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Irritable bowel syndromeIrritable bowel syndrome (IBS) is a common disorder that affects your large intestine (colon). Irritable bowel syndrome commonly causes cramping, abdominal pain, bloating gas, diarrhea and constipation. Despite these uncomfortable signs and symptoms, IBS doesn't cause permanent damage to your colon.
Most people with IBS find that symptoms improve as they learn to control their condition. Only a small number of people with irritable bowel syndrome have disabling signs and symptoms.
Fortunately, unlike more-serious intestinal diseases such as ulcerative colitis and Crohn's disease, irritable bowel syndrome doesn't cause inflammation or changes in bowel tissue or increase your risk of colorectal cancer. In many cases, you can control irritable bowel syndrome by managing your diet, lifestyle and stress.

References :
http://www.mayoclinic.com/health/irritable-bowel-syndrome/DS00106

In recent years, rapidly emerging technologies and improved techniques have brought minimally invasive endoscopic surgery closer to a once-elusive goal: incisionless surgery. At the forefront of this trend, Columbia and Weill Cornell physicians at NewYork-Presbyterian Hospital have been developing NOTES (natural orifice translumenal endoscopic surgery) in both research and clinical settings.


NOTES human trial on transoral, transvaginal cholecystectomiesNOTES uses various body orifices as points of entry, including the vagina, rectum, and mouth, instead of initiating an operation from the skin. The hope is that NOTES which is being even less invasive than laparoscopic surgery, will be able to reduce or eliminate pain, leave no scars, and shorten recovery time. Possible applications include appendix operations and biopsies, as well as more significant operations such as removing parts of the stomach and intestine. The method challenges the basic paradigm of surgery: the idea that cutting across the lumen of an organ into the patient's abdominal cavity is to be avoided.

"Surgeons are always taught not to cross those walls unless they're operating on that specific organ," said Marc Bessler, MD. "The big issue we've addressed is how to close the organ you're going through, safely."

This Spring at NewYork-Presbyterian Hospital/Columbia University Medical Center, Dr. Bessler and his colleagues Dennis L. Fowler, MD, and Peter D. Stevens, MD, used NOTES techniques and laparoscopic assistance to complete the first flexible endoscopic transvaginal cholecystectomy in the United States. They inserted an endoscope through the patient's vaginal wall, then into her body cavity. Using that scope, they detached her gallbladder and removed it through the vagina, which they then sutured. To ensure that the technique was performed as safely as possible, the team used laparoscopic assistance. The first operation involved a few incisions. Soon afterward, the doctors conducted the same surgery on a second patient and made only 1 navel incision measuring 5 mm, which is just wide enough to insert the smallest available standard clip used in laparoscopy.


Marc Bessler, MD
NOTES uses various orifices as points of entry, including the mouth.Based on the successful outcomes of these 2 cases, NOTES seems promising, according to Dr. Bessler. The second patient went home the same day as her surgery and did not need pain medication. Although the idea of operating through a sexual organ might make some people feel uneasy, he explained, the procedure focuses on an area of the vaginal wall near the cervix that has minimal pain sensation and is not involved in sexual function. Dr. Bessler plans to evaluate outcomes after every 10 patients and hopes to soon move into a comparative trial that randomly assigns patients to gallbladder removal by either laparoscopy or NOTES.



At NewYork-Presbyterian Hospital/Weill Cornell Medical Center, colorectal surgeons are tailoring the NOTES approach to the large intestine, entering the patient's body via the rectum. "We're trying to develop means by which diseases of the large intestine can be entirely treated through the channels of the large intestine," said Jeffrey W. Milsom, MD. "We're doing hybrid endoscopic and laparoscopic procedures using 2 or 3 tiny incisions in the abdomen to augment this capability of removing lesions from inside the colon, which would otherwise require bowel resections."

The NewYork-Presbyterian/Weill Cornell team consists of Dr. Milsom along with Toyooki Sonoda, MD, Sang Lee, MD, and Alfons Pomp, MD. Together, they have carried out the hybrid procedure in nearly 40 patients. The group is also conducting lab research in animal and cadaver models to develop completely incisionless procedures, techniques that will eventually treat a variety of diseases including benign intestinal growths, rectal prolapse, strictures, infections that lie adjacent to the colon, and possibly even cancer.

Additionally, Dr. Milsom's team is collaborating with bioengineers at NewYork-Presbyterian/Weill Cornell to form Minimally-Invasive New Technologies (MINT), a project that explores how technology can expand minimally invasive surgery. For example, imaging modalities such as 3-dimensional CT scanning, ultrasound, and MRI might couple with endoscopy in the operating room, or newly designed scopes could have improved optics and give surgeons better access to insert necessary tools.

"NOTES is the next natural evolution of what we've been doing over the past 15-plus years," said Dr. Milsom, who bases his current work on the more than 3,000 laparoscopic colon resections he has completed during his career. "Surgery is becoming more and more minimized, as the optics and tools used to carry out surgical actions are all becoming more miniaturized. So, it's more evolutionary than revolutionary."



Diet and exercise can do wonders for the body’s appearance, restoring curves and muscle tone that had been hidden underneath layers of fat for years; unfortunately, those methods are not completely effective. Sometimes, some of the fat clings to your body, refusing to melt away. To remedy these cases, the liposuction procedure is sometimes employed.


Preparing


First, the doctor must determine whether or not the procedure itself will benefit the patient, so there is a kind of screening process. Liposuction is usually recommended for those who are in good health, have only a small amount of fat to lose and have skin that is elastic and will shrink down when the fat is removed.

Once a person has been determined to be a good candidate, they are given an appointment date and instructions for how to prepare (this usually includes dietary restrictions).


In-Patient vs. Out-Patient


These days, liposuction is a simple procedure. When there are small pockets of fat being removed, it is often does as an out-patient procedure. This means you can be in and out of the hospital in a single day.

However, if someone is having fat removed from large areas, or have other potential health complications, they may be required to be an in-patient and stay the night at the hospital for observation.


Fat Removal


As the procedure takes place, the patient is given an anesthetic (either localized for very small fat pockets or general for larger areas). Then, the doctor helps break down the fat in one of several ways. One popular way is to insert a solution into the fat pockets that essentially loosens the fat up. Another way is to use an ultrasound machine to turn the fat into liquid.

Next, the doctor inserts a metal tool called a cannula into the pockets of fat and suctions them out. It is not unlike a vacuum cleaner with an attachment. The doctor continues until the pockets have been mostly removed and your body shape is more appealing.


Liposuction Procedure

Diet and exercise can do wonders for the body’s appearance, restoring curves and muscle tone that had been hidden underneath layers of fat for years; unfortunately, those methods are not completely effective. Sometimes, some of the fat clings to your body, refusing to melt away. To remedy these cases, the liposuction procedure is sometimes employed.


Preparing


First, the doctor must determine whether or not the procedure itself will benefit the patient, so there is a kind of screening process. Liposuction is usually recommended for those who are in good health, have only a small amount of fat to lose and have skin that is elastic and will shrink down when the fat is removed.

Once a person has been determined to be a good candidate, they are given an appointment date and instructions for how to prepare (this usually includes dietary restrictions).


In-Patient vs. Out-Patient


These days, liposuction is a simple procedure. When there are small pockets of fat being removed, it is often does as an out-patient procedure. This means you can be in and out of the hospital in a single day.

However, if someone is having fat removed from large areas, or have other potential health complications, they may be required to be an in-patient and stay the night at the hospital for observation.


Fat Removal


As the procedure takes place, the patient is given an anesthetic (either localized for very small fat pockets or general for larger areas). Then, the doctor helps break down the fat in one of several ways. One popular way is to insert a solution into the fat pockets that essentially loosens the fat up. Another way is to use an ultrasound machine to turn the fat into liquid.

Next, the doctor inserts a metal tool called a cannula into the pockets of fat and suctions them out. It is not unlike a vacuum cleaner with an attachment. The doctor continues until the pockets have been mostly removed and your body shape is more appealing.

Liposuction Procedure

The Recovery Process


Liposuction causes a lot of bruising, soreness and overall exhaustion. The body needs time to recover after the procedure is complete. For small procedures, this can mean just a couple of days while for more extensive liposuction treatments, several weeks may be needed.

Liposuction is a common, quick process, but the specifics of how the procedure will affect you should be discussed with a qualified physician.

A good alternative for the surgery is using smart lipo ..This fat loss treatment would be a great option if you can’t afford surgery cost.




References :
http://www.lifeaura.com/liposuction-procedure/

LASIK or Lasik (Laser-Assisted in situ Keratomileusis), commonly referred to as laser eye surgery, is a type of refractive surgery for the correction of myopia, hypermetropia, and astigmatism. The LASIK surgery is performed by an ophthalmologist who uses a laser or microkeratome to reshape the eye's cornea in order to improve visual acuity. For most patients, LASIK provides a permanent alternative to eyeglasses or contact lenses. Major side effects include halos, starbursts, night-driving problems and eye dryness.

LASIK is most similar to another surgical corrective procedure, photorefractive keratectomy (PRK), and both represent advances over radial keratotomy in the surgical treatment of refractive errors of vision. For patients with moderate to high myopia or thin corneas which cannot be treated with LASIK and PRK, the phakic intraocular lens is an alternative.

 Procedure

The procedure involves creating a thin flap on the eye, folding it to enable remodeling of the tissue beneath with a laser and repositioning the flap.


How is Lasik Performed

Preoperative procedures

Contact lenses

Patients wearing soft contact lenses are instructed to stop wearing them 5 to 21 days before surgery. One industry body recommends that patients wearing hard contact lenses should stop wearing them for a minimum of six weeks plus another six weeks for every three years the hard contacts have been worn. The cornea is avascular because it must be transparent to function normally. Its cells absorb oxygen from the tear film. Thus, low-oxygen-permeable contact lenses reduce the cornea's oxygen absorption, sometimes resulting in corneal neovascularization—the growth of blood vessels into the cornea. This causes a slight lengthening of inflammation duration and healing time and some pain during surgery, because of greater bleeding. Although some contact lenses (notably modern RGP and soft silicone hydrogel lenses) are made of materials with greater oxygen permeability that help reduce the risk of corneal neovascularization, patients considering LASIK are warned to avoid over-wearing their contact lenses. Usually, it is recommended that they discontinue wearing contact lenses days or weeks before the LASIK eye surgery.

Pre-operative examination and education

In the USA, the FDA has approved LASIK for age 18 and over.More importantly the patient's eye prescription should be stable for at least one year prior to surgery. The patient may be examined with pupillary dilation and education given prior to the procedure. Before the surgery, the patient's corneas are examined with a pachymeter to determine their thickness, and with a topographer, or corneal topography machine, to measure their surface contour. Using low-power lasers, a topographer creates a topographic map of the cornea. The procedure is contraindicated if the topographer finds difficulties such as keratoconus The preparatory process also detects astigmatism and other irregularities in the shape of the cornea. Using this information, the surgeon calculates the amount and the location of corneal tissue to be removed. The patient is prescribed and self-administers an antibiotic beforehand to minimize the risk of infection after the procedure and is sometimes offered a short acting oral sedative medication as a pre-medication. Prior to the procedure, anaesthetic eye drops are instilled.

Operative procedure 

How is Lasik Performed

Flap creation

A soft corneal suction ring is applied to the eye, holding the eye in place. This step in the procedure can sometimes cause small blood vessels to burst, resulting in bleeding or subconjunctival hemorrhage into the white (sclera) of the eye, a harmless side effect that resolves within several weeks. Increased suction causes a transient dimming of vision in the treated eye. Once the eye is immobilized, the flap is created. This process is achieved with a mechanical microkeratome using a metal blade, or a femtosecond laser that creates a series of tiny closely arranged bubbles within the cornea. A hinge is left at one end of this flap. The flap is folded back, revealing the stroma, the middle section of the cornea. The process of lifting and folding back the flap can sometimes be uncomfortable.

Laser remodelling

The second step of the procedure uses an excimer laser (193 nm) to remodel the corneal stroma. The laser vaporizes the tissue in a finely controlled manner without damaging the adjacent stroma. No burning with heat or actual cutting is required to ablate the tissue. The layers of tissue removed are tens of micrometres thick. Performing the laser ablation in the deeper corneal stroma provides for more rapid visual recovery and less pain than the earlier technique, photorefractive keratectomy (PRK). During the second step, the patient's vision becomes blurry, once the flap is lifted. They will be able to see only white light surrounding the orange light of the laser, which can lead to mild disorientation. The excimer laser uses an eye tracking system that follows the patient's eye position up to 4,000 times per second, redirecting laser pulses for precise placement within the treatment zone. Typical pulses are around 1 millijoule (mJ) of pulse energy in 10 to 20 nanoseconds.

Repositioning of the flap
After the laser has reshaped the stromal layer, the LASIK flap is carefully repositioned over the treatment area by the surgeon and checked for the presence of air bubbles, debris, and proper fit on the eye. The flap remains in position by natural adhesion until healing is completed.


Postoperative care
postoperative eye drops


Patients are usually given a course of antibiotic and anti-inflammatory eye drops. These are continued in the weeks following surgery. Patients are told to rest and are given dark eyeglasses to protect their eyes from bright lights and occasionally protective goggles to prevent rubbing of the eyes when asleep and to reduce dry eyes. They also are required to moisturize the eyes with preservative-free tears and follow directions for prescription drops. Occasionally after the procedure a bandage contact lens is placed to aid the healing, and typically removed after 3–4 days. Patients should be adequately informed by their surgeons of the importance of proper post-operative care to minimize the risk of complications


References

http://en.wikipedia.org/wiki/LASIK




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