Cystolithotomy Surgical Steps

Preoperative Patient Preparation

• Exclusion or treatment of a urinary tract infection
• Perioperative antibiotic prophylaxis
• Supine position with slight hyperextension of the lumbar spine
• Disinfection and draping
• Insert a transurethral catheter and fill the bladder with 200–300 ml

Surgical Technique

• Lower midline incision or Pfannenstiel incision
• Cut the linea alba
• After blunt dissection of the retropubic space (cavum retzii), insert a wound retractor
• Vertical cystostomy, which is secured with sutures to prevent further tearing
• Remove bladder stones, foreign bodies or bladder tamponade, controll bleeding.
• If necessary, perform simple prostatectomy
• If needed, insert a suprapubic catheter
• Close the bladder in two layers (mucosa – muscularis)
• Drainage of retropubic space
• Closure of the linea alba, skin closure

 Open Suprapubic Cystolithotomy Surgery Video

References 

http://www.urology-textbook.com/cystolithotomy.html

6/14/2020 03:15:00 PM

NEW Research in The Lancet | CRASH-3 trial provides evidence that tranexamic acid, a low-cost drug, could prevent deaths from TBI by as much as 20% depending on severity of the injury https://ift.tt/2VVwbU1 Worldwide, roughly 69 million people will experience a traumatic brain injury (TBI) each year. CRASH-3 was one of the largest head injury clinical trials ever conducted and led by London School of Hygiene & Tropical Medicine showed that a low-cost drug could prevent deaths from TBI by as much as 20% depending on severity of the injury. Tranexamic acid (TXA) was most effective in mild-moderate head injuries but showed no clear impact in severely injured patients. It’s also safe to give and is most effective the earlier it is given. If TXA is given to all TBI patients immediately after injury, it could prevent tens or hundreds of thousands of deaths around the globe each year. via WSF Instagram

10/20/2019 07:42:00 AM

Pupillary Light Reflex Pathway #neurosurgeon #neuro #neurosurgery #neurological #Pupil #neuroscience #neurology #neurochirurgie #lightreflex #pupillary #Lightreflexpathway https://ift.tt/33tMQAo via WSF Instagram

10/19/2019 09:42:00 PM

Anatomy of Basal Ganglia - Axial View

Structures generally included in the basal ganglia are the caudate, putamen, and globus pallidus in the cerebrum, the substantia nigra in the midbrain, and the subthalamic nucleus in the diencephalon.

Basal ganglia's primary function is likely to control and regulate activities of the motor and premotor cortical areas so that voluntary movements can be performed smoothly.

Dysfunction results in a wide range of neurological conditions including disorders of behaviour control and movement.

Those of behaviour include Tourette syndrome, obsessive–compulsive disorder, and addiction.

Movement disorders include, most notably Parkinson's disease, which involves degeneration of the dopamine-producing cells in the substantia nigra, Huntington's disease, which primarily involves damage to the striatum, dystonia, and hemiballismus


 #neurosurgeon #neuro #neurosurgery #neurological #basalganglia #neuroscience #neurology #neurochirurgie #neuroradiology #BGBleed #caudate #caudatenucleus https://ift.tt/33tMQAo via WSF Instagram

10/17/2019 12:36:00 AM

Right Caudate Nucleus Bleed with Intraventricular Extension 

80yr male came with complaints of  Altered Sensorium, Left sided weakness and Slurring of speech.

BP on presentation was 180/100mmHg

GCS:E2V2M5

Pupils:B/L 1.5 mm SRTL

Lt sided Hemiparesis

#neurosurgeon #neuro #neurosurgery #neurological #basalganglia #neuroscience #neurology #neurochirurgie #neuroradiology #intracranialhemorrhage #hematoma #BGBleed #caudatenucleus (https://ift.tt/33tMQAo) via WSF Instagram

10/16/2019 05:00:00 PM

Hunt and Hess Scale for Subarachnoid Hemorrhage

#neurosurgeon #neuro #neurosurgery #neurological #SAH #neuroscience #neurology #neurochirurgie #neuroradiology #subarachnoid #subarachnoidhemorrhage 

10/15/2019 09:06:00 PM

• 62 year old Man from a remote village had come with complaints of swellings in neck from past 1 year. The swellings were painless.
• He had a history of hoarseness of voice, loss of appetite and significant loss of weight.
• There was an irregular mass in the midline which moves on swallowing.
• Multiple large fixed nodes were palpable (Left Side - Mid jugular, lower jugular large nodes and Right Side - Multiple small nodes, middle and lower jugular group)
• On palpation of left side of neck, Berry's sign was positive (Berry’s sign is the absence of carotid pulsation on palpation) 
• FNAC revealed Papillary Thyroid Carcinoma.

Left Side of Neck

Right Side of Neck

1/22/2017 01:36:00 PM