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𝗥𝗌𝗯𝗌𝘁𝗶𝗰 𝗧𝗔𝗥𝗚𝗣 𝘃𝘀. 𝗟𝗮𝗜𝗮𝗿𝗌𝘀𝗰𝗌𝗜𝗶𝗰 𝗜𝗣𝗢𝗠 𝗥𝗲𝗜𝗮𝗶𝗿 𝗌𝗳 𝗩𝗲𝗻𝘁𝗿𝗮𝗹 𝗛𝗲𝗿𝗻𝗶𝗮 Defect closure: 🔵Standard of care in both approaches 🔵Robot facilitates closure of larger defect up to a maximum size of 5cm for TARUP repair Comparison: 🔎Retromuscular (rTARUP) vs. Intraperitoneal (IPOM) mesh placement 🔎No tacks (rTARUP) vs. Use of tacks (IPOM)...

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Derby Pancreaticobiliary & Robotic AWR Unit

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11,606 görÃŒntÃŒleme • 2 yıl önce •via X (Twitter)

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@Innov_Medicine @SAGES_Updates @MISIRG1 @BehindTheKnife @MedicalAdv @imedverse @rbarbosa91 @altaf_awan12 @ib9994 @javlatif Both are done beautifully and excellent skill

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Robotic TAPP (rTAPP) Repair of Left Inguinal Hernia with Imbrication of Transversalis Fascia Why imbricate: 🔵Direct defect/large hernia risk factors for postoperative seroma 🔵In open hernia repair, direct defect often closed ➡Helps create a flat posterior wall and expedite mesh placement 🔵However it is not a routine practice during MIS Robotic Imbrication of Transversalis fascia: 🔎Possible advantages include: ➡Reduce seroma risk formation ➡Reduce risk of recurrence (mesh migration) 🔎Avoid deep bite ➡Cord structures can be easily caught in sutures
3:08

Robotic TAPP (rTAPP) Repair of Left Inguinal Hernia with Imbrication of Transversalis Fascia Why imbricate: 🔵Direct defect/large hernia risk factors for postoperative seroma 🔵In open hernia repair, direct defect often closed ➡Helps create a flat posterior wall and expedite mesh placement 🔵However it is not a routine practice during MIS Robotic Imbrication of Transversalis fascia: 🔎Possible advantages include: ➡Reduce seroma risk formation ➡Reduce risk of recurrence (mesh migration) 🔎Avoid deep bite ➡Cord structures can be easily caught in sutures

Derby Pancreaticobiliary & Robotic AWR Unit

16,444 görÃŒntÃŒleme • 5 ay önce

𝗟𝗮𝗜𝗮𝗿𝗌𝘀𝗰𝗌𝗜𝗶𝗰 𝗙𝗲𝗻𝗲𝘀𝘁𝗿𝗮𝘁𝗲𝗱 𝗊𝘂𝗯𝘁𝗌𝘁𝗮𝗹 𝗖𝗵𝗌𝗹𝗲𝗰𝘆𝘀𝘁𝗲𝗰𝘁𝗌𝗺𝘆 Patient Presentation: 🔵History of severe cholecystitis 🔵CT on index admission showed: ➡Cholecysto-colic fistula ➡Air locules on GB ➡Figure 1 below 🔵Follow up CT (~4 months later): ➡Good improvement with apparent resolution of fistula as absence of air in GB ➡Figure 2 below 🔵Symptomatic gallstones 🔵Listed for planned biliary surgery Operative Approach: 🔎Colonic adhesion to GB fundus 🔎Fused hepatocystic triangle ➡Decision to perform subtotal cholecystectomy 🔎Dissection plane (window) identified between GB and colon 🔎Presumed area of fistula tract detached with cuff of GB wall 🔎Stone retrieved and GB opened to identify cystic duct ostium on opening GB ➡Closed with 2/0 Vicryl 🔎Gallbladder dissected off as far as safe to do so 🔎Detached colonic attachment with GB cuff ➡No obvious fistula tract ➡The area was under run to achieve haemostasis 🔎Cystic artery transfixed with figure of 8 suture 🔎Drain x 1 ➡Removed after 24 hours 🔎Uneventful postop course #FOAMed #MedTwitter #GITwitter #SoMe4Surgery #HPB
3:55

𝗟𝗮𝗜𝗮𝗿𝗌𝘀𝗰𝗌𝗜𝗶𝗰 𝗙𝗲𝗻𝗲𝘀𝘁𝗿𝗮𝘁𝗲𝗱 𝗊𝘂𝗯𝘁𝗌𝘁𝗮𝗹 𝗖𝗵𝗌𝗹𝗲𝗰𝘆𝘀𝘁𝗲𝗰𝘁𝗌𝗺𝘆 Patient Presentation: 🔵History of severe cholecystitis 🔵CT on index admission showed: ➡Cholecysto-colic fistula ➡Air locules on GB ➡Figure 1 below 🔵Follow up CT (~4 months later): ➡Good improvement with apparent resolution of fistula as absence of air in GB ➡Figure 2 below 🔵Symptomatic gallstones 🔵Listed for planned biliary surgery Operative Approach: 🔎Colonic adhesion to GB fundus 🔎Fused hepatocystic triangle ➡Decision to perform subtotal cholecystectomy 🔎Dissection plane (window) identified between GB and colon 🔎Presumed area of fistula tract detached with cuff of GB wall 🔎Stone retrieved and GB opened to identify cystic duct ostium on opening GB ➡Closed with 2/0 Vicryl 🔎Gallbladder dissected off as far as safe to do so 🔎Detached colonic attachment with GB cuff ➡No obvious fistula tract ➡The area was under run to achieve haemostasis 🔎Cystic artery transfixed with figure of 8 suture 🔎Drain x 1 ➡Removed after 24 hours 🔎Uneventful postop course #FOAMed #MedTwitter #GITwitter #SoMe4Surgery #HPB

Derby Pancreaticobiliary & Robotic AWR Unit

17,864 görÃŒntÃŒleme • 2 yıl önce

BRAZIL 🟢 vs JAPAN 🔎 PARAGUAY 🟢 vs GERMANY 🔎
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BRAZIL 🟢 vs JAPAN 🔎 PARAGUAY 🟢 vs GERMANY 🔎

PopCulture

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Laparoscopic Ileocaecal Resection with Intracorporeal Anastomosis and ICG Patient Presentation: 🔎Sudden onset severe abdominal pain 🔎Tender abdomen 🔎No previous abdominal surgery 🔎High WCC 🔎Lactate ➡5 on arrival down to 2 in 2 hours following fluid resuscitation 🔎CT abdomen/pelvis ➡Red arrows show no small bowel perfusion with mural thickening ➡Green arrows show perfused small and large bowel ➡Mesenteric vessels patent Surgical Approach: 🔎Lap EGS approach ➡Torsion of small bowel with Meckel's adhesion to abdominal wall acting as pivot point ➡80cm ischaemic small bowel involving ileocaecal junction 🔎Specimen retrieved via extension of LUQ 12mm port
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Laparoscopic Ileocaecal Resection with Intracorporeal Anastomosis and ICG Patient Presentation: 🔎Sudden onset severe abdominal pain 🔎Tender abdomen 🔎No previous abdominal surgery 🔎High WCC 🔎Lactate ➡5 on arrival down to 2 in 2 hours following fluid resuscitation 🔎CT abdomen/pelvis ➡Red arrows show no small bowel perfusion with mural thickening ➡Green arrows show perfused small and large bowel ➡Mesenteric vessels patent Surgical Approach: 🔎Lap EGS approach ➡Torsion of small bowel with Meckel's adhesion to abdominal wall acting as pivot point ➡80cm ischaemic small bowel involving ileocaecal junction 🔎Specimen retrieved via extension of LUQ 12mm port

Derby Pancreaticobiliary & Robotic AWR Unit

17,492 görÃŒntÃŒleme • 1 ay önce

🟢🟢🟢🟢⚪⚪⚪⚪🔎🔎🔎🔎 🟢🟢⚫⚫⚫⚪⚪⚪🔎🔵🔎🔎 🟢🟢🟢🟢⚫⚪⚪⚪🔵🔵🔎🔎 🟢🟢⚫⚫⚫⚪⚪🔵🔎🔵🔎🔎 🟢🟢⚫🟢⚪⚪⚪⚪🔎🔵🔎🔎 🟢🟢⚫⚫⚫⚪⚪⚪🔎🔵🔎🔎 🟢🟢🟢⚪⚪⚪⚪🔎🔎🔎 🟢🟢⚪⚪⚪⚪🔎🔎 🟢⚪⚪⚪⚪🔎 ⚪⚪
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🟢🟢🟢🟢⚪⚪⚪⚪🔎🔎🔎🔎 🟢🟢⚫⚫⚫⚪⚪⚪🔎🔵🔎🔎 🟢🟢🟢🟢⚫⚪⚪⚪🔵🔵🔎🔎 🟢🟢⚫⚫⚫⚪⚪🔵🔎🔵🔎🔎 🟢🟢⚫🟢⚪⚪⚪⚪🔎🔵🔎🔎 🟢🟢⚫⚫⚫⚪⚪⚪🔎🔵🔎🔎 🟢🟢🟢⚪⚪⚪⚪🔎🔎🔎 🟢🟢⚪⚪⚪⚪🔎🔎 🟢⚪⚪⚪⚪🔎 ⚪⚪

𝙇𝙖 𝘜𝙧𝙪𝙟𝙞𝙩𝙖 ⭐🖀💙⭐

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🔎🔵🟡🟢TWISTER 🟢🟡🔎🔵 A great #PhysEd instant activity with many ways to modify! Lots of color recognition and balance! Follow PE School on YouTube ⬇
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🔎🔵🟡🟢TWISTER 🟢🟡🔎🔵 A great #PhysEd instant activity with many ways to modify! Lots of color recognition and balance! Follow PE School on YouTube ⬇

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🌈 Rainbow Waterfall 🌈 🔎 🟠 🟡 🟢 🔵 🟣 🔎 🟠 🟡 🟢 🔵 🟣 🔎 🟠 🟡 🟢 🔵 🟣 🔎 🟠 🟡 🟢 🔵 🟣 🔎 🟠 🟡 🟢 🔵 🟣 🔎 🟠 🟡 🟢 🔵 🟣 🔎 🟠 🟡 🟢 🔵 🟣 🔎 🟠

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Comms from the final moments of Major IV 🗣 🔎 LA Thieves vs OpTic Texas 🟢
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Comms from the final moments of Major IV 🗣 🔎 LA Thieves vs OpTic Texas 🟢

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Principles of Szabo Knot 🔎Square knot - 2 throws 🔎Slip knot - unlock by pulling in opposite directions 🔎Slide - non-closed grasper 🔎Lock 🔎Final throw Useful in: 🟢Tissue approximatiob under slight tension 🟢Deep areas i.e. OG hiatus, pelvis #MedEd #SurgEd #surgery

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FINAL DAY of Premier League QUICK-FIRE predictions 🔥🏆 Robbie Savage Fraser Fletcher ⏰ 16:00 🔵 Man City vs Aston Villa 🊁 🔵 Brighton vs Man United 🔎 ⚪ Fulham vs Newcastle United ⚫ ⚪ Tottenham Hotspur vs Everton 🔵 🔎 Liverpool vs Brentford 🐝 🍷 Burnley vs Wolves 🐺 🌳 Nottingham Forest vs Bournemouth 🍒 ⚒ West Ham vs Leeds 🟡 🔎 Sunderland vs Chelsea 🔵 🊅 Crystal Palace vs Arsenal 🔎 #EPL 18+ | GambleAware

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We stan with normal guys!! 👇 🔎 🟠 🟡 ⚪ 🟢 🔵 🟣 🟀 ⚫ 🔎 🟠 🟡 ⚪ 🟢 🟣 🟀 ⚫ 👇 🔎 🟠 🟡 ⚪ 🟢 🔵 🟣 🟀 ⚫ 🔎 🟠 🟡 ⚪ 🟢 🟣 🟀 ⚫ 👇 🔎 🟠 🟡 ⚪ 🟢 🔵 🟣 🟀 ⚫ 🔎 🟠 🟡 ⚪ 🟢 🟣 🟀 ⚫ 👇 🔎 🟠 🟡 ⚪ 🟢 🔵 🟣 🟀 ⚫ 🔎 🟠 🟡 ⚪ 🟢 🟣 🟀 ⚫
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We stan with normal guys!! 👇 🔎 🟠 🟡 ⚪ 🟢 🔵 🟣 🟀 ⚫ 🔎 🟠 🟡 ⚪ 🟢 🟣 🟀 ⚫ 👇 🔎 🟠 🟡 ⚪ 🟢 🔵 🟣 🟀 ⚫ 🔎 🟠 🟡 ⚪ 🟢 🟣 🟀 ⚫ 👇 🔎 🟠 🟡 ⚪ 🟢 🔵 🟣 🟀 ⚫ 🔎 🟠 🟡 ⚪ 🟢 🟣 🟀 ⚫ 👇 🔎 🟠 🟡 ⚪ 🟢 🔵 🟣 🟀 ⚫ 🔎 🟠 🟡 ⚪ 🟢 🟣 🟀 ⚫

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Tips for Transcystic Laparoscopic CBD Exploration 🔎3mm choledochoscope ➡Direct visualisation of duct 🔎Cephalad retraction 🔎Incise cystic duct parallel to CBD stone 🔎If large CBD stone ➡withdraw scope over wire and provide gentle traction 🔎Milk backwards 🔎Keep CBD in view 🔎Reduce speed of irrigation to trap CBDS What are your tips and tricks for transcystic LCBDE? #FOAMed #GITwitter #surgery #hpb #MedEd #SoMe4Surgery
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Tips for Transcystic Laparoscopic CBD Exploration 🔎3mm choledochoscope ➡Direct visualisation of duct 🔎Cephalad retraction 🔎Incise cystic duct parallel to CBD stone 🔎If large CBD stone ➡withdraw scope over wire and provide gentle traction 🔎Milk backwards 🔎Keep CBD in view 🔎Reduce speed of irrigation to trap CBDS What are your tips and tricks for transcystic LCBDE? #FOAMed #GITwitter #surgery #hpb #MedEd #SoMe4Surgery

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Introducing: ORBLINS🟢🔵🔎🟡 🟢Fight scaling enemies through your run 🔵Build a deck of orbs 🔎Unlimited scaling for OP builds 🟡Dodge bosses attacks while matching marbles Demo out soon Follow for updates 🙂
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Introducing: ORBLINS🟢🔵🔎🟡 🟢Fight scaling enemies through your run 🔵Build a deck of orbs 🔎Unlimited scaling for OP builds 🟡Dodge bosses attacks while matching marbles Demo out soon Follow for updates 🙂

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🔎 🔎🔵 🔎🔵🟢 August 7th. Save the Date.
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🔎 🔎🔵 🔎🔵🟢 August 7th. Save the Date.

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