China 
Africa 
Explore chapters and articles related to this topic
Bariatric surgery
Published in Mark Davenport, James D. Geiger, Nigel J. Hall, Steven S. Rothenberg, Operative Pediatric Surgery, 2020
Lindel C.K. Dewberry, Thomas H. Inge
A locking, toothed grasper is next inserted below the xiphoid, applied to tissue just superior to the right crus of the diaphragm, and used to retract the left lobe of the liver anteriorly to expose the gastroesophageal junction. The lesser curve gastric pouch will be created beginning with the dissection at the angle of His. A sufficient plane is then created between the stomach and diaphragm at the angle of His, extending to the left crus, utilizing dissection both bluntly and with the Harmonic scalpel (Ethicon Inc., Cincinnati, OH, USA).
General Surgery
Published in Tjun Tang, Elizabeth O'Riordan, Stewart Walsh, Cracking the Intercollegiate General Surgery FRCS Viva, 2020
Rebecca Fish, Aisling Hogan, Aoife Lowery, Frank McDermott, Chelliah R Selvasekar, Choon Sheong Seow, Vishal G Shelat, Paul Sutton, Yew-Wei Tan, Thomas Tsang
A 75-year-old man presents with a pearly nodule at the angle of his eye. How would you assess him?The likely diagnosis is a basal cell carcinoma (BCC).Take a history − risk factors (sunburn, arsenic exposure, immunosuppression, Xeroderma Pigmentosum).Examine the lesion (BCC − pearly nodule with a raised, rolled edge, central ulceration and scabbing), perform a full skin survey and check nodal basins.
Obese Patient (BMI 32) with Reflux Disease and Diabetes Mellitus
Published in Savio George Barreto, Shailesh V. Shrikhande, Dilemmas in Abdominal Surgery, 2020
It is possible to separate the operation into three distinct phases. The first is the creation of a non-distensible lesser curve–based gastric pouch using an endoscopic stapler. This is achieved through dissection at the angle of His, followed by the lesser curve using an energy device, such as the Harmonic Ace. The first staple firing is then performed horizontally no more than 5 cm distal to the gastroesophageal junction. A 36-Fr bougie is then inserted to calibrate the size of the pouch following which further staple firings are performed in a vertical direction toward the angle of His until pouch creation is complete.
Turbulent Flow in a Cavernous Sinus Lesion: Does It Suggest Something?
Published in Neuro-Ophthalmology, 2021
Vaibhav Kumar Jain, Vivek Singh, Akshata Charlotte, Vikas Kanaujia, Kumudini Sharma
A 14-year-old boy was referred for neuro-ophthalmological evaluation due to a one month history of double vision. He reported having a boil at the angle of his mouth with cellulitis on the left side of the face two weeks before the onset of the diplopia, which had resolved on systemic antibiotics. On examination at his initial presentation elsewhere, he had visual acuity of 20/20 in each eye. A −3 restriction of abduction of the right eye was noted on ocular motility examination.2 The rest of the ophthalmological examination including the pupillary reactions and fundi was within normal limits. His systemic evaluation did not reveal any abnormalities. A clinical diagnosis of an isolated VIth nerve palsy was made and a post-infectious cause, intracavernous sinus lesion, or clival chordoma were suspected. Magnetic resonance imaging (MRI) with contrast demonstrated a sellar mass with contrast enhancement and extension into the right cavernous sinus with the internal carotid artery being pushed peripherally, suggestive of a cavernous sinus haemangioma.
Managing respiratory complications in infants and newborns with congenital diaphragmatic hernia
Published in Expert Opinion on Orphan Drugs, 2020
Sandeep Shetty, Fahad M. S. Arattu Thodika, Anne Greenough
Gastroesophageal reflux disease (GORD) is the most common gastrointestinal sequelae [145], occurring in more than 50% of infants with CDH [144]. The incidence of gastroesophageal reflux in CDH survivors, however, is variable between institutions, likely due to differences in the diagnostic method used, for example pH monitoring, upper gastrointestinal contrast study or clinical history. The incidence of gastroesophageal reflux also correlates with defect size and need for patch repair [145,146]. The pathophysiology of gastroesophageal reflux may include abnormal hiatal anatomy at the gastroesophageal junction and lack of an angle of His in some patients [147]. A trend toward more infants who underwent FETO having GORD has been reported (71% versus 44%; p = 0.070) [148].
Technical aspects and standardization of the totally robotic Roux-en-Y gastric bypass. Results of a single surgeon experience with a 5-year follow-up
Published in Acta Chirurgica Belgica, 2022
Emmelie Reynvoet, Veerle Van Vlodrop, Kurt Hendrick, Dries Vandeweyer, Carlos Vaz
The dissection is started at the angle of His (Figure 4). The stomach is retracted with the grasper. With the coagulation hook the left crus is released from adhesions and an eventual hernia can be reduced. The dissection is done until a good vision on the base of the left crus can be obtained. Thereafter the fat pad at the anterior surface of the stomach is released and removed from the abdomen. At 4-5cm of the angle of His, or the gastroesophageal junction, the horizontal section plane is determined (Figure 5). A clear vision on the posterior side of stomach is required before stapling. To perform this dissection, the stomach is lifted to the abdominal wall and with the coagulation hook the posterior wall of the stomach is freed from adhesions. Once a free part of the stomach wall is dissected the grasper is replaced to retract this free tissue and this way, step by step, the posterior wall of the stomach is released from adhesions. Thereafter the first stapler is brought in a horizontal line, 90° oblique to the lesser curvature. We use a 60 mm stapler with a stapler height of 1.8 mm. After this horizontal transection, a plane is created to facilitate a straight stapler line, oblique to the horizontal stapler, in the direction of the angle of His. This dissection is done very carefully until the posterior side is free of adhesions and a vision from the backside on the left crus is obtained. For the vertical transsection, usually two to three cartridges are needed which are positioned on the guidance of the gastric tube. Once the pouch is created a thorough evaluation of the vascularisation is performed and if needed an Indocyanine Green (ICG) test is performed.