Recent advances in bariatric surgery include the development of minimally invasive procedures like mini gastric bypass and endoscopic interventions. Obesity is a growing global epidemic that increases the risk of chronic diseases and mortality. Bariatric surgery procedures have become more common and effective treatments for severe obesity, led by laparoscopic sleeve gastrectomy and Roux-en-Y gastric bypass. Newer procedures and endoscopic techniques aim to provide weight loss benefits with less risk and invasiveness than traditional bariatric surgery.
Minimal invasive Surgery in Management of colorectal cancerpiyushpatwa
Laparoscopic Anterior resection. After insertion of ports with patient in steep trendelenburg position Inferior mesenteric artery was identified and high ligation done with division of left colic artery and then medial to lateral dissection was done. Subsequently inferior mesenteric vein was dissected and clipped and divided. Distal dissection proceeded just behind the superior rectal artery and after identification and preservation of the hypogastric nerves, upper rectum was mobilised. Division of bowel was done at upper rectum after giving adequate distal margin and end to end anastomosis was done using circular stapler.
In Depth review of the Surgical management of esophageal carcinoma including management overview, endoscopic management, Type of surgeries, Open, and minimally invasive, Extent of lymphadenectomy. Literature review of evidence for type of surgery and complications
Minimal invasive Surgery in Management of colorectal cancerpiyushpatwa
Laparoscopic Anterior resection. After insertion of ports with patient in steep trendelenburg position Inferior mesenteric artery was identified and high ligation done with division of left colic artery and then medial to lateral dissection was done. Subsequently inferior mesenteric vein was dissected and clipped and divided. Distal dissection proceeded just behind the superior rectal artery and after identification and preservation of the hypogastric nerves, upper rectum was mobilised. Division of bowel was done at upper rectum after giving adequate distal margin and end to end anastomosis was done using circular stapler.
In Depth review of the Surgical management of esophageal carcinoma including management overview, endoscopic management, Type of surgeries, Open, and minimally invasive, Extent of lymphadenectomy. Literature review of evidence for type of surgery and complications
POEM (Per Oral Endoscopic Myotomy) is a rising well known treatment for Achalasia ....... in this ppt we discuss the feasibility of POEM versus dilation and Heller's myotomy
Understant what is obesity and Bariatric Surgery, what are the risk factors and how to overcome on the it. For more information visit at http://gisurgery.info
Dr Pravin John and Dr John Thanakumar, Anurag Hospital, Coimbatore present the differences between metabolic and obesity surgery - dept of advanced laparoscopy and obesity
Component seperation technique for the repair of very large ventral hernias nikhilameerchetty
Includes all the ventral hernia repairs with the loss of domain and the various methods of component separation technique with their success rate for their repair ,few videos showing the methods of repair in addition to the latest techniques of repair .
Oncoplastic Breast surgery is simultaneous application of lumpectomy and reconstructive techniques. The word ‘oncoplastic’ is derived from the Greek words ‘onco’ (tumour) and ‘plastic’ (to mould).
Approximately 10% to 30% of patients submitted to BCS alone are not satisfied with the aesthetic outcomes like “swan beak/ parrot beak deformities. The main reasons are related this is the tumour resection which can produce asymmetry, retraction, and volume changes in the breast.
Recently, increasing attention has been focused on oncoplastic procedures since the immediate application of plastic breast surgery techniques provide a wider local excision while still achieving the goals of a better breast shape and symmetry to obtain oncologically sound and aesthetically pleasing results. Thus, by means of customized techniques the surgeon ensures that oncologic principles are not jeopardized while meeting the needs of the patient from an aesthetic point of view.
POEM (Per Oral Endoscopic Myotomy) is a rising well known treatment for Achalasia ....... in this ppt we discuss the feasibility of POEM versus dilation and Heller's myotomy
Understant what is obesity and Bariatric Surgery, what are the risk factors and how to overcome on the it. For more information visit at http://gisurgery.info
Dr Pravin John and Dr John Thanakumar, Anurag Hospital, Coimbatore present the differences between metabolic and obesity surgery - dept of advanced laparoscopy and obesity
Component seperation technique for the repair of very large ventral hernias nikhilameerchetty
Includes all the ventral hernia repairs with the loss of domain and the various methods of component separation technique with their success rate for their repair ,few videos showing the methods of repair in addition to the latest techniques of repair .
Oncoplastic Breast surgery is simultaneous application of lumpectomy and reconstructive techniques. The word ‘oncoplastic’ is derived from the Greek words ‘onco’ (tumour) and ‘plastic’ (to mould).
Approximately 10% to 30% of patients submitted to BCS alone are not satisfied with the aesthetic outcomes like “swan beak/ parrot beak deformities. The main reasons are related this is the tumour resection which can produce asymmetry, retraction, and volume changes in the breast.
Recently, increasing attention has been focused on oncoplastic procedures since the immediate application of plastic breast surgery techniques provide a wider local excision while still achieving the goals of a better breast shape and symmetry to obtain oncologically sound and aesthetically pleasing results. Thus, by means of customized techniques the surgeon ensures that oncologic principles are not jeopardized while meeting the needs of the patient from an aesthetic point of view.
Rivision surgery after laparoscopic sleeve gastrectomyIbrahim Abunohaiah
Revision Surgery After Laparoscopic Sleeve Gastrectomy
Introduction to bariatric surgery
When to Revise a Weight Loss Surgery?
Options for redo surgery.
Laparoscopic Roux-en-Y gastric Bypass.
Weight Loss Solutions at Nova helps many lose weight safely and successfully.
Reduces blood pressure, diabetic and coronary conditions while improving mobility.
Weight loss surgery - is it the right choice? By TruweightTruweight
If you think that you are too busy to follow a healthy way to lose weight then you need to at least consider the risks associated with Weight Loss Surgeries and their side effects.
surgeries involved in gastroenterology: gastrointestinal surgery, conditions treated with gastrointestinal surgeries,procedure and side effects of these surgeries, open gastrointestinal surgeries and minimally invasive gastrointestinal surgeries
A presentation by Dr Jacob Chisholm on Developments In Gastrointestinal Therapies.
Jacob Chisholm is an upper gastrointestinal and general surgeon with an interest in weight loss and metabolic surgery. Jacob received his undergraduate degree (MBBS) from the University of Adelaide, a postgraduate research degree (Masters of Surgery) from Flinders University and is a Fellow of the Royal Australasian College of Surgeons. He trained in surgery at the Royal Adelaide and Flinders Medical Centre before completing a bariatric fellowship in 2007. Jacob was appointed chief surgical resident at Flinders Medical Centre in 2008 and has been a consultant surgeon at that institution since 2010. Jacob joined the Adelaide Bariatric Centre in 2010.
Similar to Recent advances in Bariatric surgery (20)
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
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.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
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MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
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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.
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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.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of 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 leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
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. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
3. ❑ Chronic disease
❑ Increasing prevalence in adults, adolescents and children
❑ Now considered a global epidemic
❑ Morbidly obese - at risk of physical and metabolic co-morbidities
❑ Severely impair health
❑ Increase mortality.
4. HARMS CAUSED:
❑ Higher relative risk of Hypertension
❑ Hypercholesterolemia
❑ Diabetes Mellitus
❑ Reduces Life expectancy (by an average of 8-10 years in the
case of severe obesity)
5. It is now considered that the principal driver
of the increasing incidents of D.M. is
increasing prevalence of obesity…….
RECENT FACT…..
8. Some trends about procedures……
❑ Mostcommonlyperformedprocedureintheworldin2013-laparoscopicRoux-en-Y
gastricbypass(45%)
❑ followed by laparoscopicsleeve gastrectomy (37%)and laparoscopicadjustable gastric
Banding(10%).
9. Contd….
❑Roux-en-Y gastric bypass - decreased from 2003 to 2008(-16%) and
continued to decrease slightly from 2011 to 2013(-1.6%)
❑But still represents the most performed bariatric/metabolic
procedure in theworld.
❑ Sleeve gastrectomy - steep increase from 2003 to 2013(+37%)
❑ Thus becoming the second most performed bariatric /metabolic
procedure in the world
10. RYGB
❑ Roux en Y gastric bypass - considered as the gold standard bariatric
surgery procedure
❑ Because….
Provide durable weight loss
Improve metabolic profile of patients
Reduce mortality associated with the complications of obesity such
as cardiovascular disease and cancer
12. Contd….
❑ Almost at the same time, when the popularity of the LAGB was ↓ ,
SG emerged as a new procedure with ↑ worldwide acceptance
❑ Reasons behind it-
▪ Technically less demanding
▪ Good short and mid-term results,
▪ Lower incidence of short & long term complications and re-
operation rates
16. ❑ Developed by Dr Robert Rutledge in 1997
❑ First reported by him in 2001
❑ Consists of first creating a long vertical gastric pouch along the
lesser curvature side usually starting at the antrum distal to the
crow's feet
❑ Second, a Billroth type II loop gastrojejunostomy formed with a 200-
cm or longer afferent limb from the ligament of Treitz.
18. Advantages over RYGB
❑ Simpler procedure as compared to RYGB
❑ Only one anastomosis
❑ Shorter operative time
❑ Fewer sites of anastomotic leaks and internal hernias
❑ Easy to teach with a shorter learning curve
❑ Ease of reversibility - technically much easier than the RYGB
❑ Better reported regarding weight loss and comorbidity
26. ❑ Main principle of this procedure is to reduce gastric
volume (Endoscopic gastroplasty) via suturing or
stapling or tissue anchor placement.
❑ Available devices for endoluminal gastroplasty are:
1. EndoCinch System
2. Transoral Gastroplasty System (TOGA)
3. Primary Obesity Surgery Endoluminal (POSE)
27. TRANSORAL GASTROPLASTY SYSTEM (TOGA)
❑ First endoscopic device for gastric restrictive surgery
❑ 8 cm. long tube (stapled pouch) is created along the lesser
curvature of stomach
❑ Less invasive
❑ Less complications
❑ Faster recovery
❑ 46% excess wt. loss in 6month
s.
28.
29. ENDOCINCH SYSTEM
❑ Originally developed for GERD
❑ It is a suturing device that endoscopically uses a suction
chamber to capture the gastric wall and creates pleats using
tagged suture to reduce gastric volume
❑ Mean excess wt. loss of 21% at 1 month & 58% at 12 months
30.
31. PRIMARY OBESITY SURGERY ENDOLUMINAL
❑ Simple restrictive endoscopic method
❑ Suturing/plicating gastric fold
❑ mainly in Fundus & antrum
❑ Reduces capacity of stomach & induces early satiety
❑ 44.9 % excess wt. loss in 1 yr
32.
33. SPACE OCCUPYING DEVICES
❑ Bioenteric Intragastric Balloon - mostpopular and commonlyusedIGB
❑ consists of asilicone spherical balloon (very resistant to gastric acids) with asmooth surface
to reduce gastricmucosaerosion risk
❑ filled with isotonicsaline
❑ possessesaradiopaque self sealing valvethat allows localizing it with simple radiation
❑ capacity = 600 -800 mLsalıne
❑ Themaximum duration accepted forthe balloonin situ is6months
36. .Duodenal – JejunalBypass-
❑ Endoscopically implanted deviceshavebeen developed to
reproduce the bypasseffects similar to surgical procedures
❑ E.G.-The EndoBarrier gastrointestinal linerissingleuse
endoscopicimplant mimickingaduodenal-bypass.
❑ It is60cmimpermeable polymersleeve.
❑ Proximal end containsnickel titanium implant
anchored in the duodenalbulb
❑ Distal end extendsinto the proximal jejunum
❑ Placement under endoscopically under G.A.
under fluoroscopy
38. THE FUTURE : WHAT’S NEXT
❑ Traditionally It was believed that weight loss after bariatric surgery was
entirely due to reduced calorie intake due to mal-absorption or
restriction
❑ Recently Scientists have postulated other mechanisms of
bariatric surgery which favor weight loss & diabetic control
❑ E.g. metabolic effects of bariatric surgery
❑ hormonal response after bariatric surgery
❑ Role of gut microbia
❑ Role of bile acid
❑ By knowing these mechanism it may help us design safer, more effective
& less invasive therapy
39. KEY POINTS
▪ Obesityisaworldwideepidemic,with increasingratesacrosstheworld
▪ The prevalence of obesityin the UnitedKingdomis the highestin Europe
▪ There hasbeen aworldwide decreasein the LAGB asaprimary bariatric procedure with asteep
increase in the SG,whichhasalready become the mostfrequent primary bariatric procedure in some
countries
▪ Mini gastricbypass isanattractive bariatric procedure asitcould be asimpler and saferalternative
to the gold standardRYGBwith shorteroperative time, lower complicationrates, betterweight
loss,reducedhospitalizationin the long term, and with ashorterlearning curve.
▪ Mini gastric bypassisassociatedwith a30-daymortality of 0.14%,1%leak rate and 76% EWLat 12
months. Thisgivesthe MGBasaferand more effectiveprofile than the gold standard RYGB
40. • In recent years ,there hasbeen an increase in the development of
endoscopic techniques for managing obesity.
• Thesedifferent techniques have been usedasprimary therapy, asabridge
to bariatric surgery, or asarevisional procedure after bariatric surgery.
• Understanding the mechanisms by which the different bariatric
surgical procedures work will help usin the development of safer, more
effective and lessinvasive therapies