Open cholecystectomy vs laparoscopic cholecystectomyDrThakkar
1. Open Cholecystectomy v/s Laparoscopic cholecystectomy - Gallbladder Stone Surgery
2. Introduction - Gallstones are a common occurrence in northern India. However, this trend is now showing pa
3. n India presence probably because of migration and blending of cultures and lifestyle. As many as 16% and 29% of women above the age of 40-49 years and 50-59 years, respectively, had gall stones. For every patient with symptomatic gallstone disease there are many more with asymptomatic gallstones. Laparoscopic cholecystectomy has now replaced open cholecystectomy as the first-choice of treatment for gallbladder stone and inflammation of the gallbladder.
4. Open Cholecystectomy - Cholecystectomy is one of the most commonly performed abdominal surgical procedures. The laparoscopic approach is preferred due to documented physiologic, economic, and cosmetic benefits compared with the open approach. However, when laparoscopic cholecystectomy is not possible or cannot be completed safely, open cholecystectomy is indicated. Open cholecystectomy may also be performed as an integral part of another operation (eg, pancreaticoduodenectomy) or incidentally, if indicated, during another gastrointestinal operation (eg, colon resection).
5. Laparoscopic cholecystectomy - Cholecystectomy is one of the most commonly performed abdominal surgical procedures, and in developed countries many are performed laparoscopically. As an example, 90 percent of cholecystectomies in the United States are performed laparoscopically. Laparoscopic cholecystectomy is considered the "gold standard" for the surgical treatment of gallstone disease. This procedure results in less postoperative pain, better cosmetics, and shorter hospital stays and disability from work than open cholecystectomy [2-8]. However, the overall serious complication rate in laparoscopic cholecystectomy remains higher than that seen in open cholecystectomy.
6. Risks & Complications - The risk of complications is very low, however, potential risks might include: - Bleeding, Infection, Common bile duct injury, Minor shoulder pain (from the carbon dioxide gas), Bile leakage.
7. Benefits: - Less discomfort than regular surgery, Shorter hospital stay, with a quicker recovery time compared to regular (open) surgery, Smaller scars than regular surgery.
8. Consult us for Gallbladder Stone Treatment - For Appointment Call 079-29703438 Or Visit :- www.drchiragthakkar.com
Difficult Laparoscopic Cholecystectomy-When and Where is the Need to Convert?Apollo Hospitals
Laparoscopic cholecystectomy has now become the treatment of choice for the gall bladder stone. With increasing experience, surgeon has started to take more difficult cases which were considered relative contra indications for laparoscopic removal of gall bladder few years back.
We conducted this study at our hospital and included all laparoscopic cholecystectomy done from May'08 to January'10. Total time taken in surgery, conversion rate and complication rate were analysed. Factors making laparoscopic cholecystectomy difficult were also analysed. We defined difficult laparoscopic cholecystectomy when we found -dense fibrotic adhesions in and around Callot's triangle, gangrenous gall bladder, empyma, large stone impacted at gall bladder neck, contracted gall bladder, Mirrizi's syndrome, h/o biliary pancreatitis, CBD stones, acute cholecystitis of <72 hrs duration.
Out of 206 cases done during above period, 56 cases were considered difficult. Only two cases were converted to open.
With growing experience and technical advancement surgery can be completed in most of the difficult cases. This is important because recently it is shown in literature that laparoscopic cholecystectomy is associated with less morbidity than open method irrespective of duration of the surgery.
Laparoscopic cholecystectomy is the current gold standard for surgical removal of the Gall bladder, particularly in benign pathologies. Hence, it is necessary to highlight some steps to accomplish this procedure successfully while avoiding pitfalls.
Open cholecystectomy vs laparoscopic cholecystectomyDrThakkar
1. Open Cholecystectomy v/s Laparoscopic cholecystectomy - Gallbladder Stone Surgery
2. Introduction - Gallstones are a common occurrence in northern India. However, this trend is now showing pa
3. n India presence probably because of migration and blending of cultures and lifestyle. As many as 16% and 29% of women above the age of 40-49 years and 50-59 years, respectively, had gall stones. For every patient with symptomatic gallstone disease there are many more with asymptomatic gallstones. Laparoscopic cholecystectomy has now replaced open cholecystectomy as the first-choice of treatment for gallbladder stone and inflammation of the gallbladder.
4. Open Cholecystectomy - Cholecystectomy is one of the most commonly performed abdominal surgical procedures. The laparoscopic approach is preferred due to documented physiologic, economic, and cosmetic benefits compared with the open approach. However, when laparoscopic cholecystectomy is not possible or cannot be completed safely, open cholecystectomy is indicated. Open cholecystectomy may also be performed as an integral part of another operation (eg, pancreaticoduodenectomy) or incidentally, if indicated, during another gastrointestinal operation (eg, colon resection).
5. Laparoscopic cholecystectomy - Cholecystectomy is one of the most commonly performed abdominal surgical procedures, and in developed countries many are performed laparoscopically. As an example, 90 percent of cholecystectomies in the United States are performed laparoscopically. Laparoscopic cholecystectomy is considered the "gold standard" for the surgical treatment of gallstone disease. This procedure results in less postoperative pain, better cosmetics, and shorter hospital stays and disability from work than open cholecystectomy [2-8]. However, the overall serious complication rate in laparoscopic cholecystectomy remains higher than that seen in open cholecystectomy.
6. Risks & Complications - The risk of complications is very low, however, potential risks might include: - Bleeding, Infection, Common bile duct injury, Minor shoulder pain (from the carbon dioxide gas), Bile leakage.
7. Benefits: - Less discomfort than regular surgery, Shorter hospital stay, with a quicker recovery time compared to regular (open) surgery, Smaller scars than regular surgery.
8. Consult us for Gallbladder Stone Treatment - For Appointment Call 079-29703438 Or Visit :- www.drchiragthakkar.com
Difficult Laparoscopic Cholecystectomy-When and Where is the Need to Convert?Apollo Hospitals
Laparoscopic cholecystectomy has now become the treatment of choice for the gall bladder stone. With increasing experience, surgeon has started to take more difficult cases which were considered relative contra indications for laparoscopic removal of gall bladder few years back.
We conducted this study at our hospital and included all laparoscopic cholecystectomy done from May'08 to January'10. Total time taken in surgery, conversion rate and complication rate were analysed. Factors making laparoscopic cholecystectomy difficult were also analysed. We defined difficult laparoscopic cholecystectomy when we found -dense fibrotic adhesions in and around Callot's triangle, gangrenous gall bladder, empyma, large stone impacted at gall bladder neck, contracted gall bladder, Mirrizi's syndrome, h/o biliary pancreatitis, CBD stones, acute cholecystitis of <72 hrs duration.
Out of 206 cases done during above period, 56 cases were considered difficult. Only two cases were converted to open.
With growing experience and technical advancement surgery can be completed in most of the difficult cases. This is important because recently it is shown in literature that laparoscopic cholecystectomy is associated with less morbidity than open method irrespective of duration of the surgery.
Laparoscopic cholecystectomy is the current gold standard for surgical removal of the Gall bladder, particularly in benign pathologies. Hence, it is necessary to highlight some steps to accomplish this procedure successfully while avoiding pitfalls.
Safe Laparoscopic Cholecystectomy Techniques that are discussed here are based on current literature and Evidence Based Medicine guidelines and reviews.
LAPAROSCOPIC CHOLECYSTECTOMY- OPERATIVE SURGERY
#surgicaleducator #operativesurgery #laparoscopiccholecystectomy #usmle #babysurgeon #surgicaltutor
Dear viewers,
• Greetings from “Surgical Educator”
• Because of the popular demand by viewers of the YouTube channel “Surgical Educator”, I have decided to create and upload videos on common surgeries.
• I have already uploaded videos on open and Laparoscopic Appendicectomy, Thyroidectomy, Modified Radical Mastectomy and Open Cholecystectomy.
• In this video today, I have discussed Laparoscopic Cholecystectomy- the flagship procedure for laparoscopic surgeries.
• However, these videos are not real surgeries but the theoretical aspect of operative surgery like going through an atlas of operative surgery.
• Along with these videos, I recommend you to watch real operative surgery videos as well and the links are:
• https://www.youtube.com/watch?v=VStEzI1jL8Y
• https://www.youtube.com/watch?v=O8j4kwpzd24
• This will give a very good opportunity for the surgical trainees to mentally rehearse various surgical steps in a sequential manner prior to actual surgery. You can watch the video in the following links:
• surgicaleducator.blogspot.com
• youtube.com/c/surgicaleducator
LC is one most of laparoscopic surgery that general surgery resident should to achieving before graduate the training.This slide is referenced from SAGES technique.
Laparoscopic Management Of Pseudocyst Pancreas.pptxVarunraju9
The treatment focus of psedo pancreatic cyst is shifting slowly in to minimally invasive procedures and the scientific data is assuring it's long standing future with good results.
Safe Laparoscopic Cholecystectomy Techniques that are discussed here are based on current literature and Evidence Based Medicine guidelines and reviews.
LAPAROSCOPIC CHOLECYSTECTOMY- OPERATIVE SURGERY
#surgicaleducator #operativesurgery #laparoscopiccholecystectomy #usmle #babysurgeon #surgicaltutor
Dear viewers,
• Greetings from “Surgical Educator”
• Because of the popular demand by viewers of the YouTube channel “Surgical Educator”, I have decided to create and upload videos on common surgeries.
• I have already uploaded videos on open and Laparoscopic Appendicectomy, Thyroidectomy, Modified Radical Mastectomy and Open Cholecystectomy.
• In this video today, I have discussed Laparoscopic Cholecystectomy- the flagship procedure for laparoscopic surgeries.
• However, these videos are not real surgeries but the theoretical aspect of operative surgery like going through an atlas of operative surgery.
• Along with these videos, I recommend you to watch real operative surgery videos as well and the links are:
• https://www.youtube.com/watch?v=VStEzI1jL8Y
• https://www.youtube.com/watch?v=O8j4kwpzd24
• This will give a very good opportunity for the surgical trainees to mentally rehearse various surgical steps in a sequential manner prior to actual surgery. You can watch the video in the following links:
• surgicaleducator.blogspot.com
• youtube.com/c/surgicaleducator
LC is one most of laparoscopic surgery that general surgery resident should to achieving before graduate the training.This slide is referenced from SAGES technique.
Laparoscopic Management Of Pseudocyst Pancreas.pptxVarunraju9
The treatment focus of psedo pancreatic cyst is shifting slowly in to minimally invasive procedures and the scientific data is assuring it's long standing future with good results.
IVU is the radiographic examination of urinary tract including renal parenchyma, calyces and pelvis after intravenous injection of contrast media. Study was carried out at UCMS, Bhairawa, Nepal.
Capsule endoscopy_ A new dimension of endoscopy Final.pptxYasir Arafat
Capsule endoscopy is a modern diagnostic procedure that has revolutionized the field of gastroenterology. It involves swallowing a small capsule containing a camera that captures images of the digestive tract as it passes through the body. These images are then transmitted to a recording device, allowing physicians to visualize the entire gastrointestinal tract from the oesophagus to the colon.
Laparoscopic surgery has undergone rapid development in recent years. Laparoscopic cholecystectomy was first performed in 1985. Since the introduction of laparoscopic cholecystectomy into general practice in 1990, it has rapidly become the dominant procedure for gallbladder surgery.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
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!
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
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.
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
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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.
1. Case-2
Acute Pancreatitis- Leading Pancreatic Pseudocyst- Endoscopic Treatment
performed (EUS Guided Cystogastrostomy )
A 36 yrs/ Male referred to us for the favor of EUS ( Endoscopic Ultrasound) sos guided
drainage of Pancreatic pseudocyst secondary to an episode of severe acute pancreatitis (
alcohol related) about 11 months back. The size of pseudocyst was around 11 cms x 10
cms and there was no regression of size in the last 11 months and patient complained of
intermittent pain and vomiting and hence EUS was considered.
EUS showed a large pseudocyst with some compression on stomach without any
abnormal vessels or pseudoaneurysm. EUS guided cystogastrostomy was then performed
with a therapeutic EUS scope. After placement of double pigtail stent the pseudocyst
regressed immediately and patient was observed overnight and sent home the next day.
On follow up patient is symptomatic and stent has been removed, so far in 23 months of
follow up there is no recurrence.
1.EUS showed large pseudocyst
without debris
2. EUS guided transgastric puncture
--------------------------------------------------------------------------------------------------------------------Endoscopy Asia
2nd Floor, Lion Tarachand Bapa Hospital Marg,Jain Society, Sion (West),Mumbai 400 022, India. Contact
No (09:30 - 20:30) 022 2404 3522 / 2404 4680, 3208 8827 / 8 / 9 | Emergency (08:30 - 23:30) +91 93200
91763 / 98200 91763 | Email: enquiry@endoscopyasia.com |Telefax: 022 2404 4680
2. 3. Puncture tract dilated with cystotome
5. Double pigtail stent draining clear
Pseudocyst fluid into the stomach
4. Tract further dilated with a 6 mm
balloon
6 Fluoroscopy shows double pigtail stent
Placed across the stomach wall into the
Pseudocyst. Echoendoscope seen.
Expert comments:
It is well known that after an episode of acute pancreatitis some patient may develop
pseudocyst of pancreas. Almost 2/3rd of them resolve spontaneously over a period of 6-8
months and about 1/3 of them may become symptomatic which requires treatment.
Traditionally the treatment of Pancreatic Pseudocyst has been Surgical – either open
surgery or Laparoscopic.
However, with the advent of EUS guided drainage, in our experience for last 1 decade
eversince we pioneered the Interventional EUS in Mumbai and India, almost 95-97% of
symptomatic Pseudocysts at Endoscopy Asia can be managed with EUS guided drainage
procedure. Published studies have shown similar conclusion that most patients with
Pancreatic pseudocyst either secondary to acute or chronic pancreatitis can be managed
successfully with EUS guided drainage, hence the role of Surgery is there only if EUS
--------------------------------------------------------------------------------------------------------------------Endoscopy Asia
2nd Floor, Lion Tarachand Bapa Hospital Marg,Jain Society, Sion (West),Mumbai 400 022, India. Contact
No (09:30 - 20:30) 022 2404 3522 / 2404 4680, 3208 8827 / 8 / 9 | Emergency (08:30 - 23:30) +91 93200
91763 / 98200 91763 | Email: enquiry@endoscopyasia.com |Telefax: 022 2404 4680
3. infrastructure and expertise are not available, especially if there is a non bulging
pseudocyst..
Though large bulging pseudocysts can be drained even endoscopically, whenever
possible EUS guided drainage will provide a safer window of puncture across the gut
wall and thereby prevent complications such as bleeding and perforation that can occur.
Case 3
Bleeding per rectum- Endoscopic diagnosis and treatment
A 48yrs/ F was referred to us for the favor of colonoscopy to evaluate the exact etiology
of bleeding per rectum off and on for last 6 months leading to drop in Hb. Patient was
treated conservatively for colitis and piles by a family physician. However, patient
continued to have symptoms despite several months of treatment and hence went to see a
Surgeon who asked for a colonoscopic evaluation.
Ileo-colonoscopic evaluation revealed a large 4 cms bilobed polyp with a thick stalk at
the recto-sigmoid junction. Rest of the colon upto the caecum and also the last 15 cms of
terminal ileum was normal. Polypectomy was then performed with a snare and cautery
after injection of diluted saline adrenaline into the stalk. Complete resection of the polyp
was achieved and was sent for HPE, which revealed tubulovillous adenoma without
dysplasia. Patient was sent home the same evening.
1. Large bilobed polyp with thick stalk
seen in Recto-sigmoid region.
2. Diluted saline adrenaline injected in the
stalk
--------------------------------------------------------------------------------------------------------------------Endoscopy Asia
2nd Floor, Lion Tarachand Bapa Hospital Marg,Jain Society, Sion (West),Mumbai 400 022, India. Contact
No (09:30 - 20:30) 022 2404 3522 / 2404 4680, 3208 8827 / 8 / 9 | Emergency (08:30 - 23:30) +91 93200
91763 / 98200 91763 | Email: enquiry@endoscopyasia.com |Telefax: 022 2404 4680
4. 3. The stalk strangulated with a
polypectomy Snare
4. No evidence of bleeding from the
resected site
5. Polyp retrieved with a Roth net.
6. Bilobed resected polyp was sent for
histopathological examination
Expert comments
Patient above the age of 45 yrs with h/o bleeding per rectum should be investigated in
detail and empirical treatment without a definitive diagnosis should be avoided. In this
case patient suffered for almost 6 months before getting the a definitive diagnosis and
effective endoscopic treatment in the same sedation and was cured of her symptoms.
Pedunculated or even flat sessile colonic lesions can be successfully resected with
endoscopic techniques such as polypectomy as in this case or we can employ more
sophisticated tools that can perform EMR ( Endosocpic Mucosal Resection ) or ESD (
Endoscopic Submucosal Dissection).
It is our policy at Endoscopy Asia to inspect 10-15 cms of terminal ileum in all patients
referred to us for Colonoscopy and more so if we are looking for a lesion that could
bleed. It is also important to perform these procedures under one sedation at the pilot
--------------------------------------------------------------------------------------------------------------------Endoscopy Asia
2nd Floor, Lion Tarachand Bapa Hospital Marg,Jain Society, Sion (West),Mumbai 400 022, India. Contact
No (09:30 - 20:30) 022 2404 3522 / 2404 4680, 3208 8827 / 8 / 9 | Emergency (08:30 - 23:30) +91 93200
91763 / 98200 91763 | Email: enquiry@endoscopyasia.com |Telefax: 022 2404 4680
5. endoscopy, both the diagnostic and therapeutic aspects when we deal with bleeding per
rectum in an infrastructure which is equipped enough with all the methods of endoscopic
haemostasis.
--------------------------------------------------------------------------------------------------------------------Endoscopy Asia
2nd Floor, Lion Tarachand Bapa Hospital Marg,Jain Society, Sion (West),Mumbai 400 022, India. Contact
No (09:30 - 20:30) 022 2404 3522 / 2404 4680, 3208 8827 / 8 / 9 | Emergency (08:30 - 23:30) +91 93200
91763 / 98200 91763 | Email: enquiry@endoscopyasia.com |Telefax: 022 2404 4680