Dr. Ram Prasad Subedi Health blog

Ryles Nasogastric Tube:  This is a narrow tube made of non-toxic, medical grade polyvinyl chloride (PVC) or polyurethane. The distal end is coned with steel balls sealed into the tube to facilitate easy insertion. Four lateral eyes along the distal end provide efficient drainage of secretions/fluids. The tubes are marked at 50, 60 and 70 cm from the distal end for accurate placement into the abdomen. The radio-opaque line provided throughout the tube helps radiographic visualisation. The proximal end is provided with a universal funnel connector for easy extension and allows a drain or feeding bag to be connected. Sizes available are 6–18F for adults and 10–14F for children. Ryles tubes are available in packs that have been pre-sterilised with ethylene oxide. They are also available individually in peelable pouch packs. Nasogastric tubes are used for: aspiration in cases of intestinal obstruction and pyloric stenosis diagnosis of gastrointestinal haemorrhages and acute gastric...

Telescopes And Lens Systems in surgery: Telescopes are used to visualise inside the abdomen during laparoscopy or cystoscopy. The size ranges from 0.8 mm (needle scope) to 15 mm diameter. The brightness of the image reduces with decreasing size of the scope. The angle of view can be a straight-on view at 0° or angled at 0°/30°/45°/70°/120°. Zero-degree telescopes provide a field of view of only 76°. A 30° telescope provides a total field of view of 152°. The 30° forward oblique angle permits far greater latitude for viewing areas under difficult anatomical conditions, has an unobstructed view from a distance and provides more space for instrument manoeuvrability. There are two lens system designs: conventional thin lens system Hopkins rod–lens system. The thin lens system, which consists of a series of objective lenses to transport the image down the laparoscope, is used less commonly. The Hopkins lens system, which consists of a series of quartz-rod lenses, carries the image through t...

Minimal access surgery: Minimal access surgery is now commonplace in a wide range of specialties. With increased surgeon expertise, absolute contraindications of MIS surgery have been replaced by relative contraindications based on surgeon experience. Reduced blood loss, and improved visualisation may make minimal access surgery the approach of choice for obese patients, Jehovah’s Witness or even in certain re-do procedures (particularly with the advent of surgical robotics).

Surgical Navigation and Tumor Localization: Augmented reality in surgery allows for the overlay of real-time imaging/data onto the surgical field. It may improve localisation of tumour pathology or anatomical structures and can be used to ‘navigate’ the surgeon to the area of interest. Virtual reality has been used for simulation and training and can improve the learning curve for novel minimal access surgery approaches. Ref: Bailey and Love 28th edition