Psychiatry-Armchair or armed!

A friend, who is a psychiatrist, was recounting a session with one of her patients. This patient was on treatment for a substance abuse disorder. The patient wanted prescriptions for a drug which the doctor did not agree with. The patient got wild and threatened the doctor with dire consequences if his demands were not met with. The doctor had to inform the authorities about the threat and seek protection for a few days.
While psychiatry is considered a comfortable speciality by other specialists with pictures of Freud and Jung playing around in their mind, this story says the opposite. Every doctor has to deal with professional hazards and many of them can be life threatening.

Hydrocele of canal of Nuck

The canal of Nuck was first described by Anton Nuck in 1691. It is an abnormal pouch of peritoneum similar to processus vaginalis in males. It can give rise to a hydrocele or form a cyst in women. It can be mistaken for an inguinal hernia and is often detected only during surgery, It is supposed to be a rare finding and only about 400 cases have been reported so far. Here is the link to the original article!http://reader.digitale-sammlungen.de/de/fs1/object/goToPage/bsb11268766.html?pageNo=146
I did a surgery recently which had these findings and am just doing a literature search for the same.

Top gun

With the rapid adoption of minimally invasive surgery, surgeons need to possess a basic level of competency in laparoscopic surgery. One of the fundamental skills required is the ability to do intracorporeal suturing. This technique is learnt by surgeons using the top gun approach.
Top gun approach is borrowed from the US navy's fighter pilot training program. This method involves breaking down complex tasks to their most elemental level and execution of drills to facilitate complex tasks. This helps the surgeon to master surgical technique in a graded manner and consistently achieve good results.

Endoscopy vs laparoscopy

The instrument used for upper GI endoscopy is a flexible endoscope. It uses the principles of fiber optics to shine light into the body. It has a tiny camera attched at its end which records the images and transmits them onto a screen so that both the doctor and the patient can see.
Laparoscopy uses a scope to look into the abdominal cavity. The scope may be rigid or flexible, rigid scopes being more commonly used. It uses the principles of Hopkins rod lens system to transmit images to the monitor.This was devised by Harold Hopkins, a physicist who used glass rods to fill the air spaces spaces between lenses and greatly improved the quality of images.
Some regions of the body like gastrointestinal tract will always require flexibe endoscopes while the rod-lens endoscopes produce such high clarity images that they are the instruments of choice in laparoscopic surgeries.

Laparoscopic appendicectomy

Laparoscopic appendicectomy- Information for patients

What is appendicitis?

Appendicitis in inflammation of appendix which is a small tubular structure located where large and small intestines meet.

How is appendicitis treated?

The doctor may order some tests to determine if surgery is necessary. If diagnosis is confirmed, the doctor may decide to remove your appendix by doing surgery.

What happens during surgery?

You will undergo general anaesthesia wherein you are put to deep sleep and will not feel pain. The surgery takes approximately an hour. The doctor makes small cuts in your abdomen through which camera and instruments are put and your appendix is removed.

Diet

You can start with clear fluids after about 6-8 hours and resume your normal diet if there is no nausea or vomiting.

Activity

You should not lift heavy weights for 4- 6 weeks. You can gradually increase your walking and activity as directed by your surgeon.

Medications

After surgery, you may be given antibiotics and you should continue taking them as prescribed. You may be given pain medication and you should take them as suggested by your doctor.

Bandages

You may have small bandages over the incisions. Do not be alarmed if a small amount of bleeding is seen. If dressing becomes wet or dirty, it needs to be changed. Do not apply any ointments or creams over the incisions.

When to call the doctor

·         Fever

·         Excessive pain

·         Lot of bright red bleeding

Disclaimer: This is for information only. For queries, talk to your doctor.

Elaborating a bit more

Laparoscopy is the art of peering into abdominal cavities while performing surgeries. The most common surgeries being performed today are laparoscopic appendicectomy, laparoscopic cholecystectomy and laparoscopic hernia surgeries. Patients used to tolerate big incisions for lack of better options.Due to improved technology, patients can afford to undergo laparoscopic surgeries at almost the same cost as the conventional open surgeries.
The advantages of laparoscopic surgeries are that the scars are smaller, the pain after operations is less and patients can return to work faster.
The disadvantages include increased expenses because of the equipment and general anaesthesia.