World Surgery Forum: Videos

A helmet with infrared light that can heal brain after mild head injury or concussion. This therapy is called Photobiomodulation.

Mild traumatic brain injuries, such as concussions, account for 75% of all cases in the U.S.

Acceleration and deceleration within the cranial vault leads to tearing and stretching of nerve fibers. Alteration of ionic balance and mitochondrial dysfunction makes it difficult for the cells to function while also limiting energy available for healing.

This wearable technology uses light therapy to speed brain recovery. This helmet emits near-infrared light. The light will penetrate the skull and reverse the impaired cellular metabolism that characterizes concussions.

This device can be used in an outpatient setting.

#Concussion
#Traumatic #Head #Injury

Research Paper: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5927185/
Read More: https://www.concussionalliance.org/light-therapy-photobiomodulation

5/23/2020 03:01:00 PM

Milestones in the history of intestinal anastomosis

Intestinal anastomosis has been successfully performed for more than 150 years using a variety of techniques and suture materials. Major milestones in the development of this technique are:

Lembert : Seromuscular suture technique for bowel anastomosis in 1826

Kocher : Utilised a two-layer anastomosis. First a continuous all-layer suture using catgut, then an

inverting continuous (or interrupted) seromuscular layer suture using silk

Halsted : Favoured a one layer extramucosal closure, it was felt to cause the least tissue necrosis or

luminal narrowing. This technique has now become widely accepted.

Currently accepted technique for intestinal anastomosis

Of these, the method that has proven successful in most situations and in the hands of most surgeons has been the two-layer anastomosis using interrupted silk sutures for an outer inverted seromuscular layer and a running absorbable suture for a transmural inner layer.

The only appreciable shortcoming of the two-layer technique is that it is somewhat tedious and time-consuming to perform. Recently, several reports have appeared advocating a single-layer continuous anastomosis using monofilament plastic suture.

Single layer continuous extramucosal closure has now become widely accepted.

A single-layer continuous anastomosis can be constructed in significantly less time and with a similar rate of complications compared with the two-layer technique. It also costs less than any other method and can be incorporated into a surgical training program without a significant increase in complications.

Single Layer , Extramucosal, Interrupted- End to End bowel anastomosis (simulation)

Side to side bowel anastomosis (simulated)

Difference between Extramucosal Technique and Seromuscular Suture Technique

The extramucosal suture must include the submucosa as this has a high collagen content and is the most stable suture layer in all sections of the gastrointestinal tract.

Suture Materials used in Intestinal Anastomosis

Catgut and silk have been replaced by synthetic, usually absorbable, polymers.

The suture materials should be of 2/0–3/0 size and made of an absorbable polymer, which can be braided (e.g. polyglactin), or monofilament (e.g. polydioxanone), mounted on an atraumatic round-bodied needle.

Suture bites should be approximately 3–5 mm deep and 3–5 mm apart depending on the thickness of
the bowel wall.

Stay sutures are put to avoid the need for tissue forceps. They are important for displaying the bowel

ends and in accurate alignment of the bowel and the placement of the sutures.

Important Considerations while doing Bowel Anastomosis

In cases of major size discrepancy of size of bowel end to be anastamosed, a side-to-side or end-to-side anastomosis is done.

In cases of minor size discrepancy, Cheatle split (making a cut into the antimesenteric border) may
help to enlarge the lumen of distal, collapsed bowel and allow an end-to-end anastomosis to be fashioned.

Bowel edges should be pink and bleeding prior to anastomosis.

References

Bailey and Love's Short Practice of Surgery, 27th Edition: International Student's Edition

Single-Layer Continuous Versus Two-Layer Interrupted Intestinal Anastomosis

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2/04/2018 01:36:00 AM

On this website I am trying to collect all the free resources for preparation of MRCS Part B. As you are well aware that rather than theoretical knowledge, MRCS Part B focuses on clinical application of the knowledge. It is tested in simulated situations in this exam. Hence videos play an important role in giving us a deeper understanding of what we can expect in the examination.

Not everyone can afford to spend on costly preparatory courses available online. Youtube features many free videos which offer a good coverage of the scenarios tested in MRCS Part B. I have made a playlist of all the videos which are relevant for MRCS Part B preparation. Below is the list of videos and the link to watch them.

Free MRCS OSCE Examination Videos

MRCS Part B Videos

Average Video Duration:8 minutes and 25 seconds | Total Playlist Duration: 0 days, 10 hours, 48 minutes and 43 seconds

1	Thyroid Status Examination - OSCE Guide	2015-02-25 15:22:54	ziaYBkgEZNU	00:06:29
2	Hip examination for OSCE revision	2012-02-22 14:41:26	ROzFs4FQnTQ	00:07:31
3	Hip Joint Examination - OSCE Guide	2015-08-19 18:56:16	KAgRJTsXHrU	00:06:01
4	Clinical Examination - Head and Neck Lymph nodes	2015-10-08 09:15:32	_N89T_Yqu68	00:02:53
5	Shoulder Examination - OSCE Guide (New Version)	2015-08-24 22:52:00	TDs1IOFYnMo	00:06:37
6	Spine Examination - OSCE Guide (New Version)	2015-08-03 06:57:21	CJVGpciEMoI	00:04:59
7	Examination Of Parotid Gland	2011-11-06 13:17:51	Gx1vVwA5AFU	00:02:54
8	Tests For Examination Of The Lower Back - Everything You Need To Know - Dr. Nabil Ebraheim	2013-03-07 22:36:40	zfWKcTixM6E	00:06:02
9	Lachman's Test , ACL Injury - Everything You Need To Know - Dr. Nabil Ebraheim	2015-07-17 21:30:01	tf2xBJZFcg4	00:03:12
10	ISBAR - Case Study 1	2012-03-23 02:18:22	1Wl9qogPw1E	00:04:28
11	ISBAR - Case Study 2	2012-03-23 02:18:22	AmZKJ3JAPsE	00:04:03
12	Elbow Examination	2007-11-19 07:43:47	bMJjbIT3zek	00:01:52
13	Breaking bad news	2016-06-30 07:58:10	k0_04r8hPAs	00:05:55
14	How to Break Bad News.avi	2012-01-14 20:40:10	hkYCcFgSEZc	00:08:33
15	electrosurgery principles	2011-02-06 18:13:52	7LW78yoaEe0	00:11:38
16	How to Palpate the Salivary Glands	2014-11-19 04:35:48	ryQh39mA6Hg	00:01:57
17	Qpercom presents OMIS in Action: Breaking Bad News OSCE Station	2013-05-23 15:08:29	QvW_g6w8uY0	00:09:08
18	Breast Examination - OSCE Guide	2015-07-23 23:35:35	76g_tNWMhCE	00:05:40
19	CSA case = Breaking Bad News (Done well)	2013-06-30 18:18:38	lJN6g0V5Q-U	00:09:25
20	Diabetic foot examination - OSCE guide (New Version)	2015-03-27 15:24:29	vwIyulPnXcg	00:05:32
21	Gait Assessment - Normal Gait and Common Abnormal Gaits	2015-02-19 21:51:58	PZBiv0uSXVg	00:23:14
22	Peripheral Vascular Examination - OSCE Guide (New Version)	2015-04-21 11:23:18	6beOTEKx1ek	00:06:25
23	Abdominal Examination - OSCE Guide (New Version)	2015-02-19 15:24:25	XOefpxm38bc	00:06:57
24	MENTOR CSA CONSULTS - ANGRY PATIENT	2013-08-09 13:36:24	POiRQrrQJQU	00:07:58
25	Varicose Vein Examination for Finals	2008-05-27 17:54:32	jsCoSHP4RmE	00:09:20
26	Laparoscopic Anatomy - WITH labels	2013-10-19 20:32:07	h3mUMhtIZ_A	00:04:45
27	Differential diagnosis of abdominal pain according to abdominal regions	2013-03-05 10:21:48	HbG7t7vfRRM	00:12:24
28	Deleted video	2016-02-09 14:25:07	2cyA3zHqq2s	00:16:26
29	Diagnosis & Examination of the floor of the mouth(Bimanual technique)(Dentistry)	2013-04-20 11:42:55	FPeWSkBSoOo	00:00:28
30	MCC Extraoral Exam	2014-09-18 14:17:57	K3Gx6GHn0OE	00:12:52
31	SKELETAL SYSTEM ANATOMY: Cranial fossa of the human skull	2013-03-06 22:00:56	weJ-eaDRIGs	00:06:38
32	SKELETAL SYSTEM ANATOMY: Anterior aspect of the human skull	2013-03-06 22:19:25	We2QFap4qyU	00:05:14
33	SKELETAL SYSTEM ANATOMY: Lateral aspect of the human skull	2013-03-06 22:05:39	XLDiuHE3ToU	00:03:55
34	SKELETAL SYSTEM ANATOMY: Inferior aspect of the human skull	2013-03-06 21:45:15	cUnIgkZ10KY	00:05:42
35	TMJ Video - Temporomandibular Joint	2014-04-29 04:52:49	4vQwyMHPXkk	00:06:49
36	Vascular OSCE Examination	2013-01-19 22:00:34	5Y-0OWZDbeo	00:03:37
37	How to talk about the normal abdominal plain X-ray	2014-07-28 11:40:04	iVCicL158BY	00:13:34
38	Radial Nerve Palsy, injury - WRIST DROP . Everything You Need To Know - Dr. Nabil Ebraheim	2010-11-09 15:19:52	_Cu6ttAhe8Y	00:04:54
39	Chest Tube ATLS	2014-06-13 12:12:33	qR3VcueqBgc	00:03:17
40	Chest Tube Insertion NEJM	2014-01-10 05:44:56	f_JWzLiUNhE	00:16:07
41	Joseph Musowoya - Trialling a patient assessment checklist for critically ill surgical patients	2014-11-25 19:20:46	jggurLNJYRM	00:08:11
42	Clinical Brain Death Testing	2015-04-13 02:12:30	qiZBGFWvv4E	00:18:52
43	The Effect of Supplemental Oxygen (ABG Interpretation - Lesson 17)	2012-05-31 07:25:26	9klrDCall9M	00:28:36
44	6 Easy Steps to ABG Analysis	2013-05-17 16:48:14	WUf-cPpnrXw	00:13:19
45	Arterial blood gas interpretation in 5 min	2013-10-16 10:27:49	Y0Q4inCKv2A	00:05:00
46	Arterial Puncture for Blood Gas Analysis.flv	2011-11-24 16:49:17	YuFK22n-tvI	00:09:07
47	Initial Assessment of a Trauma Patient - Normal Scenario.wmv	2012-02-17 15:28:36	hLuC0T7RsKI	00:14:42
48	Initial Assessment of a Trauma Patient - Multi-System Injury (Part 1).wmv	2012-02-17 15:20:35	n5DUC1Lit08	00:11:42
49	Reading the 12-lead ECG/EKG - six quick steps	2013-07-15 09:53:33	lhrajncAh9A	00:13:23
50	Intro to EKG Interpretation - The 5 Cardinal Rules	2014-03-15 07:12:53	r2zQvatebxA	00:11:58
51	Gross Anatomy of Pancreas	2015-04-25 15:22:40	1oj13Uua00A	00:03:05
52	SKELETAL SYSTEM ANATOMY: Bones of the thigh- Femur	2013-03-04 18:47:14	Xb-U3Jjj-n4	00:03:26
53	The Facial Nerve (CNVII): Animated Review	2016-04-26 15:09:22	AMAR-hv7knI	00:06:37
54	How to interpret an abdominal CT	2015-11-23 13:52:25	Eg3GeUmOeYE	00:25:18
55	Catheterisation - OSCE Guide	2015-05-02 18:54:25	2iLPfCAMgZs	00:04:34
56	Basic life support - Head tilt Chin lift Jaw thrust	2015-03-29 07:52:57	XNZed1oBeTA	00:02:25
57	How to perform Tracheostomy - An Emergency Procedure - Operative Live Surgery by Dr Vaidya	2013-02-26 14:09:49	9EOUeWIz5yM	00:02:31
58	tracheostomy	2011-12-31 10:54:48	Qc0tNXF8tU8	00:05:36
59	Centeral venous cath. (internal jugular vein).wmv1	2010-06-16 19:25:22	4-uyTUzPSJ8	00:07:31
60	Centeral venous cath.(internal jugular vein).wmv2	2010-06-16 19:51:49	UrHwKQY8qEQ	00:08:00
61	femoral hernia repair	2016-03-09 22:23:43	1UnfSdPA59Q	00:14:13
62	How open femoral hernia surgery is carried out	2013-08-14 13:24:59	dy2s6BbohBs	00:02:00
63	Laparoscopic Splenectomy : Minimally invasive spleen removal surgery	2015-11-09 09:31:18	zrB4i32ORhs	00:11:54
64	Two Incision Four Compartment Fasciotomy	2010-01-18 21:48:25	-1NDJkFH1vM	00:04:15
65	Trendelenburg Test (CR)	2011-08-14 04:46:04	mA3enWJ53Kc	00:00:36
66	Froment's Sign	2012-08-20 19:15:54	yJTIhm1VfSI	00:01:14
67	Tinel Sign: Wrist⎟Carpal Tunnel Syndrome	2015-12-14 18:21:22	U8cPjPeZgFw	00:01:59
68	Carpal Tunnel Syndrome - Everything You Need To Know - Dr. Nabil Ebraheim	2015-09-25 23:27:45	tjyU55ilshQ	00:12:48
69	A guide to intravenous fluids (IV)	2014-08-21 19:21:15	pln-x9YKnK0	00:09:46
70	2. Examination of an Ulcer - Clinical Examination - Dr. Vaidya	2016-04-27 10:16:57	Y6FsRHFcyoI	00:14:03
71	Cardiovascular Examination - OSCE Guide (New Version)	2015-02-23 16:53:40	eBnzjerIHj0	00:07:38
72	Excision of skin lesion (simulated)	2014-04-02 16:03:19	hjtRQygj20Q	00:01:53
73	Naevus Excision	2015-10-01 05:49:54	TABHPV3XUvU	00:03:19
74	OSCE Guides - Approach to the patient with knee pain	2016-08-27 15:22:49	5pixSqEhg9c	00:17:18
75	Dr. Gillard's presentation of Lumbar Spine and Disc Anatomy	2014-08-20 12:50:08	XXNA87SbuUc	00:25:52
76	Dr. Gillard lectures on How to Read Your Lumbar MRI	2014-08-22 12:52:25	3YnMzXOTd2I	00:23:39
77	Chest Anatomy - Trachea, Oesophagus, Lungs and Heart Anatomy - Radiology Pictures and Images	2016-09-11 12:34:28	4LBvWLAVdd4	00:06:58