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.
HARMONIC SYNERGY® Blades use high-frequency mechanical vibration to simultaneously cut and coagulate at the same time, sealing vessels at lower temperatures than electrosurgery:
Precise: Minimal lateral thermal tissue damage for safer dissection near vital structures
Reliable: Seals and divides vessels <= 2mm, as well as lymphatics
Versatile: Cuts, coagulates and dissects, reducing instrument exchanges
HARMONIC SYNERGY® Blades use high-frequency mechanical vibration to simultaneously cut and coagulate at the same time, sealing vessels at lower temperatures than electrosurgery:
Precise: Minimal lateral thermal tissue damage for safer dissection near vital structures
Reliable: Seals and divides vessels <= 2mm, as well as lymphatics
Versatile: Cuts, coagulates and dissects, reducing instrument exchanges
LAPAROSCOPIC HAND INSTRUMENTS, ACCESSORIES AND ERGONOMICSsinghanubhav5
EXTENSIVE COVERAGE OF LAPAROSCOPIC INSTRUMENTS AND THEIR ERGONOMICS TO HELP SURGEONS TO KNOW HOW TO USE THEIR LAP INSTRUMENTS IN MOST APPROPRIATE WAY AND THEIR ERGONOMICS TO BE COMFERTABLE DURING SURGERY AND PATIENTS LIFE ALSO MORE SAFE.
Slideshow of Laparoscopic Surgery by Prof. R.K. Mishra Prof. R.K. Mishra has the distinction of being first Asian who is honoured as Professor of Minimal Access Surgery by legislated University of Govt. of India. He is is currently the most experienced professor of minimal surgery in the world who has alone as a single faculty trained more than 3000 surgeon and gynaecologists from 108 countries. http://www.laparoscopyhospital.com/drrkmishra.htm
This presentation will help u know with the history,present and coming up trends in laparoscopy .Also it is an acquaintance presentation regarding laparoscopy.
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.
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.
Basics of laproscopic surgery..
by dr navdeep s kamboj presented at sgrdumsar amritsar.
topics covered--
1 basics of laparoscopy
2 lap cholecystectomy
3 lap appendixcectomy
pneumoperitonem
merits and demerits of laproscopy
ligasure
endoscopy,
laparoscopic instruments
LAPAROSCOPIC HAND INSTRUMENTS, ACCESSORIES AND ERGONOMICSsinghanubhav5
EXTENSIVE COVERAGE OF LAPAROSCOPIC INSTRUMENTS AND THEIR ERGONOMICS TO HELP SURGEONS TO KNOW HOW TO USE THEIR LAP INSTRUMENTS IN MOST APPROPRIATE WAY AND THEIR ERGONOMICS TO BE COMFERTABLE DURING SURGERY AND PATIENTS LIFE ALSO MORE SAFE.
Slideshow of Laparoscopic Surgery by Prof. R.K. Mishra Prof. R.K. Mishra has the distinction of being first Asian who is honoured as Professor of Minimal Access Surgery by legislated University of Govt. of India. He is is currently the most experienced professor of minimal surgery in the world who has alone as a single faculty trained more than 3000 surgeon and gynaecologists from 108 countries. http://www.laparoscopyhospital.com/drrkmishra.htm
This presentation will help u know with the history,present and coming up trends in laparoscopy .Also it is an acquaintance presentation regarding laparoscopy.
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.
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.
Basics of laproscopic surgery..
by dr navdeep s kamboj presented at sgrdumsar amritsar.
topics covered--
1 basics of laparoscopy
2 lap cholecystectomy
3 lap appendixcectomy
pneumoperitonem
merits and demerits of laproscopy
ligasure
endoscopy,
laparoscopic instruments
Laparoscopy is an operation performed in the abdomen or pelvic area using small incisions, often less than 1.5 cm, with the assistance of a Laparoscopic camera, typically for gallbladder, colon, kidney, and other procedures. Before, if an operation had to be conducted in the belly, doctors had to cut open the area, hence the name laparotomy.
General x-ray machine and fluoroscopy
the presentation to medical workers
contain simple explanation about radiation protection in the radiology department
Surgical instruments and hospital equipmentsSHIVANEE VYAS
The diagnostic tools are more important to the surgeon than his surgical instruments. Accurate diagnosis is essential for appropriate and effective treatment. Without the use of instruments, we would not be able to visualize directly the duodenum, bile ducts, colon or even joints, etc.
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.
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!
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.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
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.
CDSCO and Phamacovigilance {Regulatory body in India}NEHA GUPTA
The Central Drugs Standard Control Organization (CDSCO) is India's national regulatory body for pharmaceuticals and medical devices. Operating under the Directorate General of Health Services, Ministry of Health & Family Welfare, Government of India, the CDSCO is responsible for approving new drugs, conducting clinical trials, setting standards for drugs, controlling the quality of imported drugs, and coordinating the activities of State Drug Control Organizations by providing expert advice.
Pharmacovigilance, on the other hand, is the science and activities related to the detection, assessment, understanding, and prevention of adverse effects or any other drug-related problems. The primary aim of pharmacovigilance is to ensure the safety and efficacy of medicines, thereby protecting public health.
In India, pharmacovigilance activities are monitored by the Pharmacovigilance Programme of India (PvPI), which works closely with CDSCO to collect, analyze, and act upon data regarding adverse drug reactions (ADRs). Together, they play a critical role in ensuring that the benefits of drugs outweigh their risks, maintaining high standards of patient safety, and promoting the rational use of medicines.
2. ContentsContents
1. General description
2. Principals of laparoscopy
3. Composition of laparoscope
I. Equipment cart
II. Insufflating system
III. Imaging system
IV. Instrumentations
V. Electro-surgical-cautery
system
3. Laparoscopy
Laparoscopy is a technologically dependent
surgery comprising of computerized designed
instruments with microprocessor controlled safety
features.
Principal of laparoscopy
Identification of pathology and surgical
intervention is the solely principal of laparoscopy.
4. COMPOSITION OF A LAPAROSCOPE
1. Equipment cart
2. Insufflating system
3. Imaging system
4. Instrumentations
5. Electro-surgical-cautery system
5. Equipment cart
Multiple shelves for different equipments
1. Monitor shelf
2. Light source shelf
3. Co2 insufflators shelf
4. Electro-surgical shelf
6. Monitor shelf
Camera reader shelf
Co2 insufflators shelf
Light source shelf
Electro-surgical shelf
Figure: Equipment cart
7. Insufflating system
Insufflation system allows gas to fill the
abdominopelvic cavity to maximize visualization.
Insufflation system are designed to deliver the gas at
low as well as high pressure to ensure the constant set
intra-abdomino-pelvic pressure during surgery.
Insufflations tube with 0.3 micron filter is
recommended to prevent contamination with bacteria,
micro-particles and debris from insufflators and gas
tank.
8. CO2 Cylinders
Available sizes are
2.5 lb CO2 tanks
• 5 lb CO2 cylinders
• 7 lb CO2 tanks
• 10 lb CO2 cylinders
• 15 lb CO2 tanks
• 20 lb CO2 tanks
• 35 lb CO2 tanks
• 50 lb CO2 tanks
Figure: CO2 Cylinders
9. CO2 Cable:
It is flexible,
friendly use and
highly tensile in
strength to ensure
the proper
delivery of gas
from insufflators
to intra-peritoneal
cavity without
leakage.
Figure: CO2 Cable
11. Imaging system
1. Light source
2. Fiber-optic cable
3. Camera console
4. Endoscope/Telescope
5. Monitor
12. Light source
Three types are there
1. Halide
2. Halogen
3. Xenon
Halogen: 250 watts inbuilt
lamp and this is economical
Xenon: 175-300 watts lamp
and this is expensive Figure: Light source
13. LIGHT CABLES
There are two types of
light cables
Fluid filled cables and
fiber-optic cables
Fiber-optic cables
They conduct less heat
They are soft and sound to handle
They don’t produce hindrance
while handling camera console
They are easily autoclaved
Fluid filled cables
They conduct more heat
Stiffer and tough in nature
They produce hindrance while
handling camera console
They are difficult to be autoclaved
15. Camera console
The camera head consists of a goal lens, a prism assembly
and three sensors for acquiring the primary colors of the
image.
Optical zoom is advantageous because it doesn't have
negative effect on the look resolution.
White balancing and contrast
Zoom options
Digital enhancement options to create sharper images.
17. Endoscope/Telescope:
British physicist Hopkins invented in 1952.
Normally used telescope is the Hopkins Forward
Oblique Telescope 30°, diameter 10mm length 33cm,
and is autoclavable.
At the distal end is a front lens complex (inverting real-
image lens system, IRILS) which creates an inverted
and real image of the subject.
Forward viewing, 300 angled and 450 angled.
20. Monitor
Surgical monitors are no different from the T.V. We watch at home.
The existing television systems in use differ according to the country.
The U.S.A uses the NTSC (National Television System Committee)
system.
In European countries the PAL (Phase Alternation by Line) system is in
use.
There is also a French system called SECAM (Sequential color and
memory).
The broadcasting standards for each are summarized below:
Standard resolution monitors have 400 lines
High definition monitors have 1200 lines.
22. Handling devices
It contains following parts
i. Tip
ii. Insulated outer tube
iii. Rotator
iv. Attachment for electro-surgical
cord
v. Rachet for locking
24. TROCAR
A trocar is a laparoscopic device that is made up of
an obturator (which may be a metal or plastic
sharpened or non-bladed tip) and a cannula (basically a
hollow tube).
Trocars are placed through the abdomen
during laparoscopic surgery.
The trocar functions as a portal for the subsequent
placement of other instruments, such as graspers,
scissors, staplers, etc
26. What should be the good qualities of a
handling device?
It is usually 33 cm long
Jaws to be adequately elastic to perform atraumatic
handling
Easy to disassemble and reassemble
Parts should be interchangeable between similar
instruments
Easy cleaning and sterilization
Simple design with minimum number of hinges and bolts
27. Scissors
Reposable scissors: They combine reusable handle with
disposable scissor. They can be straight or curved scissors.
Reusable scissor: They combine reusable handle and reusable
scissors. They can be straight or curved scissors.
These scissors are called Metzenbaum scissors
Types
Straight scissor
Micro curved scissor
Hook scissor
33. Dissectors
Most commonly used is Maryland dissector.
Maryland dissector:
· Maryland dissector instrument is inserted through 5 mm trocar.
· Dissector comes with long, curved jaws and fine-tapered tips
· Dissectors used mainly for separation of sac from cord structures
·Also finding use for other blunt dissection purposes
· Rotating shaft for allowing easy dissection with lesser strain to surgeon's
wrist
· Sharp and insulated scissor finish
· As a monopolar electrosurgical instrument it finds use for dissection and
hemostasis using flexible endoscopes with working channel
36. Clip applicator
This is used to ligate the vessels and ducts. The
applicator is first loaded with metallic clip and then
clip is applied by applying pressure to handle of the
instrument.
38. Veress needle
A Veress needle is a spring-loaded needle used to
create pneumoperitoneum for laparoscopic surgery.
The tool was first developed in 1932 by Janos Veres,
a Hungarian internist.
Modern needles are 12 to 15 cm long, with an external diameter of
2 mm.
The outer cannula consists of a beveled needle point for cutting
through tissues of the abdominal wall. A spring-loaded, inner stylet is
positioned within the outer cannula. This inner stylet has a dull tip to
protect any viscera from injury by the sharp, outer cannula.
40. Suction and irrigation cannula
This tube is essentially used in case of antra-
abdominal leakage in order to was out the
affected area.
This is three way cannula in which one end is used
for suction, another for irrigation and third one for
being placed in abdominal cavity.