Operations

Orbital floor reconstruction with medpor titanium mesh implant after a "blowout" fracture of the orbital floor. The thin floor of the orbit is broken and a piece of this bone is generally displaced downward into the maxillary sinus. Orbital tissue herniating into the sinus through the resulting defect in the orbital floor may become entrapped, causing diplopia; if the displacement of the bony fragment is large enough, enophthalmos may develop. The goal is to maintain or restore the best possible physiologic function and aesthetic appearance to the area of injury.

6th rib free bone flap/graft for facial reconstruction! 

Free flap is used to reconstruct an existing defect.

Many types of tissues can be taken and be used as a "free flap" including skin and fat, muscle, nerve, bone, cartilage (or any combination of these). Basically "free" implies that the tissue, with its blood supply is detached totally from one site (the donor site) to be transferred to another site (the recipient site), with the circulation re-established by making anastomoses of the vessels.

 

As I told to @mrs_angemi we're kind of completing each other, she deals with the dead while I deal with the live patients, ying and yang! 

Diagnosing the cause of death is no less important than diagnosing a disease in a patient, because this is where the physician and scientists get the information about mortality rate from various conditions, the state of health of the person before he or she died, and whether any medical diagnosis and treatment before death was appropriate. With the help of findings during autopsies we can diagnose patients even before the disease is going into a fatal stage, and this is when @mrs_angemi comes into the picture, her account was deactivated also after mine, and brought back on. She's dedicating herself not only to her job, but also to educate the younger ones, and that is why my respect to her is enormous. 

To a finer topic, who hearts?

One of the most fascinating branch of medicine is Neurosurgery. 

The nervous system surrounds every inch of our body. Every single movement, sensation, feeling and emotion are coming from it, traveling from one nerve cell to another, thus the neurosurgeon plays God when he reaches the operating table to pull the unique strings that stimulates our body. 

He must be delicate enough not to damage, yet encouraged and skilled enough to treat the best. 

In this image the brain is exposed after removing a bone flap (craniotomy) and the dura mater which covers the brain.

Hemicolectomy (surgical procedure to remove one side of the colon) due to colon perforation and numerous ingested foreign bodies in a psychiatric patient! 

Intentional foreign body ingestion is commonly seen in adult patients with mental disabilities, significant substance abuse, psychiatric disorders, or external motivations (such as avoidance of a jail sentence).

The swallowing of foreign bodies can be accidental or intentional.

About 80-90% of ingested foreign bodies spontaneously pass through the gastrointestinal tract, with only 10-20% requiring endoscopic or surgical intervention. 

 

Behold, The Ghost Heart! This is absolutely a medical miracle, a giant step closer for millions in need of new organs.

This is an experimental "ghost heart" which has been decelluralized. Decellularization is a tissue engineering technique designed to strip out all the cells from a donor organ, leaving nothing but the connective tissue that used to hold the cells in place. This scaffold of connective tissue - called a "ghost organ" for its pale and almost translucent appearance - can then be reseeded with a patient's own cells, with the goal of regenerating an organ that can be transplanted into the patient without fear of tissue rejection.

Photo 2/2, continuation of the previous case (reminder - Subaortic stenosis and the surgical removal of the fibrous subaortic ring). Intraoperatively the heart was placed on a heart-lung machine (cardiopulmonary bypass). Postoperatively, the resected subaortic ring is shown. 

Transesophageal echocardiography and pressure measurement comparison are utilized to help assess the adequacy of repair.

Photo 1/2 of an open heart surgery prior to removal of a Subaortic ring. This patient suffered from a condition called Subaortic Stenosis, narrowing of the left ventricle of the heart just below the aortic valve through which blood must pass on its way up into the aorta. The narrowing (by forming a fibrous ring) cuts the flow of blood. Subaortic stenosis may be congenital (present at birth) or acquired as part of a particular form of heart disease known as "idiopathic hypertrophic subaortic stenosis" (IHSS).

 

Appearance of the aortic valve leaflets following reimplantation with the Gelweave Valsalva graft. 

Gelweave Valsalva is the world's first custom designed aortic root graft, indicated for repair and replacement of damaged and diseased thoracic aorta in cases of aneurysm, dissection or coarctation. It is used in valve sparing or combined prosthetic valve implant techniques. It combines the advantages of proper anatomical reconstruction with those of annular stabilization.