2019 - what is 24h

    • Sunday, December 29, 2019

    callao madrid ALUMNA DEL CALLAO ES CAMPEONA SUDAMERICANA DE TENIS SUB12

    callao madrid ALUMNA DEL CALLAO ES CAMPEONA SUDAMERICANA DE TENIS SUB12

    callao madrid ALUMNA DEL CALLAO ES CAMPEONA SUDAMERICANA DE TENIS SUB12

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    People & Blogs Upload TimePublished on 5 Nov 2014

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    callao madrid PALMAS MAGISTERIALES PARA CARMEN ANAYA

    callao madrid PALMAS MAGISTERIALES PARA CARMEN ANAYA

    callao madrid PALMAS MAGISTERIALES PARA CARMEN ANAYA

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    People & Blogs Upload TimePublished on 14 Oct 2014

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    Educación PREVAED GARANTIZA SEGURIDAD EN II.EE DEL CALLAO

    Educación PREVAED GARANTIZA SEGURIDAD EN II.EE DEL CALLAO
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    callao madrid DREC BRINDA CENA A 33 DIRECTORES DEL CALLAO

    callao madrid DREC BRINDA CENA A 33 DIRECTORES DEL CALLAO

    callao madrid DREC BRINDA CENA A 33 DIRECTORES DEL CALLAO

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    People & Blogs Upload TimePublished on 25 Nov 2014

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    callao madrid HIP HOP

    callao madrid HIP HOP

    callao madrid HIP HOP

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    People & Blogs Right Round Flo Rida Get Busy Sean Paul Upload TimePublished on 19 Sep 2014

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    Educación EVALUACION DE DOCENTES PARA ASCENSO A ESCALA CETPROS

    Educación EVALUACION DE DOCENTES PARA ASCENSO A ESCALA CETPROS
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    Educación DREC APLICÓ PRUEBA REGIONAL DE INICIO EN LAS II.EE PÚBLICAS Y PRIVADAS DEL CALLAO

    Educación DREC APLICÓ PRUEBA REGIONAL DE INICIO EN LAS II.EE PÚBLICAS Y PRIVADAS DEL CALLAO

    Educación DREC APLICÓ PRUEBA REGIONAL DE INICIO EN LAS II.EE PÚBLICAS Y PRIVADAS DEL CALLAO

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    People & Blogs Upload TimePublished on 18 Apr 2018

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    Educación ENTREGAN LIBROS A COLEGIOS DE RED 8

    Educación ENTREGAN LIBROS A COLEGIOS DE RED 8
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    callao madrid PRENTAN NUEVO DE LA DREC EN VENTANILLA

    callao madrid PRENTAN NUEVO DE LA DREC EN VENTANILLA

    callao madrid PRENTAN NUEVO DE LA DREC EN VENTANILLA

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    People & Blogs Upload TimePublished on 4 Dec 2014

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    callao madrid CATEGORÍA CANTO

    callao madrid CATEGORÍA CANTO

    callao madrid CATEGORÍA CANTO

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    People & Blogs Upload TimePublished on 19 Sep 2014

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    callao madrid NOCHE DE TALENTOS. CATEGORÍA CANTO

    callao madrid NOCHE DE TALENTOS. CATEGORÍA CANTO
    4e-|0321

    callao madrid NOCHE DE TALENTOS. CATEGORÍA CANTO

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    People & Blogs Upload TimePublished on 2 Sep 2014

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    Educación LANZAMIENTO DE CAMPAÑA DE DELITOS DE CRIMEN ORGANIZADO EN COLEGIOS DE LA REGIÓN CALLAO

    Educación LANZAMIENTO DE CAMPAÑA DE DELITOS DE CRIMEN ORGANIZADO EN COLEGIOS DE LA REGIÓN CALLAO

    Educación LANZAMIENTO DE CAMPAÑA DE DELITOS DE CRIMEN ORGANIZADO EN COLEGIOS DE LA REGIÓN CALLAO

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    People & Blogs Better When I'm Dancin'-28221 Upload TimePublished on 10 Apr 2019

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    callao madrid LO MEJOR DE LO MEJOR 2014

    callao madrid LO MEJOR DE LO MEJOR 2014

    callao madrid LO MEJOR DE LO MEJOR 2014

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    People & Blogs Guajira Pa´ Mi Barrio Upload TimePublished on 21 Nov 2014

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    callao madrid DESCARTAN PLOMO Y DESNUTRICIÓN EN IE JOSE GALVEZ

    callao madrid DESCARTAN PLOMO Y DESNUTRICIÓN EN IE JOSE GALVEZ

    callao madrid DESCARTAN PLOMO Y DESNUTRICIÓN EN IE JOSE GALVEZ

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    People & Blogs Upload TimePublished on 19 Nov 2014

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    callao madrid FINAL CONCURSO CREA Y EMPRENDE 2014 corregido

    callao madrid FINAL CONCURSO CREA Y EMPRENDE 2014 corregido

    callao madrid FINAL CONCURSO CREA Y EMPRENDE 2014 corregido

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    People & Blogs Upload TimePublished on 3 Nov 2014

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    callao madrid JUEGOS FLORALES. CATEGORÍA ARTE INSTRUMENTAL, ETAPA REGIONAL

    callao madrid JUEGOS FLORALES. CATEGORÍA ARTE INSTRUMENTAL, ETAPA REGIONAL

    callao madrid JUEGOS FLORALES. CATEGORÍA ARTE INSTRUMENTAL, ETAPA REGIONAL

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    People & Blogs Upload TimePublished on 16 Sep 2014

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    callao madrid DREC Y CAFED ORGANIZAN II FERIA VOCACIONAL PARA ESTUDIANTES DEL QUINTO DE SECUNDARIA

    callao madrid DREC Y CAFED ORGANIZAN II FERIA VOCACIONAL PARA ESTUDIANTES DEL QUINTO DE SECUNDARIA

    callao madrid DREC Y CAFED ORGANIZAN II FERIA VOCACIONAL PARA ESTUDIANTES DEL QUINTO DE SECUNDARIA

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    People & Blogs Upload TimePublished on 3 Oct 2014

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    callao madrid Desfile cívico escolar en Sarita Colonia - Región Callao

    callao madrid Desfile cívico escolar en Sarita Colonia - Región Callao
    En la Av. Víctor Raúl Haya de la Torre y la Av. Fernando Belaunde Terry, al costado de la comisaría en el AA.HH SARITA COLONIA, se realizó el desfile CÍVICO ESCOLAR POR EL 195 ANIVERSARIO PATRIO.
    El evento contó con la presencia de autoridades regionales, educativas y policiales de la Región Callao.
    Participaron más de mil alumnos de los colegios públicos y privados de la Zona de Sarita Colonia, con la actuación especial de la banda del colegio particular George Washintong de Bellavista.
    El evento por las fiestas patrias lo realizó el Gobierno Regional a través de la Dirección Regional de Educación del Callao, y contó con la participación de 15 colegios de la zona, quienes compitieron con sus batallones y escoltas, y alegorías a la patria.
    Los resultados de la competencia:
    1er Puesto Inicial Público: Juan Pablo II
    1er Puesto Inicial Privado: Divino Cautivo
    1er Puesto Primaria Público: Sarita Colonia
    1er Puesto Primaria Privado: Divino Cautivo
    1er Puesto Secundaria Público: Sarita Colonia
    1er Puesto Secundaria Privado: Divino Cautivo

    callao madrid Desfile cívico escolar en Sarita Colonia - Región Callao

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    People & Blogs Upload TimePublished on 13 Jul 2016

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    callao madrid 5 DIRECTORES CHALACOS DESTACAN A NIVEL NACIONAL

    callao madrid 5 DIRECTORES CHALACOS DESTACAN A NIVEL NACIONAL

    callao madrid 5 DIRECTORES CHALACOS DESTACAN A NIVEL NACIONAL

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    People & Blogs Upload TimePublished on 1 Nov 2014

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    callao madrid EXPO FERIA DE CETPROS EN PLAZA CASANAVE

    callao madrid EXPO FERIA DE CETPROS EN PLAZA CASANAVE

    callao madrid EXPO FERIA DE CETPROS EN PLAZA CASANAVE

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    People & Blogs Upload TimePublished on 30 Sep 2014

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    callao madrid JFNE.2014 CONCURSO DE BANDAS. ETAPA REGIONAL

    callao madrid JFNE.2014 CONCURSO DE BANDAS. ETAPA REGIONAL
    CONTINUA LOS JUEGOS FLORALES ESCOLARES NACIONALES 2014, EN ETAPA REGIONAL, LA IE. JUNIOR CÉSAR DE LOS RIOS CLASIFICÓ A LA SIGUIENTE ETAPA. LA MACRO REGIONAL, COMO VAN, SON CANDIDATO A TRAERSE LA DE ORO.

    callao madrid JFNE.2014 CONCURSO DE BANDAS. ETAPA REGIONAL

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    People & Blogs Upload TimePublished on 16 Sep 2014

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    callao madrid DEVIDA. PROGRAMA JOVENES LIDERES

    callao madrid DEVIDA. PROGRAMA JOVENES LIDERES

    callao madrid DEVIDA. PROGRAMA JOVENES LIDERES

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    People & Blogs Upload TimePublished on 4 Nov 2014

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    callao madrid CONDECORAN A LUCHIN

    callao madrid CONDECORAN A LUCHIN

    callao madrid CONDECORAN A LUCHIN

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    People & Blogs Upload TimePublished on 28 Oct 2014

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    Educación MONITOREO MATRICULA 2018 EN LA IE LOS JAZMINES

    Educación MONITOREO MATRICULA 2018 EN LA IE LOS JAZMINES
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    callao madrid DIA DEL DIRECTOR CHALACO EN LA PUNTA

    callao madrid DIA DEL DIRECTOR CHALACO EN LA PUNTA

    callao madrid DIA DEL DIRECTOR CHALACO EN LA PUNTA

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    People & Blogs Upload TimePublished on 19 Dec 2014

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    callao madrid ELECCIONES DE ALCALDE ESCOLAR IE POLITECNICO

    callao madrid ELECCIONES DE ALCALDE ESCOLAR IE POLITECNICO

    callao madrid ELECCIONES DE ALCALDE ESCOLAR IE POLITECNICO

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    People & Blogs Upload TimePublished on 18 Nov 2014

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    callao madrid EXPERIENCIAS EXITOSAS REGION CALLAO 2014

    callao madrid EXPERIENCIAS EXITOSAS REGION CALLAO 2014

    callao madrid EXPERIENCIAS EXITOSAS REGION CALLAO 2014

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    People & Blogs Guajira Pa´ Mi Barrio Isn't She Lovely Stevie Wonder Upload TimePublished on 11 Dec 2014

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    callao madrid 11 y 12 NOV PRUEBA ECE 2014

    callao madrid 11 y 12 NOV PRUEBA ECE 2014

    callao madrid 11 y 12 NOV PRUEBA ECE 2014

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    People & Blogs Upload TimePublished on 14 Nov 2014

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    callao madrid CADETE III AÑO CM. LEONCIO PRADO, JOSHUE NAPURI

    callao madrid CADETE III AÑO CM. LEONCIO PRADO, JOSHUE NAPURI

    callao madrid CADETE III AÑO CM. LEONCIO PRADO, JOSHUE NAPURI

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    People & Blogs Upload TimePublished on 9 Sep 2014

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    callao madrid IE SAN PEDRO LIDERA RANKING DEL MINEDU

    callao madrid IE SAN PEDRO LIDERA RANKING DEL MINEDU

    callao madrid IE SAN PEDRO LIDERA RANKING DEL MINEDU

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    People & Blogs Upload TimePublished on 20 Nov 2014

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    Thursday, December 26, 2019

    carencia stucked stapler

    carencia stucked stapler
    Managment of First stucked stapler,during doing a gastric Bipartition for treatment of Diabetes Tye 2.

    carencia stucked stapler

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    106 views views27 followers
    People & Blogs Upload TimePublished on 20 Jul 2017

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    carencia Bariatric Surgeon Dubai UAE #Weight Loss Surgeon Dubai UAE #Obesity#Iranian Hospital Dubai UAE

    carencia Bariatric Surgeon Dubai UAE #Weight Loss Surgeon Dubai UAE #Obesity#Iranian Hospital Dubai UAE
    Bariatric Surgeon Dubai UAE #Weight Loss Surgeon Dubai UAE #Obesity #Iranian Hospital Dubai UAE

    carencia Bariatric Surgeon Dubai UAE #Weight Loss Surgeon Dubai UAE #Obesity#Iranian Hospital Dubai UAE

    3 Likes3 Dislikes
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    People & Blogs Upload TimePublished on 4 May 2019

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    carencia Iranian Hospital Dubai#Obesity

    carencia Iranian Hospital Dubai#Obesity
    Bariatric Surgeon Dubai UAE #Weight Loss Surgeon Dubai UAE #Obesity Treatment Dubai #Diabetes

    carencia Iranian Hospital Dubai#Obesity

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    People & Blogs Upload TimePublished on 3 May 2019

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    carencia My patient after OAGB/MGB#Iranian Hospital Dubai #Weight Loss Surgery #المستشفی الایرانی دبی

    carencia My patient after OAGB/MGB#Iranian Hospital Dubai #Weight Loss Surgery #المستشفی الایرانی دبی
    Bariatric Surgeon Dubai UAE #Weight Loss Surgeon Dubai UAE #Obesity Treatment Dubai #Diabetes
    Pakistan Bariatric Surgery #Pakistan Obesity #Pakistan Weight Loss Surgery #Pakistan Diabetic Surgery #Pakistan Sleeve Gastrectomy

    carencia My patient after OAGB/MGB#Iranian Hospital Dubai #Weight Loss Surgery #المستشفی الایرانی دبی

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    People & Blogs Upload TimePublished on 3 May 2019

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    carencia SASI Part 2

    carencia SASI Part 2
    SASI,one of the effective Metabolic Surgery for the treatment of Diabetes type 2.by Imran abbas.

    carencia SASI Part 2

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    63 views views27 followers
    People & Blogs Upload TimePublished on 15 Oct 2016

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    carencia At my Clinic, Iranian Hospital, Dubai

    carencia At my Clinic, Iranian Hospital, Dubai
    Bariatric Surgeon Dubai UAE #Weight Loss Surgeon Dubai UAE #Obesity Treatment Dubai #Diabetes
    Pakistan Bariatric Surgery #Pakistan Obesity #Pakistan Weight Loss Surgery #Pakistan Diabetic Surgery #Pakistan Sleeve Gastrectomy

    carencia At my Clinic, Iranian Hospital, Dubai

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    People & Blogs Upload TimePublished on 3 May 2019

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    carencia Surgical Treatment of diabetes#Obesity Surgery #Iranian Hospital Dubai UAE #المستشفی الایرانی دبی

    carencia Surgical Treatment of diabetes#Obesity Surgery #Iranian Hospital Dubai UAE #المستشفی الایرانی دبی
    Bariatric Surgeon Dubai UAE #Weight Loss Surgeon Dubai UAE #Obesity Treatment Dubai #Diabetes
    #pakistani Bariatric surgery #pakistani Weight Loss Surgery #Pakistani Obesity & Diabetic Surgery #المستشفی الایرانی دبی
    Pakistani Bariatric Surgeon #Pakistan Obesity #Pakistan Weight Loss Surgery #Pakistan Diabetic Surgery

    carencia Surgical Treatment of diabetes#Obesity Surgery #Iranian Hospital Dubai UAE #المستشفی الایرانی دبی

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    People & Blogs Upload TimePublished on 3 May 2019

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    carencia With professor Surendhra Ugale #London#Weight Loss Surgery #Iranian Hospital Dubai UAE #Obesity

    carencia With professor Surendhra Ugale #London#Weight Loss Surgery #Iranian Hospital Dubai UAE #Obesity
    Bariatric Surgeon Dubai UAE #Weight Loss Surgeon Dubai UAE #Obesity Treatment Dubai #Diabetes
    #pakistani Bariatric surgery #pakistani Weight Loss Surgery #Pakistani Obesity & Diabetic Surgery #المستشفی الایرانی دبی

    carencia With professor Surendhra Ugale #London#Weight Loss Surgery #Iranian Hospital Dubai UAE #Obesity

    3 Likes3 Dislikes
    21 views views27 followers
    People & Blogs Upload TimePublished on 3 May 2019

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    carencia MIni gastricbypass #Weight Loss Surgery #Iranian Hospital Dubai#المستشفی الایرانی دبی

    carencia MIni gastricbypass #Weight Loss Surgery #Iranian Hospital Dubai#المستشفی الایرانی دبی
    #pakistani Bariatric surgery #pakistani Weight Loss Surgery #Pakistani Obesity & Diabetic Surgery #المستشفی الایرانی دبی
    Minigastric By pass step by step IMRAN ABBAS MD,DIBGS,FMIS,FWAMS,FASMBS CONSULTANT LAPROSCOPIC BARIATRIC SURGEON, DUBAI,UAE LIFE LINE HOSPITAL IRANIAN HOSPITAL MEDICAL SPECIALIST CENTRE
    PATIENT POSITION
    SUPINE
    SEMILITHOTOMY
    SEMISITTING POSITION
    TROCAR POSITION
    PORT A (10 mm optical) Just Left lateral To Linea Alba In male 10 cm from Xiphoid In female 15 cm from Xiphoid
    PORT B 12 mm 10cm Left Lateral & Parallel to Port A
    PORT C 5mm 3-4 cm below right costal margin at lateral rectus sheath
    PORT D 5mm 1cm below xiphoid
    PORT E 5mm Left Ant Axillary Line 3cm below costal margin


    STEP ONE
    Safe Entery By Optical Port Just Left Lateral To Linea Alba
    Confirm Peritoneal Fold Before Enterence

    Step Two
    Liver Retraction
    Holding The Liver With Locking Grasper With Grasping Soft Tissue At Right Crus


    Step Three & four
    His Angle Dissection
    1cm Distal to EG Juntion
    Much Helpful For Stapling Of Last Stapler
    Rule out any Intestinal adhesion

    STEP 5
    Creation Of Lesser Omental Window
    Begin at Crow,s Foot
    Window Must be 2cm just attach with stomach wall
    Adhesiolysis if any adhesion with pancreas


    STEP SIX
    1st Reticular Stapler From Port B
    Use 4.5 mm Cartridge
    Use Green,Gold,Purple,Black

    STEP SEVEN
    All Staplers From Port B
    Making a wide long Gastric Pouch with the Guide on 36 F Bouggei
    Cartridge 60mm
    Cartridge Colour Blue,Golden,Purple

    STEP EIGHT
    Final Stapler From Port B
    Cartrige Blue
    Stay 1-1.5 cm lateral to EG Junction(Fat Pad)

    STEP NINE
    Gastrotomy mid point just posterior to 1st stapler line

    STEP TEN
    Identify Trietz Ligament
    Intestinal Measurment Clock wise hand to hand
    Measure 150 to 200 cm of Jejunum
    Entrostomy


    STEP 11
    Gastrojejunostomy
    Cartridge Blue 45mm,30mm
    Thick arm of cartridge inside intestine
    Never manipulate intestine aggressively
    Retract down ward the gastric pouch if necessary
    Posterior anastomosis,middle to medial of gastric pouch,distance B/W two stapler line must be more than 1cm,if less than 1cm than must be bury


    STEP 12
    Closure of gastrostomy/enterostomy
    Suture PDS 2-0 blue colour needle 30mm

    STEP 13
    Air Leak Test
    Control hemostasis
    Check Stapler Line especially Remannant
    Insert drain carrogate Drain
    Control Port Site for bleeding

    Bariatric Surgeon Dubai UAE #Weight Loss Surgeon Dubai UAE #Obesity Treatment Dubai #Diabetes

    carencia MIni gastricbypass #Weight Loss Surgery #Iranian Hospital Dubai#المستشفی الایرانی دبی

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    385 views views27 followers
    People & Blogs Upload TimePublished on 28 Mar 2017

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    carencia Bariatric Surgeon Dubai UAE #Weight Loss Surgeon Dubai UAE #Obesity#Iranian Hospital Dubai UAE

    carencia Bariatric Surgeon Dubai UAE #Weight Loss Surgeon Dubai UAE #Obesity#Iranian Hospital Dubai UAE
    #pakistani Bariatric surgery #pakistani Weight Loss Surgery #Pakistani Obesity & Diabetic Surgery #المستشفی الایرانی دبی
    Pakistan Bariatric Surgery #Pakistan Obesity #Pakistan Weight Loss Surgery #Pakistan Diabetic Surgery #Pakistan Sleeve Gastrectomy

    carencia Bariatric Surgeon Dubai UAE #Weight Loss Surgeon Dubai UAE #Obesity#Iranian Hospital Dubai UAE

    2 Likes2 Dislikes
    13 views views27 followers
    People & Blogs Upload TimePublished on 3 May 2019

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    carencia Gastric Bipartition#Obesity Surgery #Iranian Hospital Dubai #المستشفی الایرانی دبی

    carencia Gastric Bipartition#Obesity Surgery #Iranian Hospital Dubai #المستشفی الایرانی دبی
    Misfired 1st Stapler in a case of gastric bipartition.

    carencia Gastric Bipartition#Obesity Surgery #Iranian Hospital Dubai #المستشفی الایرانی دبی

    2 Likes2 Dislikes
    85 views views27 followers
    People & Blogs Upload TimePublished on 21 Jul 2017

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    carencia bleeding

    carencia bleeding

    carencia bleeding

    1 Likes1 Dislikes
    27 views views27 followers
    People & Blogs Upload TimePublished on 28 Aug 2016

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    carencia Pakistan Bariatric Surgery #Pakistan Obesity #Pakistan Weight Loss Surgery #Pakistan Sleeve gastrect

    carencia Pakistan Bariatric Surgery #Pakistan Obesity #Pakistan Weight Loss Surgery #Pakistan Sleeve gastrect
    Bariatric Surgeon Dubai UAE #Weight Loss Surgeon Dubai UAE #Obesity Treatment Dubai #Diabetes
    #pakistani Bariatric surgery #pakistani Weight Loss Surgery #Pakistani Obesity & Diabetic Surgery #المستشفی الایرانی دبی
    Pakistan Bariatric Surgery #Pakistan Obesity #Pakistan Weight Loss Surgery #Pakistan Diabetic Surgery #Pakistan Sleeve Gastrectomy

    carencia Pakistan Bariatric Surgery #Pakistan Obesity #Pakistan Weight Loss Surgery #Pakistan Sleeve gastrect

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    People & Blogs Upload TimePublished on 3 May 2019

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    carencia Ramadan Kareem #Healthy life style Weight Loss Surgery #Obesity #Iranian Hospital Dubai UAE

    carencia Ramadan Kareem #Healthy life style Weight Loss Surgery #Obesity #Iranian Hospital Dubai UAE
    Bariatric Surgeon Dubai UAE #Weight Loss Surgeon Dubai UAE #Obesity Treatment Dubai #Diabetes
    #pakistani Bariatric surgery #pakistani Weight Loss Surgery #Pakistani Obesity & Diabetic Surgery #المستشفی الایرانی دبی

    carencia Ramadan Kareem #Healthy life style Weight Loss Surgery #Obesity #Iranian Hospital Dubai UAE

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    People & Blogs Upload TimePublished on 3 May 2019

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    carencia My Operation Room in Iranian Hospital Dubai,UAE #Weight Loss Surgery #Diabetes#المستشفی الایرانی دبی

    carencia My Operation Room in Iranian Hospital Dubai,UAE #Weight Loss Surgery #Diabetes#المستشفی الایرانی دبی
    Bariatric Surgeon Dubai UAE #Weight Loss Surgeon Dubai UAE #Obesity Treatment Dubai #Diabetes

    carencia My Operation Room in Iranian Hospital Dubai,UAE #Weight Loss Surgery #Diabetes#المستشفی الایرانی دبی

    1 Likes1 Dislikes
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    People & Blogs Upload TimePublished on 3 May 2019

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    balitang pandaigdig TRAGO HIDROSOLUBLE POSTNISSEN

    balitang pandaigdig TRAGO HIDROSOLUBLE POSTNISSEN
    Es el control de trago hidrosoluble posterior a funduplicatura para valorar la integridad y comparación con el preparatorio y evaluar la nueva válvula o esfínter esofágico inferior creado por cirugía así como nos ayuda para valorar en caso de fugas o filtraciones

    balitang pandaigdig TRAGO HIDROSOLUBLE POSTNISSEN

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    Science & Technology Upload TimePublished on 9 Jun 2014

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    carencia Bariatric Surgeon Dubai UAE #Weight Loss Surgeon Dubai UAE #Obesity Treatment Iranian Hospital Dubai

    carencia Bariatric Surgeon Dubai UAE #Weight Loss Surgeon Dubai UAE #Obesity Treatment Iranian Hospital Dubai
    #pakistani Bariatric surgery #pakistani Weight Loss Surgery #Pakistani Obesity & Diabetic Surgery #المستشفی الایرانی دبی

    carencia Bariatric Surgeon Dubai UAE #Weight Loss Surgeon Dubai UAE #Obesity Treatment Iranian Hospital Dubai

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    People & Blogs Upload TimePublished on 3 May 2019

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    carencia Minigastric bypass by Imran Abbas#Obesity Surgery #Iranian Hospital Dubai #Weight Loss Surgery #Obes

    carencia Minigastric bypass by Imran Abbas#Obesity Surgery #Iranian Hospital Dubai #Weight Loss Surgery #Obes
    #pakistani Bariatric surgery #pakistani Weight Loss Surgery #Pakistani Obesity & Diabetic Surgery
    Minigastric Bypass video with Technical points.
    MINI GASTRIC BYPASS TECHNICAL POINTS
    IMRAN ABBAS MD,Laparoscopic Bariatric Surgeon,Dubai.
    SurgicalTeam & Their Position:
    Surgeon(B/W legs),First Assisstant Camera holder(patient right side),Second Assisstant(patient left side).
    Instruments:
    New version Laparoscope with at least two moniters,0 degree &30 degree lens,two atraumatic graspers,one single action grasper short arms,Needle holder,one suction irrigation,energy source hormonic 7+ or ligasure.
    Patient position:
    supine,open arms,semisitting(45 degree),semilithotomy,semiflexed knees(pillos under both knees) and fixed with bed.
    Patient must wear antithrombotic socks during surgery.
    2gm cepazoline and 5000 units heparin(sc) just before starting the surgery.
    Port position:
    1st port 10mm(optical port) just left lateral to mid line,about 12cm(males) 15cm(female) from xiphoid process.
    2nd port 12mm, 10 cm left lateral and parallel to first port.
    3rd port 12mm, right of patient 10cm superolateral to 1st port.
    4th port 5mm, left anterior axillary line of patient just 2cm beneath costal margin.
    5th port: 5mm, in epigastrum.
    1st step;
    A general intraabdominal view,any intestinal adhesion or any other incidental pathology.
    Retract liver with the help of left hand grasper and fix endoclinch grasper by grasping right crus.
    2nd step:
    Decompress the stomach by an orogastric tube that must be sizer(38F) and after decompressing,orogastric tube must be retract till esophagus.
    3rd step:
    Grasp most upper portion of omentum by endoclinch grasper from 5th port and retract below.
    4th step:
    Grasp the gastric fundus by left hand grasper(single action) when mobile arm of single action is below and retract fundus below and medially.
    5th step:
    Meticulous dissection of HIS angle,becarful to esophagus and upper short gastric vessel and put a mesh gauze after dissection at HIS site.
    6th step:
    Watch carefuly small intestine just by manupulating the omentum medially to rule out intestinal adhesion.
    7th step:
    Grasp the gastrohepatic ligament just at the incisura angularis and retract it superiorly at the same time assisstant grasp stomach about 10cm below to incisura angularis and retract below and lateral.dissect by hormonic along with horizental portion of incisura angularis just with two bites you will be in lesser sac,if posterior adhesions present than change your hand and grasp hormonic by left hand and stomach by right hand superiorly & lateraly and assisstant will be off,and start dissection by harmonic,than you will be in leser sac,dissect gently so much that a stapler arm can easily enter.
    8th step:
    1st stapler 45mm green in male & redo and Golden in female,by left hand horizently,becarful do not fold stomach and confirm orogastric tube is not in stomach.
    9th step:
    Insert Orogastric tube(sizer) 38F.
    10th step:
    Staple verticaly attach to sizer,dissect posterior adhesions while assisstant tenting the stomach,becareful splenic artery,and also left gastric artry when dissecting for 3rd stapler.
    11th step:
    Last stapler, dissect posterior side while assisstant is tenting the stomach,till you reach the gauze that you placed in HIS angle dissection site,blue arm of stapler below and assisstant retract mentum below and surgeon grasp the fundus and retract below,just see the blue arm in HIS angle site,just lateral to esophageal gastric junction fat pad(1cm lateral to EG juntion).
    12th step:
    See the stapler line on bothside and put a gauze in between two pouches.
    13th step:
    Perforate the gastric pouch for anastomosis,preference posteriorly,just below the transverse stapler line, perforate by hormonic fix arm while anesthesia assisstant holding sizer in gastric pouch with a little pressure,if more vasculature is present at posterior side,you can use anterior side.
    14th step:
    with the help of camera holder when he is watching just LUQ mobilize omentum superomedially by your left hand and than assisstant enter verticaly and hold the colon mesentry and exlore Trietz ligament.Measure small intestintine while mobilizing it superolaterally till 200cm(It depends on patient BMI,I prefer 180 cm).
    15 th step:
    Check the loop reach easily to gastric pouch and than perforate while holding by left hand.
    16 th step:
    Enter the stapler blue 45mm, while blue arm is below,enter blue arm gently in intestine and pull down the gastric pouch,becareful do not push intestine above forcefully it will perforate bowl.
    17 th step:
    Enter in gastric foramen metalic arm of stapler and when stapling becareful stapler line a little toward gastric mesentry by this way there will be no chance of ischemia.
    18 th step:
    Stitching the defect with PDS 0-2 continously,seromuscular of small intestine and full thickness of stomach.
    19th step:
    Air leak test,hold gentely the both afferent & effent arm of bowl 10 cm beyond gastrojejunostomy.

    carencia Minigastric bypass by Imran Abbas#Obesity Surgery #Iranian Hospital Dubai #Weight Loss Surgery #Obes

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    People & Blogs Upload TimePublished on 25 Aug 2016

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    carencia Perforated cecal diverticulitis, Laparoscopic access in a morbid obese patient with 157 kg weight

    carencia Perforated cecal diverticulitis, Laparoscopic access in a morbid obese patient with 157 kg weight
    Bariatric Surgeon Dubai UAE #Weight Loss Surgeon Dubai UAE #Obesity Treatment Dubai #Diabetes #Iranian Hospital Dubai UAE #المستشفی الایرانی دبی
    Best services of Laparoscopic surgery especially weight loss surgery and surgical treatment of diabetes type 2, in Dubai, with best package.

    carencia Perforated cecal diverticulitis, Laparoscopic access in a morbid obese patient with 157 kg weight

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    People & Blogs Upload TimePublished on 15 Jul 2019

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    carencia Patient from Nigeria after Weight Loss Surgery #Iranian Hospital Dubai#المستشفی الایرانی دبی

    carencia Patient from Nigeria after Weight Loss Surgery #Iranian Hospital Dubai#المستشفی الایرانی دبی
    Bariatric Surgeon Dubai UAE #Weight Loss Surgeon Dubai UAE #Obesity Treatment Dubai #Diabetes

    carencia Patient from Nigeria after Weight Loss Surgery #Iranian Hospital Dubai#المستشفی الایرانی دبی

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    People & Blogs Upload TimePublished on 3 May 2019

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