please visit: http://www.laparoscopyhospital.com
Fluoroscopy is a form of real-time radiographic imaging used to guide procedures. It was invented in 1896 by Thomas Edison. Modern fluoroscopy uses image intensifiers or flat panel detectors to convert x-rays into visible light images. Digital systems have replaced conventional film-based fluoroscopy. Fluoroscopy provides real-time imaging but also exposes patients and staff to radiation, so dose reduction techniques must be used such as automatic brightness control, collimating to the area of interest, and minimizing unnecessary images and magnification.
CBCT imaging provides 3D imaging of the dental and maxillofacial complex, allowing for improved diagnosis and treatment planning. It involves rotating an x-ray source and detector to capture projection images from different angles, which are then reconstructed into a 3D volume using back projection algorithms. Key components include the x-ray generator, detector, and workstation for image reconstruction and display. CBCT has various applications in orthodontics for assessing dental anomalies, impacted teeth, arch discrepancies, and facilitating treatment. Guidelines recommend its use be justified based on the individual clinical situation and that radiation dose be minimized.
laparoscopy is recent advancing area in the field of general surgery. the identification and underlying mechanism of action of each laparoscopic instrument is necessary for their handling ans use.
Laparoscopy involves using small incisions and a camera to visualize the inside of the abdomen. It has several advantages over open surgery such as less pain, shorter hospital stays, and quicker recovery times. Some of the key equipment used in laparoscopy include rod lens systems and fiber optic cables for optics, trocars for abdominal access, and insufflators to inflate the abdomen with gas. Potential risks include injuries from trocars or pneumoperitoneum as well as effects of the pneumoperitoneum on respiratory and renal systems. Common procedures now performed laparoscopically include cholecystectomy, appendisectomy, hernia repair, and some cancer staging.
Laparoscopy, also known as keyhole surgery, allows surgeons to examine the abdominal organs through small incisions using a laparoscope. It was developed in the early 1900s and is now commonly used to diagnose and treat conditions of the appendix, gallbladder, intestines, and other abdominal organs. The key advantages of laparoscopy over open surgery are reduced pain, scarring, and recovery time for patients. However, it requires more technical skill from surgeons due to limited movement and vision within the abdominal cavity. Complications can include injuries from trocar insertion or electrical burns, but the risks of laparoscopy are generally low when performed by an experienced surgeon.
This document provides guidelines for laparoscopic entry techniques. It discusses positioning the patient and various methods for primary and secondary port entry. The preferred primary entry is through the umbilicus using a closed Veress needle technique. Guidelines are provided for Veress needle insertion including abdominal pressure, saline testing, and insufflation. Alternatives like Palmer's point or open Hasson technique should be considered if umbilical entry fails or is risky due to adhesions. Secondary ports should be inserted under direct vision at specific locations and angles to avoid injury.
Laparoscopic surgery uses small incisions and cameras to perform operations inside the abdomen. It has several advantages over open surgery like less pain, quicker recovery, and smaller scars. The core principles involve insufflating the abdomen with gas, visualizing and identifying structures, and triangulating surgical tools. Safety issues include potential injuries from trocar insertion and risks of bleeding. New advances in laparoscopy include single-incision techniques, robotic surgery, and natural orifice approaches.
The document discusses complications that can occur during and after laparoscopic surgeries. Some common complications discussed include:
1. Anaesthetic complications such as inadequate muscle relaxation during the procedure, hyperventilation prior to surgery, and possible air embolism from carbon dioxide used for pneumoperitoneum.
2. Complications due to pneumoperitoneum such as respiratory acidosis, increased pressure on veins, and possible effects on renal function from increased abdominal pressure.
3. Surgical complications such as injuries to organs like the stomach, bowel, bladder from trocars or instruments. Thermal injuries from diathermy are also discussed.
4. Other complications mentioned include bleeding, infections, inc
This document discusses the principles and techniques of laparoscopic surgery. It begins with an introduction to minimal access surgery and its aims of reducing somatic and psychological trauma while allowing for shorter hospital stays and faster recovery. The document then covers the categories of minimally invasive procedures and diagnostic and therapeutic applications of laparoscopic surgery. It provides details on preoperative evaluation and preparation, creating pneumoperitoneum, intraoperative equipment and techniques, postoperative care, and examples of common laparoscopic procedures like cholecystectomy, hernia repair, and fundoplication. Throughout it includes diagrams to illustrate surgical anatomy and procedure steps.
It has not changed the nature of disease
The basic principles of good surgery still apply,including appropriate case selection, excellent exposure,adequate retraction and a high level technical expertise
If a procedure makes no sense with conventional access, it will make no sense with a minimal access approach
The cleaner and gentler the act of operation, the less the patient suffers, the smoother and quicker his convalescence,the more exquisite his healed wound.
We actually do not know what is there stored for us, but we believe that laparoscopy is trending towards advancement and nano and robotic technology is going to replace in future.
3D cameras have come into existence and various newer technologies are being invented.
Carbon dioxide is commonly used for insufflation during surgery due to its endogenous and non-combustible properties. KARL STORZ offers the THERMOFLATOR® and ENDOFLATOR® insufflators, which provide precise pressure monitoring and safety features like overpressure detection. Both devices can be integrated into intelligent operating rooms and controlled via endoscopic camera systems. The THERMOFLATOR® additionally offers heated insufflation to prevent patient hypothermia.
energy devices are d most important part of an operation theator and surgery. in this presentation i have briefly described various energy devices used in general surgery and laparoscopy.
All about C-Arm system and how it workds
Copy this link to know more about Carm system -https://thetrend4u.blogspot.com/2022/10/what-is-c-arm-system-download-power.html
Minimally invasive surgery uses small incisions and miniaturized imaging systems to perform major operations with less trauma than traditional open surgery. The techniques were developed starting in the early 1900s and improved with advances like rod lens endoscopes, flexible instruments, and fluoroscopic imaging. Laparoscopic surgery involves inflating the abdominal cavity with gas to provide space to see and operate. Thoracoscopy may require deflating one lung. Other minimally invasive techniques provide access through subcutaneous tissues or body cavities without requiring incisions into organs. Endoluminal and intraluminal procedures operate from within lumens like blood vessels or the digestive tract.
Laparoscopy involves using small incisions and a camera to perform surgery in the abdomen or pelvis. It requires specialized instruments including trocars for instrument insertion, graspers and forceps for tissue manipulation, scissors and staplers for cutting and sealing, and electrosurgical devices. Key components of laparoscopy are insufflation of carbon dioxide gas, optical devices for visualization, and various instruments tailored for intra-abdominal use and manipulation of delicate tissues during minimally invasive procedures.
Electrosurgery devices use electrical energy to cut, coagulate, and ablate tissue. Common devices include monopolar and bipolar electrosurgery, which use radiofrequency energy. Ultrasonic devices like the Harmonic scalpel use ultrasonic vibrations for cutting and coagulation without electricity. Other technologies for tissue effects include vessel sealing devices, lasers which use light energy, cryosurgery using extreme cold, and microwave ablation. Proper use and monitoring of electrosurgical devices is important to prevent unintended tissue damage and burns.
This presentation will help u know with the history,present and coming up trends in laparoscopy .Also it is an acquaintance presentation regarding laparoscopy.
This document provides an overview of minimal access surgery (MAS). It defines MAS as applying modern technology to minimize surgical trauma without compromising exposure or safety. The history of MAS is traced from early laparoscopic procedures in the 1900s to developments like natural orifice transluminal endoscopic surgery (NOTES) and single incision laparoscopic surgery (SILS) more recently. The advantages of MAS include reduced pain, wounds, and recovery time compared to open surgery. Potential complications include injuries and those related to pneumoperitoneum such as arrhythmias. A variety of endoscopic, laparoscopic, and catheter-based minimal access procedures across several specialties are described in the document.
The document discusses various energy devices used in surgery including electrical, ultrasonic, laser, and mechanical sources. It provides details on electrosurgery, physics of electrosurgery, types of electrosurgical circuits including monopolar and bipolar. Effects of electrosurgery such as cutting, coagulation, and dessication are explained. Newer energy devices like harmonic scalpel, ligasure, and microwave ablation are introduced along with their advantages. Complications of electrosurgery and newer generation electrosurgical units with improved efficiency are also summarized.
This presentation of introduction of laparoscopic surgery made by Dr. R.K. Mishra Director and chief surgeon World Laparoscopy Hospital. Dr. Mishra in this presentation has explained present pas and future of laparoscopic surgery. Laparoscopy is a surgical procedure which uses a special surgical instrument called a laparoscope to look inside the body, or to perform certain operations. World Laparoscopy Hospital is the center of excellence for laparoscopic and da vinci robotic surgery training and considered as one of the best institute in the world. For more detail about laparoscopic surgery please visit: http://www.laparoscopyhospital.com
Fluoroscopy is a form of real-time radiographic imaging used to guide procedures. It was invented in 1896 by Thomas Edison. Modern fluoroscopy uses image intensifiers or flat panel detectors to convert x-rays into visible light images. Digital systems have replaced conventional film-based fluoroscopy. Fluoroscopy provides real-time imaging but also exposes patients and staff to radiation, so dose reduction techniques must be used such as automatic brightness control, collimating to the area of interest, and minimizing unnecessary images and magnification.
CBCT imaging provides 3D imaging of the dental and maxillofacial complex, allowing for improved diagnosis and treatment planning. It involves rotating an x-ray source and detector to capture projection images from different angles, which are then reconstructed into a 3D volume using back projection algorithms. Key components include the x-ray generator, detector, and workstation for image reconstruction and display. CBCT has various applications in orthodontics for assessing dental anomalies, impacted teeth, arch discrepancies, and facilitating treatment. Guidelines recommend its use be justified based on the individual clinical situation and that radiation dose be minimized.
This document discusses the key parameters and sensitivity limits of various light detectors and imaging systems. It covers unintensified detectors like vidicons, CCD cameras, and photodiode arrays, as well as intensified detectors that use image intensifiers to amplify light signals and improve sensitivity. Cooled CCD systems are also described, which can achieve sensitivities as low as 10-10 lux through techniques like cooling to reduce dark current and slower readout rates to minimize readout noise.
This document provides an overview of x-ray machines and their components and uses. It discusses the history of x-rays and their discovery in 1895. The main components of an x-ray machine are described, including the high voltage generator, control panel, x-ray tube, collimator, grid, and film or digital sensor. Different types of x-ray machines are examined, such as conventional, computed radiography, and digital radiography systems. Factors that affect image quality like kilovoltage, milliamperes, and distance are outlined. The document also reviews exposure dose limits and protective procedures for radiation workers.
The slideshare gives an overview of the different and recent advancements in the fields of digital imaging and throws a light on the clinical applications.
1. Electronic Portal Imaging Devices (EPIDs) are imaging devices mounted on linear accelerators opposite the MV x-ray source.
2. EPIDs have a wide variety of applications including real-time patient setup verification during treatment and determining beam blocking shapes and leaf positions.
3. Commercially available EPIDs include scanning liquid-filled ion chamber devices, camera-based devices, and active matrix flat panel detectors. They provide localization quality images with doses less than 3 cGy.
This document provides an overview of digital radiography and compares computed radiography (CR) and direct digital radiography (DR) systems. It discusses the limitations of traditional film screen radiography including limited dynamic range and inability to manipulate images. For CR, it describes the use of storage phosphor plates which capture x-ray information for later readout and digitization. For DR, it explains direct and indirect conversion panels used to directly convert x-rays to electrical signals. Key advantages of digital systems include immediate image viewing, manipulation, and storage without chemical processing.
Optical coherence tomography (OCT) is a non-invasive imaging technique that uses infrared light to generate high-resolution, cross-sectional images of the retina. The document traces the history and evolution of OCT technology from early time-domain systems in the 1990s to modern spectral-domain systems that provide faster scanning speeds and higher resolution. It also describes the basic principles and components of OCT imaging, various scan protocols, clinical applications for evaluating retinal conditions, and limitations of the technology.
CCTV, or closed-circuit television, is a technology that uses cameras to transmit video images to a specific place for monitoring and security purposes. The document discusses various types of CCTV cameras like dome cameras, bullet cameras, and their applications in areas like industries, crime prevention, and traffic monitoring. It also covers CCTV system components, types of lenses, image sensors, features like WDR, and considerations for camera selection and system design. Digital video recorders (DVRs) are also discussed which record video from CCTV cameras.
PerkinElmer Spotlight™ FT-IR, NIR Microscopy and Imaging Systems are built to the highest ISO-9001 manufacturing standards.
This document presents technical information and typical performance specifications based on factory tests.
The Spotlight systems take the proven and popular IR microscopy technique and add a new level of speed and applications capability. Spotlight systems incorporate high performance detectors, which deliver the ultimate in sensitivity, out-performing competitive top-of-the line IR microscopy systems. The revolutionary imaging capabilities enable previously time-consuming and difficult chemical composition studies to be performed without compromising data quality.
pill camera/ capsule endoscopy used inn medical field to find out the abnormalities of small intestine. This replaced the convectional endoscopy method.
Digital imaging involves capturing radiographic images digitally using various methods like computed radiography (CR), direct radiography (DR), or scan projection radiography (SPR). CR uses photostimulable phosphor plates while DR uses flat panel detectors, eliminating processing. Digital imaging provides advantages like improved image manipulation, reduced radiation exposure, and improved storage and sharing of images. Key types of digital radiography discussed are CR, DR, SPR, digital fluoroscopy, and digital subtraction angiography (DSA).
Fluoroscopy uses X-rays to generate real-time moving images of the internal structures of the body. Early systems used a fluorescent screen viewed directly, but modern fluoroscopy uses an image intensifier and video system. The image intensifier converts X-rays into a visible light image using input and output phosphors and an electron optic system. This amplified image can be viewed indirectly on a video monitor and recorded. Higher quality images require a balance of sufficient resolution, contrast and low noise while minimizing radiation dose to patients.
This document provides an overview of cone-beam computed tomography (CBCT) imaging. It discusses the principles of CBCT imaging, including how CBCT uses a rotating x-ray source and detector to obtain multiple 2D images that are reconstructed into a 3D volume. It describes the components of image production, clinical considerations for CBCT scans, common artifacts, and applications of CBCT imaging such as implant planning and assessment of pathology. In conclusion, CBCT is presented as an effective diagnostic imaging technique that produces high resolution 3D images of the maxillofacial region at lower radiation doses and costs compared to medical CT.
The document discusses digital radiography, including computed radiography (CR) and direct radiography using flat panel detectors. It summarizes the limitations of conventional film-based radiography and then describes the key components and workings of CR and direct digital radiography systems. Some advantages include improved image quality, ability to manipulate images digitally, faster processing, and reduced need for retakes compared to conventional methods.
This document provides an overview of cone beam computed tomography (CBCT) including its history, components, principles, and applications in dentistry. Some key points:
- CBCT was first introduced in the 1990s and provides 3D imaging with lower radiation dose than medical CT. It works by generating a cone-shaped X-ray beam and using a detector to record attenuation data, which is then reconstructed into 3D images.
- Components include an X-ray generator, image sensor, and software for image reconstruction. Images are stored in DICOM format.
- Advantages include rapid scan time, interactive display modes, and ability to view structures in multiple planes. Disadvantages include potential artifacts and inability to view
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This document provides an overview of fingerprint recognition technology (FRT). It begins with definitions of biometrics and FRT. It then discusses the history of fingerprint analysis and why fingerprints are used for identification. The document describes different fingerprint sensing technologies including optical, silicon-based capacitive, ultrasound, thermal, and piezoelectric sensors. It also covers fingerprint feature extraction, matching, storage and compression, challenges of variability, and applications of FRT. The presentation concludes with emerging 3D fingerprint technologies and references for further information.
Introduction to x-rays and x-ray inspection, Safety Operating X-Ray Cabinet Systems, Size and Weight of X-Ray Inspection Systems, How do we image the X-rays?, Magnification, Resolution, Field of View, X-Ray Inspection Area, Power of X-Ray Tube, X-Ray Sensor, Sample Positioning, x-ray applications, LED Packaging and Assembly, Semiconductor Failure Analysis, Component Counterfeit Detection, Electronic Component Manufacturing, PCB / PTH (barrel fill) Analysis, Smart Phone Design and Manufacturing, BGA Void and Head – in Pillow Analysis, RF Components and Systems, Automotive Parts, Non Destructive Testing and Evaluation, Parts – Presents- Placement, Plastic / Aluminum Molding, Medical Device Design and Manufacturing, Small Animal Imaging, Seed and Agricultural Imaging, Identification of defects in soldered components – excess voiding or excess solder, Quality control of medical temperature sensors. X-Ray images taken with TruView X-Ray Inspection systems.
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Similar to ENDOVISION IN LAPAROSCOPY PPT. DR SREEJOY PATNAIK (20)
This document discusses ways to improve patient satisfaction by putting the patient first. It emphasizes that patients are customers and the purpose of healthcare work is to serve them. It outlines factors related to doctors, patients, and the organization that can influence satisfaction. Doctors are advised to communicate effectively, respect patients, and address complaints. Hospitals should aim to minimize wait times, obtain feedback, and maintain a service-oriented culture. The document concludes that delivering patient-centered care and continually improving quality are important for satisfaction.
The presence of haematuria may be the sole symptom of an underlying disease, either benign or malignant. It is one of the most common presentations of patients with urinary tract diseases and of patients referred for urinary imaging. Painless visible haematuria (VH) is the commonest presentation of bladder cancer.
CBDSs are one of the medical conditions leading to surgical intervention. They may occur in 3%–14.7% of all patients for whom cholecystectomies are preformed. When patients present with CBD, the one important question that should be answered: what is the best modality of treatment under the giving conditions? There are competing technologies and approaches for diagnosing CBDS with regard to diagnostic performance characteristics, technical success, safety, and cost effectiveness. Management of CBDS usually requires two separate teams: the gastroenterologist and the surgical team. One of the main factors in the management is initially the detection of CBDS, before, during, or after cholecystectomy. The main options for treatment are pre- or postoperative ERCP with endoscopic biliary sphincterotomy (EST), laparoscopic or open surgical bile duct clearance. There are other options for the treat- ment of CBDS such as electrohydraulic lithotripsy (EHL), extracorporeal shockwave lithotripsy (ESWL), dissolving solutions, and laser lithotripsy. It is unlikely that one option
will be appropriate for all clinical circumstances in all centers. Variables such as disease status, patient demographics, availability of endoscopic, radiological and surgical expertise, and healthcare economics will all have significant influence on practice
The incidence of biliary injury after laparoscopic cholecystectomy (LC) has shown a declining trend though it may still be twice that as with open cholecystectomy. Major biliary or vasculobiliary injury is associated with significant morbidity. As prevention is the best strategy, the concept of a culture of safe cholecystectomy has been recently introduced to educate surgeons and apprise them of basic tenets of safe performance of LC. Various aspects of safe cholecystectomy include: (1) thorough knowledge of relevant anatomy, various anatomical landmarks, and anatomical variations; (2) an understanding of the mechanisms involved in biliary/vascular injury, the most important being the misidentification injury; (3) identification of various preoperative and intraoperative predictors of difficult cholecystectomy; (4) proper gallbladder retraction; (5) safe use of various energy devices; (6) understanding the critical view of safety, including its doublet view and documentation; (7) awareness of various error traps (e.g., fundus first technique); (8) use of various bailout strategies (e.g., subtotal cholecystectomy) in difficult gallbladder cases; (9) use of intraoperative imaging techniques (e.g., intraoperative cholangiogram) to ascertain correct anatomy; and (10) understanding the concept of time-out. Surgeons should be facile with these aspects of this culture of safety in cholecystectomy in an attempt to reduce the incidence of biliary/vascular injury during LC.
Ageing, also spelled aging, is the process of becoming older. The term refers especially to human beings, many animals, and fungi, whereas for example bacteria, perennial plants and some simple animals are potentially immortal. In the broader sense, ageing can refer to single cells within an organism which have ceased dividing (cellular senescence) or to the population of a species (population ageing).
In humans, ageing represents the accumulation of changes in a human being over time,[1] encompassing physical, psychological, and social change. Reaction time, for example, may slow with age, while knowledge of world events and wisdom may expand. Ageing is among the greatest known risk factors for most human diseases:[2] of the roughly 150,000 people who die each day across the globe, about two thirds die from age-related causes.
The causes of ageing are uncertain; current theories are assigned to the damage concept, whereby the accumulation of damage (such as DNA oxidation) may cause biological systems to fail, or to the programmed ageing concept, whereby internal processes (such as DNA methylation) may cause ageing. Programmed ageing should not be confused with programmed cell death (apoptosis).
Constipation refers to bowel movements that are infrequent or hard to pass. Constipation is a common cause of painful defecation. Severe constipation includes obstipation (failure to pass stools or gas) and fecal impaction, which can progress to bowel obstruction and become life-threatening.
Constipation is a symptom with many causes. These causes are of two types: obstructed defecation and colonic slow transit (or hypo mobility). About 50 percent of people evaluated for constipation at tertiary referral hospitals have obstructed defecation. This type of constipation has mechanical and functional causes. Causes of colonic slow transit constipation include diet, hormonal disorders such as hypothyroidism, side effects of medications, and rarely heavy metal toxicity. Because constipation is a symptom, not a disease, effective treatment of constipation may require first determining the cause. Treatments include changes in dietary habits, laxatives, enemas, biofeedback, and in particular situations surgery may be required.
Constipation is common; in the general population rates of constipation varies from 2–30 percent. In elderly people living in care homes the rate of constipation is 50–75 percent.[4] In the United States expenditures on medications for constipation are greater than US$250 million per year.
The definition of constipation includes the following:
infrequent bowel movements (typically three times or fewer per week)
difficulty during defecation (straining during more than 25% of bowel movements or a subjective sensation of hard stools; straining in this context is a strong effort to push out stool often by holding one's breath and by pushing the respective muscles in the abdominal area hard), or
the sensation of incomplete bowel evacuation.
The Rome III criteria are widely used to diagnose chronic constipation, and are helpful in separating cases of chronic functional constipation from less-serious instances.
Another definition states that less than three bowel movements per week and straining on more than 75% of occasions represents constipation in clinical surveys.
This document discusses laparoscopic common bile duct exploration (LCBDE) for the treatment of CBD stones. It outlines the advantages of the laparoscopic approach, including reduced costs, hospitalization and recovery time compared to open surgery. It describes the two main laparoscopic techniques for CBD stone removal - trans-cystic duct approach and laparoscopic choledochotomy. Key factors that determine technique selection include stone size and location, cystic/CBD duct anatomy and size, and surgeon skill. Standard port placements and step-by-step descriptions of each technique are provided. Complications are discussed. The document concludes with a brief overview of bilioenteric bypass indications and options.
The Ideal Suture Material
Can be used in any tissue
Easy to handle
Good knot security
Minimal tissue reaction
Unfriendly to bacteria
Strong yet small
Won’t tear through tissues
Cheap
USES:
To bring tissue edges together and speed wound healing (=tissue apposition)
Orthopedic surgery to help stabilize joints
Repair ligaments
Ligate vessels or tis
Robotic Surgery means computer/ Robotic assisted surgery.
It was developed to overcome the limitations of MAS and to enhance the capabilities of surgeons performing open Surgery History of Robotic surgery
The first robot to assist in surgery was the Arthrobot, which was developed and used for the first time in Vancouver in 1983.[43] Intimately involved were biomedical engineer, Dr. James McEwen, Geof Auchinleck, a UBC engineering physics grad, and Dr. Brian Day as well as a team of engineering students. The robot was used in an orthopaedic surgical procedure on 12 March 1984, at the UBC Hospital in Vancouver.
Over 60 arthroscopic surgical procedures were performed in the first 12 months, and a 1985 National Geographic video on industrial robots, The Robotics Revolution, featured the device. Other related robotic devices developed at the same time included a surgical scrub nurse robot, which handed operative instruments on voice command, and a medical laboratory robotic arm. A YouTube video entitled Arthrobot illustrates some of these in operation .
Acute pancreatitis is a potentially lethal condition that requires careful treatment and management. It involves sudden inflammation of the pancreas that can lead to the release of digestive enzymes within the abdomen. These enzymes can damage normal tissues, especially fat, and cause inflammation. The document discusses definitions of acute pancreatitis and classifications based on severity. Mild cases involve only inflammation while more severe cases can lead to pancreatic necrosis and organ failure. Treatment depends on the classification and complications. The pathogenesis involves trypsinogen activation within pancreas cells leading to autodigestion and an inflammatory response.
Every upcoming surgeon practising minimal access surgery should know the basics of urology , so that he or she can put his or her,s capabilities as a surgeon
Common symptoms of depression:
Lost of interest in the things that were previously pleasurable
Depressed and Sadness
Hopelessness
Other may Include:
Anxiety
Increased feeling of guilt
Irritability
Impatience
Sleep disturbances
Tearfulness
Difficulty concentrating
Appetite changes (loss/gain)
Increased Isolation
Somatic Pain
Substance abuse
Wound dehiscence is a complication of surgery where the surgical incision ruptures or reopens. It can lead to evisceration of internal organs. Risk factors include obesity, diabetes, wound infection, and surgical factors like tension on the incision. Symptoms include pain, swelling, and drainage at the wound site. Treatment depends on the severity but may involve antibiotics, packing the wound, or re-suturing the incision. Negative pressure wound therapy can also be used to help close wounds at high risk of dehiscence. Preventing wound dehiscence requires proper surgical technique like layered closure with adequate suture length and tissue bites.
Laparoscopic Urologic surgery, is a part of the curriculum of Minimal Access Surgery, and requires lot of skills and patience. All new surgeons carrying out Basic Laparoscopic surgery should aim at also doing Lap. Urological surgeries, which has a steep learning curve, but with with excellent outcomes.
This document discusses bariatric surgery as a treatment for obesity, diabetes, and hypertension - known as the "dangerous triad". It outlines the obesity epidemic globally and in India. Bariatric surgery is presented as the most effective long-term treatment, as other options like diet, exercise, and medication often only achieve temporary weight loss. The document describes various bariatric surgical procedures and their mechanisms for weight loss and resolving comorbidities. Case studies are presented demonstrating successful weight loss and comorbidity resolution through bariatric surgery. Risks are low but include leaks, strictures, and potential for weight regain. A multidisciplinary team approach is emphasized for best outcomes.
This document discusses the pathophysiology of bariatric surgery. It notes that obesity is a global epidemic impacting over 1.7 billion people. Obesity is associated with numerous serious health conditions and comorbidities. Diet and pharmaceutical interventions have proven ineffective for treating severe or morbid obesity. The document outlines the various medical comorbidities of obesity including metabolic, mechanical, degenerative, neoplastic, and psychological conditions. It discusses the criteria for indicating bariatric surgery including BMI over 40 or over 35 with comorbidities. The goals and various procedures of bariatric surgery including restrictive, malabsorptive, and hybrid techniques are summarized.
This document discusses the pathophysiology of bariatric surgery. It notes that obesity is a global epidemic impacting over 1.7 billion people. Bariatric surgery is effective for weight loss and treating obesity-related comorbidities. The main procedures discussed are sleeve gastrectomy, Roux-en-Y gastric bypass, and biliopancreatic diversion with duodenal switch. These work through restriction, malabsorption, or both. Gut hormones like ghrelin and GLP-1 play an important role in appetite and glucose regulation after surgery. The author also shares their experience performing various bariatric procedures in India.
What is MIS?
A minimally invasive medical procedure is defined as one that is carried out by entering the body through the skin or through a body cavity or anatomical opening, but with the smallest damage possible to these struct uresIncludes laparoscopic, endoscopic, and other approaches.
Why MIS?
Decreased patient pain
Decreased patient recovery period
Possible decrease in inflammatory response in the patient which may prove to have a better outcome in oncologic operations.
Distant future
In the distant future, there will be a para- digm shift with the development of non-inva- sive surgical techniques in combination with nanotechnologies and a new era in the devel- opment of surgery, and subsequently in surgi- cal techniques, will be opened.
Nanotechnology is an umbrella term for materials and devices that operate at the nanoskill (1 billionth of a meter). In terms of scale, a nanometer is approximately one 1/8000 of a human hair or 10 times the diam- eter of a hydrogen atom. The size of the device can vary but starts from a ten thou- sand-logic element system that will occupy a cube of no more than one hundred nanome- ters. This is a volume slightly larger than 0.001 cubic microns. This would be sufficient to hold a small computer. For example, if red blood cells are approximately eight microns in diameter, the 100 nanomicroprocessor will be 80 times smaller than a red blood cell. Devices this size could easily fit into the circulatory system and could even conceivably enter indi- vidual cells.
This document provides an overview of bariatric surgery in Odisha, India. It begins with definitions of bariatric surgery and classifications of BMI. It then discusses the comorbidities of obesity and guidelines for determining who is a suitable candidate for bariatric surgery. The document outlines various bariatric procedures including restrictive, malabsorptive, and combination procedures. It also discusses pre-op assessment, investigations, tools used in bariatric surgery, pathophysiology including the role of GI hormones, and videos demonstrating sleeve gastrectomy and Roux-en-Y gastric bypass procedures.
share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
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Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
3. ENDOVISION SYSTEM-‘EYE OF THE SURGEON’
• Revolution in optics & imaging technology helps to produce real
‘life like’ images in a magnified way, thereby helping accurate
dissection.
• ELECTRONIC EYE INSIDE THE ABDOMEN
• The imaging system includes-
– Laparoscope / Telescopes
– Light source
– Light cable
– Cameras
– Monitors
• For a ‘perfect image’ all of them should be of good quality.
• A GOOD ENDOVISION IMPROVES THE QUALITY &
PRECISION OF SURGERY & ITS OUTCOMES.
5. 1.LAPAROSCOPE OR TELESCOPE
• Invented by Hopkins in 1953 Rod Lens system.
• Present day laparoscopes - series of rod lenses in
centre with a rim of optical fibers on the outer aspect.
• Optical fibers carry light into the abdominal cavity &
rod lens system transmits the image from abdomen to
the camera.
• From the camera (attached to the proximal end or eye
piece of the scope) the images are displayed on to a
monitor.
11. LAPAROSCOPES
( TELESCOPES)
Laparoscope may vary in size ( dia.)
Size 0.8mm - (Needlescope) to 15 mm in dia.
Angle of vision - 0° /30°/ 45°, 70. 0 & 120
Rigid, flexible or semi flexible
Brightness of the image reduces with the size of the scope
The angled scopes 30° / 45° provide
Flexible field of vision.
Unobstructed view from distance
More space for maneuverability of instruments
Ability to look around the corners
12. Normal Hopkins Forward Oblique Scope -300
Diameter – 10 mm
Length - 33 cm
Extra Long – 43 cm
Autoclavable
14. 2. CAMERA SYSTEM
• It is the most important and vital part of the
imaging system and should be of good quality.
• It consists of 2 parts-
• Camera head connects to the prox. End or eye
piece of the laparoscope.
• Camera Microprocessor unit which receives,
processes and transmits the pictures to monitor.
15. Requirement of Cameras
Camera Specifications
Three important Features
1.Horizontal Resolution
2.Minimum Luminance
3.Signal to Noise Ratio
16. Horizontal Resolution (lines)
It is a measure that shows to what extent
details can be distinguished on the monitor.
It can be evaluated by establishing the limits
to which lines can be distinguished on a test
pattern.
A larger resolution value means a broader
frequency band of the video signal.
17. Minimum Luminance (lux)
It is a measure that shows to how
sensitive the camera can produce a
good picture.
It is measured in lux or footcandle unit.
1 Footcandle = 10 lux
18. Signal to Noise Ratio (dB)
An S/N ratio is noise to actual total video
signal
It shows how much higher the signal level is to
the level of noise
It is expressed in decibels (dB)
Bigger the value - better the picture
19. Features of Cameras
Horizontal resolution (lines)
Higher ---------> Better
Minimum luminance (lux)
Higher ---------> Worse
Signal to noise ratio (dB)
Higher ---------> Better
20. CAMERA SYSTEM
• Resolution of the camera directly proportionate to the
no. of pixels.
• Presently CCD cameras used – consists of tiny bits of
silicon (divided into multiple tiny sensors) called
‘pixels.’These are arranged in rows & columns and
are sensitive to light.
• When light strikes a pixel, the silicon emits
electricity, that is transmitted to the monitor.
• Electronic signals are sensed to provide the recording
image.
21. The resolution from the CCD is dependent upon the
quantity of the pixels on the sensor.
The resolution is defined as the amount of vertical lines
that may be discriminated separately in 3 quarters from
the width of the monitor screen.
The lap. Camera requires at a min. 300 lines of
resolution to supply a sufficient image.
CAMERA SYSTEM - RESOLUTION
22. TODAY’S LAPAROSCOPIC CAMERAS
Available in Single or 3 Chip
We all know the 3 Primary colours– R / G / B
All the colours are a mixture of these 3 Primary Colours in different
proportion.
Single Chip- All 3 primary colours are sensed by a single or 1 chip.
Three Chip- CCD- chips separately sense, capture and as well as
process the Primary colours.
23. TYPES OF CAMERA SYSTEMS
1. SINGLE CHIP
2. THREE CHIP OR CCD
3. HIGH DEFINITION
4. 3D
5. ROBOTIC PLATFORM
24. SINGLE CHIP CAMERA
– Multiple color sensors
provided in a single chip
providing a single image
– Monitor resolution needed
is usually 400 – 600 lines.
– Adequate for routine basic
surgeries.
26. 3- CHIP CAMERA
– In 1989 , the field of surgery experienced a revolution
in the form of ‘Laparoscopic surgery ’ with the
introduction of CCD cameras (charged couple devices)
and better light sources.
– Captures light in its 3 components
– Unified light slit into its components ‘ red, green, &
blue’(RGB) by prism located in head of the camera
– Signals are then captured by separate CCD’s containing
multiple sensors & are processed and sent to monitor.
– Currently available cameras have ability of producing
videos of resolution of 950 lines i.e. ‘high quality
images’.
– Great help in advanced lap surgeries.
27.
28. HD CAMERA
• The latest generation of cameras are high definition cameras
• They produce the resolution of 1080 horizontal lines per
inch.
• Require HD monitors to reproduce the same quality of
picture
• Offers a superior image with a wide, more natural 16:9
format and 1080p resolution for FULL HD with 2 million
pixels.
• That is the highest resolution in the medical industry.
• At present it is very costly.
32. 4 Types of Video Camera Outputs
1.RGB
Component signal
2.S-VHS or Y/C
Component signal
Chrominance & Luminance (color & light)
3.Composite video signal or BNC
-- All components of the picture combined
into one video signal
4.Digital Signals
35. The human brain combines two images to one 3D impression
BINOCULAR EFFECT-WORKING PRINCIPLE
36
5-8 % of humans don‘t have the
binocular effect
36. STANDARD 2D- EFFECT
CCU
Camera
Head Object2D Endoscope
(one channel)
Sensor
2D HD Monitor (1080 lines x 1920 pixels)
one image (all lines/pixels can be seen with
both eyes)
left Eye
right Eye
37
37. THE 3D- EFFECT
CCU
Camera
Head Object
Dual
Channel
Endoscope
Sensor 1
Sensor 2
Sterile
Adapter
3D Full HD 32“ Monitor Odd lines (line 1,3,5,7…)
even lines (line 2,4,6,8…)
Polarisation
Glasses
38
Polarisation filter
38. Dual channel endoscope creates two live-images
Camera head has two sensors
Flat screen has a polaristion filter and shows two images simultaneously
Even-numbered-lines on screen (2,4,6….) show image 1
Odd-numbered-lines on screen (1,3,5 ….) show image 2
Polarisation glasses select from image 1to (right eye) from image 2 to (left eye)
39
THE POLARISATION EFFECT
39. Circular polarising glasses separate the two images in front of the eye:
- the even lines can be seen only with the right eye
- the odd lines can be seen only with the left eye
The human brain receives a true 3D impression from flat display
The displayed object seems to grow out of the flat screen
The surgeon gets a true depth percecption
40
Stereoscopic visual effect
40. Restores the surgeon’s natural 3D vision and depth
perception.
Provides depth cues and precise spatial orientation
Shown to enhance dissection, grasping skills, suturing, stapling and
overall surgical efficiency.( Correct picking up of delicate tissues &
exact positioning of needles.)
Requires no additional certification or training for those surgeons
certified to perform laparoscopic procedures.
Reduced learning curve for young surgeons.
Enhances task performance leading to lower procedure times and
costs.
Benefits of
41. Cameras -Advantages & Disadvantages
• All cameras need
– White balancing
– Focus – manual / auto
• Some cameras have options of
– Zooming – useful for finer dissection
– Digital enhancement – provides sharper images .
– Disadvantages – development of grains which may distort
– image quality
• HD cameras
– Provide stereoscopic vision
– Costly & no clear cut advantage over existing cameras
3D Cameras ( Disadvantages )
– No optical zoom
– Scope not rotatable
– Presently scope available only as 10 mm & 00
- Wearing of Polarisation glasses
- Costly
43. NIR/ ICG – FLUORESCENCE IMAGING
Near Infra Red & Indo Cyanine Green enables non-
radioactive visualization of the entire lymphatic system
surrounding a tumor in real time.
Advtg:
1. Non- radio active LN detection
2. Multi disciplinary use – Gyaenecology, Surgery ,
Urology
3. Easy switch over from standard to fluorescence
mode by a foot switch.
4. Accuracy in en-bloc dissection during radical
lymphadenectomy
44. 3.LIGHT SOURCES
• Thanks to Edison for inventing the Electric Bulb.
• MAS depends on artificial light to inspect the closed
body cavity.
• Quality of Image obtained depends on the quantity of
light at each step of Opto-Electronic system.
• Essential vital equipment for producing images.
45. 1.Halogen ( Quartz)
Highly efficient, Halogen Gas is used, excellent colour
rendering.Gives yellow coloured light.Economical..
Sufficient for Basic Lap. Surgeries.
Available in 150 watts.
Colour temp.- 5000-6000K
Av. Life- 2000 hrs.
2.Metal Halide-
Mix of a compound ( Rare salts of the earth + Halides)
Ex; Iron & Gallium Iodide Lamp .
Provides high intensity heat alongwith brighter
light.
250 W. Av. Life- 250 hrs.
TYPES OF LIGHT SOURCES
46. 3.Xenon-
Consists of quartz glass ( high grade fused silica)
But cold white light, its tip generate considerable heat, so direct
contact with the internal organs to be avoided.
Better visual clarity
175/300 watts, approx. life of bulb 500 hrs
Colour temp: 6000-6400 k
Slightly Costly
Av. Life – 500 hrs
Natural white light
4.LED-
TYPES OF LIGHT SOURCES
47.
48. PARTS OF THE LIGHT SOURCE
1. Lamp / Bulb
2. 2.Heat Filter
3. 3.Condensing Lens
4. Manual/ Auto Intensity Control Unit
49. 1. LAMP:
Most important part .
Quality depends on the type of lamp used.
2. HEAT FILTER
Energy consumption of a Normal light source
98% heat / 2% light.
Filter reduces the heat & provides a cool light as heat gets
dissipated during transportation along the cable and the
telescope.
3. CONDENSING LENS:
Converges light emitted by the lamp to the area of the light
cable input to the scope.
It increases the light intensity per sq m area
50. 4.MANUAL/ AUTO INTENSITY CONTROL CIRCUIT
All light sources – in built circuit to adjust light intensity either
manually by the surgeon or automatically ( newer L S)
This AGC ( Auto Gain Control) of light source works
synchronously with the advanced camera systems.
51. 4.LIGHT CABLES
• Working Principle- light conducted through a curved
glass rod by total multiple internal reflections, from one
end to other end of the cable .
1. Fiber optic cables – more user friendly consists of
bundles of glass fibers, thread swaged at both ends.
Size of fibres- 10- 25 mm dia. High quality transm.
Disdv—fragile, breaks at bends ( dark spots )
2 Fluid filled cables
– Made of liq. Crystal gel, swaged at both ends.
– Transmits more light – 30% more.
– Disadvantages – stiff , fragile, cannot be autoclaved
Conducts more heat
- Use – Movies / TV as LCD /Photography
54. 4. MONITORS
• Final limb of imaging chain
• Quality of monitor essential for adequate quality of
image
• If monitor does not support resolution of camera,
then all the advantages of using high end camera is
lost.
• Principle-Horizontal linear scanning on the face of
the picture tube.Each picture frame consists of
several lines depending on the type of system used.
55. Final image on the Monitor depends on:
1. No. of lines of Resolution – denotes No.of B&W lines both
vertical & horizontal.
2. Pixels – denotes picture elements & details
3. Dot Pitch – denotes a restricting factor & represents the
phosphor element size.
INPUT CABLES INTO THE MONITOR
1. Composite- Video- via a BNC connector
2. Y/C or S- Video- via a 4-pin DIN connector.
3. RGB Video – via a multi head BNC cable connector.
4. DVI input- compatible to HD monitor / flat panel.
5. HDMI Input
Lap. Cameras supports 1 & 2 above.
New flat panel TV support – RGB input No.3
56. Monitor - Compatibility with Cameras
• Monitors with resolution of 600 lines for single
chip , > 900 lines for three chip & 1080 and above
for HD for optimal resolution are required
• High end analog digital and HD flat panel
monitors are now available,
– they can be placed at more ergonomically viable
positions,
– avoid various head, neck, shoulder ailments in Lap
surgeons
59. Maintenance
• Light Cable – Handle with care. Do not twist.
• Outer surface should be cleaned with mild detergent.
• Periodical cleaning with moist alcohol swabs.
• Avoid pt. burns under drapes.
• Light Source-
• Xenon bulb has life of 500 hrs.
- Change bulb if intensity of light decreases.
- Don’t cover light source while working- excess heating can
cause damage to it
- Periodical check of Light source exhaust fan.
*****DO NOT SEARCH FOR THE BIOMEDICAL STAFF,
TRY TO LEARN AND SOLVE IT YOURSELF.
60. Maintainence
Telescopes-
-Avoid any thermal or mechanical injury to tip of telescope.
- Clean the eye piece, light cable slot and tip with warm water.
- Chemical sterilization with Glutaldehyde or Cidex solution is
done. Few scopes are autoclavable
Camera head-
-Avoid any injury to camera head and its cable.
- Camera cover should be used to avoid contamination of
operating field.
61. Trouble shooting
• Poor picture quality may be due to
- Fogging of scopes
– It is a big problem
– Gives a dull & hazy image
– Warm water/ betadine soaked gauze / anti fog soln. are
used to clean the telescope lens
*[Connecting the insufflations tube to the optical trocar
and passage of cold CO2 causes more fogging]
62. Trouble shooting
• Poor picture quality – needs cleaning of scope tips and
camera head.
Flickering electrical interface -caused by loose
connection.
- Moisture in camera cable connecting plug - dry it with
the help of drier
- Poor cable shielding - replace cables
- Insecure connections - reattach cables
• Blurring or Distortion of picture is due to
incorrect focus - adjust camera focus
- Cracked lens internal moisture - replace scope
63. Trouble shooting
-Inadequate Lighting may be - caused by loose
connection of light cable at source or with
scope - Adjust connector light on- man. to
auto.
- Bulb is burnt out- replace the bulb.
- Fiber optic cable are damaged - replace light
cable.
- Monitor brightness turned down- adjust settings.
64. Trouble shooting
-Light is too bright
-Light is on manual max- turn on to auto mode.
-Light boost activated- deactivate boost
-Monitor brightness up- readjust
-White balancing is mandatory for obtaining
natural colour – target against a white object.
65. Troubleshooting-
• No Picture on Monitor-
- Camera control unit or other components are
not on - check power supply to all the units and
turn on power.
- Cable connection between camera head to
camera control unit and/or monitor is not
attached properly - check all connections.
66. White Balancing
Warm up the light source
Gain in STANDARD position
Fill monitor with white surface
Focus so threads are visible (no glare)
Depress WHITE BALANCE for 3 sec.
Hold image steady on white surface until the tint on the monitor
stabilizes for 2 sec.
OR DEPRESS THE REMOTE ON THE CAMERA HEAD
67.
68.
69. BEST BUY FOR A LAP SET
1.Reputation of the Company
2.After sales and service ( Locality/ state )
3. List of installations ( Add / Contact No. )
4.Check in the Internet.
5.Ask for Demo for 2 weeks.
6.Ask for Invoice/ Quotation of supplied or cheques received
7.Bargain for the best price..
8.Ask for a Package.( Hand instrument set)
9. Ask for an extended warranty.
10. Lastly, ask for supply on a rental basis/ Payments in
Installments.