Author: vegasrobotdoc

Hernia Basics

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A bulging of an organ or tissue through an abnormal opening.
Common
More than 200,000 US cases per year
Treatable by a medical professional
Usually self-diagnosable
Lab tests or imaging rarely required
Medium-term: resolves within months
Typically, a hernia involves the stomach or intestine.
Symptoms include a bulge, swelling, or pain. In some cases, there are no symptoms.
Treatment includes monitoring the condition. If needed, surgery can return tissue to its normal location and close the opening.
Ages affected
0-2
Common
3-5
Rare
6-13
Rare
14-18
Common
19-40
Common
41-60
Very common
60+
Very common
Genders affected
Males
Very common
Females
Common

 

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Gastrointenstinal Surgery

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Upper gastrointestinal surgery, often referred to as upper GI surgery, refers to a practise of surgery that focuses on the upper parts of the gastrointestinal tract. There are many operations relevant to the upper gastrointestinal tract that are best done only by those who keep constant practise, owing to their complexity. Consequently, a general surgeon may specialise in ‘upper GI’ by attempting to maintain currency in those skills.

Upper GI surgeons would have an interest in, and may exclusively perform, the following operations:

Lower gastrointestinal surgery includes colorectal surgery as well as surgery of the small intestine.

Academically, it refers to a sub-specialisation of medical practise whereby a general surgeon focuses on the lower gastrointestinal tract.

In the U.S., a student wanting to specialize and practice in adult lower GI surgery would generally have to go through four years of undergraduate college pre-medical education and get a bachelor’s degree, then finish the four years of medical school, then finish a typically five-year-long residency in general surgery, and then perform a subsequent one-year-long (minimum) residency in surgery of the small intestine or large intestine (the colon– specifically, the cecum, the vermiform appendix, the ascending colon, the transverse colon, the hepatic flexure and the splenic flexure, the descending colon, and the sigmoid colon; and also the rectum and the anus). A fellowship (in surgery of the small intestine or of the large bowel, or in pediatric/neonatal lower GI surgery, or in surgery of congenital abnormalities or rare disorders of the lower GI tract, or in emergency/trauma surgery or in cancer surgery of the area), would add on approximately one to three more years.[1]

lower GI surgeon might specialise in the following operations:

  • Colectomy
  • Low or ultralow resections for rectal cancer, etc.

Worst Foods for Digestion

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FRIED FOODS:  They’re high in fat and can bring on diarrhea. Rich sauces, fatty cuts of meat, and buttery or creamy desserts can cause problems, too.

Choose roasted or baked foods and light sauces that feature vegetables instead of butter or cream.

CITRUS FRUITS: Because they’re high in fiber, they can give some folks an upset stomach. Go easy on oranges, grapefruit, and other citrus fruits if your belly doesn’t feel right.

ARTIFICIAL SWEETENER:  Chew too much sugar-free gum made with sorbitol and you might get cramps and diarrhea. Food made with this artificial sweetener can cause the same problems.

The FDA warns that you might get diarrhea if you eat 50 or more grams a day of sorbitol, though even much lower amounts reportedly cause trouble for some people.

TOO MUCH FIBER:  Foods high in this healthy carb, like whole grains and vegetables, are good for digestion. But if you start eating lots of them, your digestive system may have trouble adjusting. The result: gas and bloating. So step up the amount of fiber you eat gradually.

BEANS  They’re loaded with healthy protein and fiber, but they also have hard-to-digest sugars that cause gas and cramping. Your body doesn’t have enzymes that can break them down. Bacteria in your gut do the work instead, giving off gas in the process.

Try this tip to get rid of some of the troublesome sugars: Soak dried beans for at least 4 hours and pour off the water before cooking.

CABBAGE AND ITS COUSINS:  Cruciferous vegetables, like broccoli and cabbage, have the same sugars that make beans gassy. Their high fiber can also make them hard to digest. It will be easier on your stomach if you cook them instead of eating raw.

FRUCTOSE:  Foods sweetened with this — including sodas, candy, fruit juice, and pastries — are hard for some people to digest. That can lead to diarrhea, bloating, and cramps.

SPICY FOODS:  Some people get indigestion or heartburn after eating them, especially when it’s a large meal.

Studies suggest the hot ingredient in chili peppers, called capsaicin, may be a culprit.

DAIRY FOODS:  If they trigger diarrhea, bloating, and gas, you may be “lactose intolerant.” It means you don’t have an enzyme that digests a sugar in milk and other forms of dairy.

Avoid those foods or try an over-the-counter drop or pill that has the missing enzyme.

PEPPERMINT : It can relax the muscle at the top of the stomach, which lets food move back into your esophagus. That can cause heartburn. Other culprits include chocolate or coffee.

Experts say you can lower the pressure that pushes the food back up if you lose extra weight, eat smaller portions, and don’t lie down after eating.

Also, learn what foods give you problems, so you can avoid them.

 

From Medicine.Net

DSA Surgeon Matthew Johnson is a fellowship trained GI & Critical Care physician.

DSA Surgeon Matthew Johnsonblausen_0316_digestivesyste is a fellowship trained GI & Critical Care physician. Gastrointestinal diseases (GI) refer to diseases involving the gastrointestinal tract, namely the esophagus, stomach, small intestine, large intestine and rectum, and the accessory organs of digestion, the liver, gallbladder, and pancreas.

New robotic surgery system arriving in 2019

1300-hospital-robot-future-timeline-technologyA next-generation surgical robotic system has been developed in Cambridge, UK. It will be used on NHS patients for the first time in 2019.

The Versius robot seen here was designed and built by CMR Surgical, formed in 2014, whose five founders brought with them global experience across the diverse disciplines of surgery, medical device development, start-ups and commercialisation. In June 2018, the company announced a record-breaking financing round that raised $100m in total, Europe’s largest private Series B medical device funding raise.
CMR’s stated aim is “to make minimal access surgery available to all”, by creating “a paradigm shift in robotic-assisted surgery”. Minimal access surgery (sometimes known as keyhole or minimally invasive surgery) is an alternative to open surgery that was first pioneered around 40 years ago. For patients and healthcare providers alike, the benefits are numerous and compelling – reduced trauma, faster recovery and improved clinical outcomes. For example, the risk of infection from a robotically assisted hysterectomy is reduced by almost a factor of three compared with open surgery (from 6.5% to 2.2%).
There are an estimated six million open surgery procedures each year that could be performed using minimal access surgery. CMR Surgical believes that robotics opens up the potential for millions more people to benefit from laparoscopic surgery.
The Versius machine is a rival to the American da Vinci system. CMR expects to introduce their new robotic system to hospitals within the next six months, beginning in the UK and Europe, then with international expansion shortly afterwards. The $4bn global market for surgical robots is predicted to increase five-fold to reach $20bn by 2024.

“Surgeons will remain in control, but as we develop the human-robot interface there may be simple parts of an operation, such as suturing or closing a wound that may be automated,” said Dr Hachach-Haram, a member of the Royal College of Surgeons’ Commission on the Future of Surgery.

GI Surgeries

gi tract2Gastrointestinal surgery is a treatment for diseases of the parts of the body involved in digestion. This includes the esophagus (ee-sof-uh-gus), stomach, small intestine, large intestine, and rectum. It also includes the liver, gallbladder, and pancreas.

Surgery may be used to remove a cancerous or noncancerous growth or damaged part of the body, such as the intestine. It may also be used to repair a problem like a hernia (a hole or weak spot in the wall of the abdomen). Minor surgical procedures are used to screen and diagnose problems of the digestive system.

Endoscopic retrograde cholangiopancreatography, or ERCP, is a procedure to diagnose and treat problems in the liver, gallbladder, bile ducts, and pancreas. It combines X-ray and the use of an endoscope—a long, flexible, lighted tube. Many health problems can partly block a portion of your esophagus.

How the ER Trauma Team at Sunrise Hospital Saved Over 211 Lives the Night of The Las Vegas Shooting

Neither Christopher Fisher nor most of his crew of trauma surgeons were planning on working on the night of October 1, 2017, the night that Stephen Paddock opened fire on a Route 91 music festival on the Strip, raining hundreds of rounds onto the crowds from his 32nd floor hotel room and ultimately killing 59 people and wounding over 500.

trauma-team
Sunrise Hospital Trauma Team – L to R: Dave MacIntyre, MD; Stephen Chock, MD, Chris Fisher; MD, Kitae Kim, MD and Matt Johnson, MD

Around 10 p.m., he got a text from the hospital, saying that there may have been a mass casualty.

He says, “About 90% of the time, the mass casualty warnings end up being kind of nothing, minor injuries, so I didn’t think too much of it, but I just got my scrubs back on and I started hearing my trauma pager go off with the first two gunshot wounds and after that I got in my car and headed back.”