Surgically altered anatomy

Endoscopic retrograde cholangiopancreatography (ERCP) in patients with surgically altered anatomy remains a challenging procedure even for the more experienced endoscopists. We present a unique case of an ERCP performed in a patient with prior Whipple surgery, where biliary access was obtained via an endoscopic ultrasound (EUS)-guided rendezvous technique, and cannulation was ultimately done using a modified therapeutic endoscope with successful biliary drainage.

5p viwhitewolf 03-07-2023 3 2   Download

Nasal intubation is indispensable for some cases that require intraoral surgical access, and the fiberoptic bronchoscope is the best tool for difficult airways. However, fiberoptic bronchoscopy is not always possible in cases with altered pharyngeal anatomy.

4p vidietmarhopp 29-12-2021 7 0   Download

In any surgical fi eld, the importance of suturing is selfevident. In eye surgery, due to the lack of elasticity of the tissues and the infl uence of sutures on the visual outcome, proper microsurgical suturing technique is paramount. Inappropriate or careless suture placement and knot tying can impact visual function. If wound construction and closure are not astigmatically neutral, the visual outcome will be altered and further surgical intervention may be required. Wound related complications are more severe in the eye than in the skin.

150p ozon_ozon 04-05-2012 86 13   Download