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Laparoscopic Cholecystectomy Laparoscopic cholecystectomy is a minimally invasive operation to remove the gallbladder, most commonly for symptomatic gallstones or acute/chronic cholecystitis. The abdomen is first inflated with carbon dioxide (pneumoperitoneum) to create working space. Usually 3–4 small ports are inserted, including a camera port. The gallbladder is retracted to... expose Calot’s triangle. The surgeon carefully identifies the cystic duct and cystic artery and confirms the Critical View of Safety before dividing anything. The cystic duct and artery are then clipped and divided. The gallbladder is dissected away from the liver bed using electrocautery, placed in a retrieval bag, and removed through one of the ports. The operative field is checked for bleeding or bile leakage, the instruments are withdrawn, the carbon dioxide is released, and the small incisions are closed. ⚠️ Important complications include bile duct injury, bleeding, bile leak, infection, retained stones, and injury to surrounding structures. Small incisions—but the most important part of the operation is knowing exactly what you are clipping before you cut.show more

Dr Ihab Suliman

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156,074 Aufrufe • vor 11 Tagen •via X (Twitter)

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Kidney stones are hard deposits made of minerals and salts. While smaller stones often pass naturally through hydration, larger or more stubborn stones require medical intervention to be cleared. Here are the 4 primary methods used by doctors: 1. Shock Wave Lithotripsy (SWL): This is the most common non-invasive treatment. A machine uses high-energy sound waves (shock waves) to create strong vibrations. These vibrations break the large stone into tiny "dust" or sand-like pieces that can then be passed through urine. 2. Ureteroscopy: For stones located in the ureter or kidney, a doctor may use a thin, flexible scope. The scope is passed through the bladder and up into the ureter. Once the stone is located, it is either captured in a small "basket" and removed or broken apart using a laser so the fragments can pass later. 3. Percutaneous Nephrolithotomy (PCNL): This is typically reserved for very large or complex stones. A small incision is made in the patient's back to reach the kidney directly. A nephroscope is then used to locate and remove the stone, often using ultrasonic or laser energy to break it up first. 4. Natural Passage: For stones smaller than 5mm, the most common "removal" method is simply waiting. This requires high fluid intake (water) and often medication (like alpha-blockers) to help relax the muscles in the ureter, allowing the stone to pass with less pain. ⚠️ Note: If you are experiencing severe pain, nausea, or fever, it is important to consult a healthcare professional immediately, as these can be signs of a blockage or infection. Educational purpose only .😊

Kidney stones are hard deposits made of minerals and salts. While smaller stones often pass naturally through hydration, larger or more stubborn stones require medical intervention to be cleared. Here are the 4 primary methods used by doctors: 1. Shock Wave Lithotripsy (SWL): This is the most common non-invasive treatment. A machine uses high-energy sound waves (shock waves) to create strong vibrations. These vibrations break the large stone into tiny "dust" or sand-like pieces that can then be passed through urine. 2. Ureteroscopy: For stones located in the ureter or kidney, a doctor may use a thin, flexible scope. The scope is passed through the bladder and up into the ureter. Once the stone is located, it is either captured in a small "basket" and removed or broken apart using a laser so the fragments can pass later. 3. Percutaneous Nephrolithotomy (PCNL): This is typically reserved for very large or complex stones. A small incision is made in the patient's back to reach the kidney directly. A nephroscope is then used to locate and remove the stone, often using ultrasonic or laser energy to break it up first. 4. Natural Passage: For stones smaller than 5mm, the most common "removal" method is simply waiting. This requires high fluid intake (water) and often medication (like alpha-blockers) to help relax the muscles in the ureter, allowing the stone to pass with less pain. ⚠️ Note: If you are experiencing severe pain, nausea, or fever, it is important to consult a healthcare professional immediately, as these can be signs of a blockage or infection. Educational purpose only .😊

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Western countries, including Ireland, are calling him for a cut in carbon tax. Yep, that’s right. At a time when the UK, Germany, Spain, Australia, Canada, destroyed their own energy industries, they also decided to charge businesses and individuals are carbon tax. All for 0.04% Co2 in the atmosphere, of which only 3% is man-made, of which the contribution of these countries is tiny. The goal is to eliminate the middle classes & small independent business.

Western countries, including Ireland, are calling him for a cut in carbon tax. Yep, that’s right. At a time when the UK, Germany, Spain, Australia, Canada, destroyed their own energy industries, they also decided to charge businesses and individuals are carbon tax. All for 0.04% Co2 in the atmosphere, of which only 3% is man-made, of which the contribution of these countries is tiny. The goal is to eliminate the middle classes & small independent business.

Concerned Citizen

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🎯 3 Teaching Pearls from the “Compact Disc” Method for ERCP Cannulation 1️⃣ Visualize the invisible. Imagine stacked CDs inside the papilla to conceptualize the 3D bile duct axis—especially in long oral protrusion (LOP). 2️⃣ Advance gently, not forcefully. Cannulation should feel like passing through the center hole of each CD. Force bends the axis and increases injury risk. 3️⃣ Alignment is everything. Ensure scope position and catheter axis are “face to face” with the imagined duct axis before advancing. Simple concept. #ERCP #Endoscopy #MedicalEducation #AdvancedEndoscopy #Basics #KFHU #BiliaryCannulation

🎯 3 Teaching Pearls from the “Compact Disc” Method for ERCP Cannulation 1️⃣ Visualize the invisible. Imagine stacked CDs inside the papilla to conceptualize the 3D bile duct axis—especially in long oral protrusion (LOP). 2️⃣ Advance gently, not forcefully. Cannulation should feel like passing through the center hole of each CD. Force bends the axis and increases injury risk. 3️⃣ Alignment is everything. Ensure scope position and catheter axis are “face to face” with the imagined duct axis before advancing. Simple concept. #ERCP #Endoscopy #MedicalEducation #AdvancedEndoscopy #Basics #KFHU #BiliaryCannulation

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1/ 🧵🧵🧵 🚨 This is one of the most important and heart wrenching threads you will read. It will be difficult to take in, but especially the Christian world needs to read it. ⚠️ Warning: The videos used are for illustration, but they are all from the atrocities perpetrated by Islamists and are graphic and may cause distress. The Islamists and the left keep you focused on Israel and the Jews. They throw out “genocide”, “famine”, “occupation”, “settlers”. But the moment you take Israel out of the equation, the lies and propaganda fall apart. You start to see what is really going on. And then more lies hit you so your focus returns to the Jews. Jihad in Africa is not a vibe. It is villages at night, churches burned, girls taken, heads sent as mail. In the last six months the dead are measured in thousands. Most of the names the world never learns are Christian. The rest are whoever refused the gunmen’s law.

1/ 🧵🧵🧵 🚨 This is one of the most important and heart wrenching threads you will read. It will be difficult to take in, but especially the Christian world needs to read it. ⚠️ Warning: The videos used are for illustration, but they are all from the atrocities perpetrated by Islamists and are graphic and may cause distress. The Islamists and the left keep you focused on Israel and the Jews. They throw out “genocide”, “famine”, “occupation”, “settlers”. But the moment you take Israel out of the equation, the lies and propaganda fall apart. You start to see what is really going on. And then more lies hit you so your focus returns to the Jews. Jihad in Africa is not a vibe. It is villages at night, churches burned, girls taken, heads sent as mail. In the last six months the dead are measured in thousands. Most of the names the world never learns are Christian. The rest are whoever refused the gunmen’s law.

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Vance: Absolutely, by all means, let's take down the temperature, but if you want to take down the temperature and you are on the left of center, the first and most important thing you can do is look in the mirror.

Vance: Absolutely, by all means, let's take down the temperature, but if you want to take down the temperature and you are on the left of center, the first and most important thing you can do is look in the mirror.

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All services to and from Glasgow Central station are cancelled as fire fighters tackle a huge blaze in the city centre. Union Street, where the incident is taking place, is closed as are most of the surrounding street. Stay tuned for updates.

All services to and from Glasgow Central station are cancelled as fire fighters tackle a huge blaze in the city centre. Union Street, where the incident is taking place, is closed as are most of the surrounding street. Stay tuned for updates.

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This was a fun shoot! MLB Player Dee Strange-Gordon is joining the small percentage of Black farmers in the US and is the CEO of Black Sheep Farms. I checked out the farm to learn what he and his team are up to. WESH 2 News Story:

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🚨🇷🇺 BIG | At Kaliningrad airport, for the first time since the start of the war, the "Covior" regime was declared. ✈️ Dozens of airplanes are circling over the city in the sky and are unable to take off. This regime is established when flight safety is threatened, most often due to unmanned aerial vehicles or unidentified objects. 🔺 During the operation of this regime, the airport ceases operations. Video is made Grok AI

🚨🇷🇺 BIG | At Kaliningrad airport, for the first time since the start of the war, the "Covior" regime was declared. ✈️ Dozens of airplanes are circling over the city in the sky and are unable to take off. This regime is established when flight safety is threatened, most often due to unmanned aerial vehicles or unidentified objects. 🔺 During the operation of this regime, the airport ceases operations. Video is made Grok AI

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I havent seen anyone post about it but one thing that stood out to me the most from the MW4 briefing is how sick the Tactical Nuke animation is. Tactical Nuke is back but the animation is completely different. You call it in a small phone and then a buckle into a skyhook a plane grabs right before the nuke drops and you look back at the map getting nuked. You also flip the map off as you fly away Its one of the sickest things I saw. The video below is an example from MW3 of what i mean.

I havent seen anyone post about it but one thing that stood out to me the most from the MW4 briefing is how sick the Tactical Nuke animation is. Tactical Nuke is back but the animation is completely different. You call it in a small phone and then a buckle into a skyhook a plane grabs right before the nuke drops and you look back at the map getting nuked. You also flip the map off as you fly away Its one of the sickest things I saw. The video below is an example from MW3 of what i mean.

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The UFO/UAP phenomenon is ancient. It has been here long before us, and it is connected to a grand hierarchy created by God. They are coming from higher dimensions, something that religions would describe as the Tree of Life. The phenomenon is part of us, and our soul is part of this grand system. We are currently in the lowest dimension, chakra, sefirot, or part of the soul, known as Malkhut in Kabbalah, Muladhara in Hinduism, and Khat in ancient Egypt. We are made of matter, but our soul is made of fire, and it is time for an upgrade. The Geophysical Event is connected to this transformation.

The UFO/UAP phenomenon is ancient. It has been here long before us, and it is connected to a grand hierarchy created by God. They are coming from higher dimensions, something that religions would describe as the Tree of Life. The phenomenon is part of us, and our soul is part of this grand system. We are currently in the lowest dimension, chakra, sefirot, or part of the soul, known as Malkhut in Kabbalah, Muladhara in Hinduism, and Khat in ancient Egypt. We are made of matter, but our soul is made of fire, and it is time for an upgrade. The Geophysical Event is connected to this transformation.

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We have spent the last three days chasing the aircraft fighting the Ross Fire in Palo Pinto County. The fire is now over 83,000 acres and only 12% contained as of the latest update today. These videos are of the Canadair CL-415 from Aeroflite assisting with the firefighting efforts. The videos are from Monday and today, Wednesday. It is absolutely incredible what these aerial teams do. And they are just one part. Everyone working in the air and on the ground is doing their part to help fight this fire and protect the communities in its path. Thank you to everyone working tirelessly to protect and save the community.

We have spent the last three days chasing the aircraft fighting the Ross Fire in Palo Pinto County. The fire is now over 83,000 acres and only 12% contained as of the latest update today. These videos are of the Canadair CL-415 from Aeroflite assisting with the firefighting efforts. The videos are from Monday and today, Wednesday. It is absolutely incredible what these aerial teams do. And they are just one part. Everyone working in the air and on the ground is doing their part to help fight this fire and protect the communities in its path. Thank you to everyone working tirelessly to protect and save the community.

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When you have an angel and a demon sitting on your right and left shoulders, this is what it means... The Tree of Life is within; the emotions and urges come from the higher dimensions of the Sefirot/Chakras/Egyptian parts of the soul. When energy flows from the left side, especially through Gevurah, that raw energy—the energy of the lion—brings anger that cannot be easily controlled. In the Egyptian system, that part of the soul is called Sekhem. From the right side, or from Chokmah and Chesed, a flow of energy brings kindness and love. There are people who receive energy only from one side, without balance. A lot of what you receive depends on the influence of the stars when you are born, and that is by design. Some are here to bring evil, some good—you need to find the balance and purify your heart.

When you have an angel and a demon sitting on your right and left shoulders, this is what it means... The Tree of Life is within; the emotions and urges come from the higher dimensions of the Sefirot/Chakras/Egyptian parts of the soul. When energy flows from the left side, especially through Gevurah, that raw energy—the energy of the lion—brings anger that cannot be easily controlled. In the Egyptian system, that part of the soul is called Sekhem. From the right side, or from Chokmah and Chesed, a flow of energy brings kindness and love. There are people who receive energy only from one side, without balance. A lot of what you receive depends on the influence of the stars when you are born, and that is by design. Some are here to bring evil, some good—you need to find the balance and purify your heart.

Open Minded Approach

167,832 Aufrufe • vor 4 Monaten

As a gynecologist, one of the most frequently asked questions is about the ''hymen''. The hymen is not a structure located deep inside the vagina. It is a thin, flexible fold of tissue situated very close to the vaginal opening, anatomically at the entrance of the vaginal canal. It is typically found about 1–2 cm inside the vaginal opening, but in many women, it is almost at the surface. Therefore, the common belief that it is located deep inside is incorrect. One of the most important points is this: The hymen is not a closed membrane. It naturally has openings that allow menstrual blood to pass. Additionally, the structure of the hymen varies from person to person. Its thickness, elasticity, and shape are not standard. In some women, it may be very thin and elastic, while in others, it may be minimal or barely noticeable. This is completely a normal anatomical variation. A common misconception is that changes in the hymen occur only due to sexual intercourse. In reality, factors such as certain physical activities or tampon use can also lead to stretching or changes in this tissue. Therefore, the hymen is not a reliable indicator of a person’s sexual history or “virginity.” In summary, the hymen is a small and variable anatomical structure. The meanings attributed to it are largely shaped by sociocultural beliefs rather than medical facts.

As a gynecologist, one of the most frequently asked questions is about the ''hymen''. The hymen is not a structure located deep inside the vagina. It is a thin, flexible fold of tissue situated very close to the vaginal opening, anatomically at the entrance of the vaginal canal. It is typically found about 1–2 cm inside the vaginal opening, but in many women, it is almost at the surface. Therefore, the common belief that it is located deep inside is incorrect. One of the most important points is this: The hymen is not a closed membrane. It naturally has openings that allow menstrual blood to pass. Additionally, the structure of the hymen varies from person to person. Its thickness, elasticity, and shape are not standard. In some women, it may be very thin and elastic, while in others, it may be minimal or barely noticeable. This is completely a normal anatomical variation. A common misconception is that changes in the hymen occur only due to sexual intercourse. In reality, factors such as certain physical activities or tampon use can also lead to stretching or changes in this tissue. Therefore, the hymen is not a reliable indicator of a person’s sexual history or “virginity.” In summary, the hymen is a small and variable anatomical structure. The meanings attributed to it are largely shaped by sociocultural beliefs rather than medical facts.

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Personal Update Was stuck in West Maui the past few days due to the wildfires without power or cell service and no access to the airport. My wife and I are fine and now are at the airport overnight waiting for our flight to Oahu then the mainland. Absolute horror scene there and my heart goes out to the locals and first responders. Shit is out of a horror movie. Here is a video and some pics before and after in Lahaina.

Personal Update Was stuck in West Maui the past few days due to the wildfires without power or cell service and no access to the airport. My wife and I are fine and now are at the airport overnight waiting for our flight to Oahu then the mainland. Absolute horror scene there and my heart goes out to the locals and first responders. Shit is out of a horror movie. Here is a video and some pics before and after in Lahaina.

Joe Dellera

99,124 Aufrufe • vor 3 Jahren

If you are an USM student, Alumni, Fan, or a resident of the Pinebelt/surrounding areas you need to be at The Rock this Saturday vs Texas State, and in 2 weeks vs Troy. The Eags are 7-2. They are 5-0 in the Sunbelt. People have wanted a winning product, and Huff has delivered by flipping a 1-11 team over night basically. The Eags not only have a chance to win the west, and play for a conference championship. But win out and with some help there is a small outside chance of being the G5 team in the playoffs. Which is crazy to say, but it’s not impossible. The team is fun to watch, and KujForCongress brings the energy to make it a good time for everyone. Don’t miss out! Need tickets call Tyler Cochran ! #SMTTT

If you are an USM student, Alumni, Fan, or a resident of the Pinebelt/surrounding areas you need to be at The Rock this Saturday vs Texas State, and in 2 weeks vs Troy. The Eags are 7-2. They are 5-0 in the Sunbelt. People have wanted a winning product, and Huff has delivered by flipping a 1-11 team over night basically. The Eags not only have a chance to win the west, and play for a conference championship. But win out and with some help there is a small outside chance of being the G5 team in the playoffs. Which is crazy to say, but it’s not impossible. The team is fun to watch, and KujForCongress brings the energy to make it a good time for everyone. Don’t miss out! Need tickets call Tyler Cochran ! #SMTTT

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🚨 Near St. Petersburg, the port of Ust-Luga is on fire again — it is one of the most important in Russia and Europe This key logistics hub on the Baltic has been under attack for several days in a row. In one of the videos — workers who are likely unable to get to their shift.

NEXTA

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