This document discusses rectal prolapse, including its anatomy, causes, clinical presentation, diagnosis, and treatment options. It describes the rectum's blood supply and drainage. Rectal prolapse can be complete or partial and is more common in older females. Surgical correction is the primary treatment and can involve perineal or abdominal approaches. Perineal procedures have higher recurrence rates than abdominal procedures like fixation of the rectum to the sacrum or pubis.
Rectal prolapse (Surgical anatomy of rectum, pathology and management0sunil kumar daha
Please find the powerpoint on Rectal prolapse. I tried present it on understandable way and all the contents are reviewed by experts and from very reliable references.
Rectal prolapse (Surgical anatomy of rectum, pathology and management0sunil kumar daha
Please find the powerpoint on Rectal prolapse. I tried present it on understandable way and all the contents are reviewed by experts and from very reliable references.
OPEN INGUINAL HERNIA REPAIR- OPERATIVE SURGERY
#surgicaleducator #operativesurgery #openinguinalherniarepair #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 and
Laparoscopic Cholecystectomy
• In this video today, I have discussed Open Inguinal Hernia Repair.
• 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 I will give a link for each surgery in the end of the video as end-cards, which I think will be very useful.
• 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
• Thank you for watching the videos.
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 .
Rectal Prolapse - Cedars Sinai Medical Center - Medicine Resident TalkTheSurgeryGroupofLA
Presentation by Yossef Nasseri, M.D.
Yosef Nasseri, M.D., is a founding member of The Surgery Group of Los Angeles, a Los Angeles based physician group providing a comprehensive approach to surgical care through advanced technology, long-term patient follow-up, and direct physician access. Dr. Nasseri is double board-certified in general and colorectal surgery and specializes in cutting-edge robotic and minimally invasive techniques for the treatment of colon and rectal cancers, inflammatory bowel disease, benign anorectal diseases, a variety of hernias, and general surgery.
OPEN INGUINAL HERNIA REPAIR- OPERATIVE SURGERY
#surgicaleducator #operativesurgery #openinguinalherniarepair #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 and
Laparoscopic Cholecystectomy
• In this video today, I have discussed Open Inguinal Hernia Repair.
• 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 I will give a link for each surgery in the end of the video as end-cards, which I think will be very useful.
• 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
• Thank you for watching the videos.
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 .
Rectal Prolapse - Cedars Sinai Medical Center - Medicine Resident TalkTheSurgeryGroupofLA
Presentation by Yossef Nasseri, M.D.
Yosef Nasseri, M.D., is a founding member of The Surgery Group of Los Angeles, a Los Angeles based physician group providing a comprehensive approach to surgical care through advanced technology, long-term patient follow-up, and direct physician access. Dr. Nasseri is double board-certified in general and colorectal surgery and specializes in cutting-edge robotic and minimally invasive techniques for the treatment of colon and rectal cancers, inflammatory bowel disease, benign anorectal diseases, a variety of hernias, and general surgery.
STARR Surgery for ODS | Defecography in Pune | Healing Hands Clinic Punehealinghandsclinic Pune
Healing Hands Clinic is a unique and speciality clinic for constipation,piles, hernia & prevention of Lifetstyle diseases. Apart from its heart of the city location, expert consultation, state of the art technology and well qualified staff are few of its assets. It is the first clinic in the city to deliver facility of Defecography for constipation. Our focus, dedication and inner feeling of curing or treating the patients with care have given us many satisfied patients.
Constipation due to difficulty in passing stools once it has reached rectum as a result of Rectorectal Intussusception (Internal Rectal Prolapse) or Rectocele.
Approximately 75% of abdominal wall hernias occur in the groin.
The lifetime risk of inguinal hernia is 27% in men and 3% in women.
And hence Of inguinal hernia repairs, 90% are performed in men, and 10% are performed in women.
The incidence of inguinal hernia in men has a distribution, with peaks before the first year of life and after age 40.
Indirect inguinal and femoral hernias occur more commonly on the right side.
This is attributed to a delay in atrophy of the processus vaginalis after the normal slower descent of the right testis to the scrotum during fetal development.
The predominance of right-sided femoral hernias is thought to be caused by the tamponading effect of the sigmoid colon on the left femoral canal
The prevalence of hernias increases and the likelihood of strangulation and need for hospitalization increase with aging.
Inguinal hernia presentation
by Shariatyfar MD
based on schwartz principles of surgery 11th edition
Qom university of medical sciences
winter 2017
email me at Mohammadali.shariatyfar@hotmail.com for Download
Good luck
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.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
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.
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.
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
Title: Sense of Taste
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 structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
2. Rectal Prolapse:
Presented By:
Dr. Sudhir. K. Jain, M.S, MBA(HCA), FRCS, FICS, FIAS.
Professor of Surgery,
Maulana Azad Medical College and Associated Lok Nayak Hospital,
New Delhi.
With Credits to:
Dr. Vishnuraja, PG2, Dept of Surgery, MAMC.
Dr. Ronal Kori, PG2, Dept of Surgery, MAMC.
1/7/2015 Dr SK Jain Prof Surgery MAMC
3. Rectum-Anatomy
• 18-20 cm long
• Begins –from rectosigmoid junction
• Ends- At anorectal junction
• Follows curve of sacrum.
Three lateral curvatures:
1. Upper/Lower- Convex to right
2. Middle-Convex to left
On mucosal side- they correspond to
semicircular folds (Houston’s valve)
• Part of rectum between middle and lower
valve is widest-ampulla of rectum.
4. Anatomy-Contd
• Upper 1/3rd: Peritoneal covering all around
• Middle 1/3rd: Peritoneal covering anteriorly
and laterally
• Lower 1/3rd: No peritoneal covering
• Lower rectum separated from other organs
by fascial condensation
• Anterior-Fascia of DenonVilliers
• Posterior- Fascia of Waldeyers
5. Mesorectum
• Present in post/lateral aspect of extraperitoneal portion of rectum .
• Derived from hindgut.
• Contents:
1. Sup rectal artery/branches
2. Sup rectal vein/tributaries
3. Lymphatics/L.nodes
4. Autonomic nerves
5. Loose areolar tissue
• Surrounded by fascia propria, which is an extension of pelvic fascia.
• Mesorectum excised along with rectum in carcinoma.
• Total mesorectal excision
6. Arterial supply
• Superior rectal artery-branch of
inferior mesenteric artery
• Middle rectal artery-branch of
anterior division of internal iliac
• Inferior rectal artery-terminal
branch of internal pudendal artery
Veins- Corresponds arteries.
Lymphatics
• Mainly upward (Upper 2/3rd) to
inferior mesenteric nodes-
Paraaortic nodes
• Laterally to internal iliac nodes-
from Lower 1/3rd .
7. Rectal prolapse
• Falling down of hind gut.
• First described by Papyrus in 1500 BC
• Types:
• 1. Complete-full thickness
• 2. Partial- Only mucosa (Circumferential, only portion of mucosa)
8. Factors preventing prolapse:
• Curvature of sacrum (under developed sacral curve)
• Tilt of pelvis
• Serpentine course of rectum
• Levator ani muscles- fixes rectum
• Puborectalis sling-Tilt and elevate lower end of rectum
9. Etiology
• Congenital
• Acquired
• Poor bowel habits
• Neurological diseases-
• Cauda equine lesion
• Spinal cord injury
• Congenital anamoly ie spina bifida
• Female gender
• Nulliparity
• Redundant rectosigmoid
• Deep pouch of douglas
• Patulous anus
• Defect in pelvic floor
• After operation- Piles surgery,
fistulotomy
• Free mesentry to entire rectum
• Lack of fixation of sactum to
rectum
• Torn perineum- Straining at
micturition
10. Clinical features
• Something coming out of anal canal during straining, coughing, lifting
weights
• Constipation (58%)
• Fecal incontinence
• More common in long standing complete prolapse
• Due to stretching of pudental and perineal nerves
• Dilatation of anal canal and relaxation of anal sphincters.
• Mucus discharge
• Bleeding (rare)- of massive or irreducible
13. Treatment:
• Surgical correction is treatment of choice
Non operative treatment: When surgery is contraindicated or
Patient refuses surgery
14. Non-Operative methods:
• Adhesive strapping of buttocks
• Manual anal support during defecation
• Correction of constipation
• Perineal exercises
• Electrical stimulation
• Submucosal injection of phenol in almond oil
• Infrared coagulation
15. Surgical Management:
• Partial prolapse
• Simple excision of prolapsed part
• Complete mucosal prolapse
• Circumferential excision
• Use of circular stapler (Used for stapled haemorrhoidopexy)
16. Management of acute irreducible rectal
prolapse:
• Reduction under anaesthesia to relax sphincter
• Tapping the buttocks together
• Trendelenberg position
• Placement of sugar/salt topically to reduce edema
• Injection of hyaluronidase
• If prolapsed rectum is not viable-resection of part
18. Perineal operations:
• High recurrence rates than abdominal operations
• Indications:
1. Pediatric age group
2. Frail/very elderly patients
3. Injury or disease of spinal cord
4. Young men
19. Thiersch repair:
• Anal canal is tightened by
passing a silver/nylon/silicone
rubber in perineal space.
20. Delrome procedure:
• Prolapse part of rectum is fully
denuded of its mucosa
• Underlying rectal musculature
plicated
• Defect of mucosa repaired
22. Abdominal Operations:
• Suspension or fixation of the rectum
1. To sacrum
2. To pubis
• Rectum is fully mobilized
• Lateral peritoneal reflections are incised
• Dissection done till levators.
• Lateral rectal ligaments divided.
23. • Rectum is fixed to sacrum by
1. Simple sutures
2. Teflon mesh (Ripstein Procedure)
3. Ivalon sponge (Polyvinyl alcohol) Well’s 1959
24. • Resection rectopexy (Fuykwan)
Anterior resection with fixation of rectum to presacral fascia
25. • Resection procedures
• Redundant sigmoid/rectum resected
• Descending colon fully mobilized till splenic flexure
• Anastomosis is constructed 12 cm above anal verge
