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Capstone group inc order internet of things world europe 2016 for money amex cash back review I don't know whether it's true or not but the story we heard at the time was that a gynecologist in France was doing a kind of gynecological procedure I guess with with the newer equipment and he knew the patient had gallstones and so he looked up at the gallbladder and wondered if he could take the gallbladder out and which you know seven hours later he did and said he'd it was a stupidest thing he'd ever done he'd never do it again you know that you you in the fall of nineteen eighty nine during the American College of Surgeons meeting there was a presentation on laparoscopic cholecystectomy that caught a lot of people's attention I said yeah I heard that some gynecologist in Germany is doing it and it's a gimmick and I think it's really like unsafe and stupid but then at the meeting of the SSAT and I think was the San Antonio time in 1990 there was a abstract that came out by Karl zuker who unfortunately has died since but he was from University of Maryland he had described in the abstract of the 30 patients and when he done laparoscopically suspect me so we were a small group of people in 1990 interested in laparoscopic cholecystectomy Harvey Sigmund myself we decided we're going to work at it on our own so we had a lab organized for us the two of us and we were playing with the pig learning how to use ensuring the camera etc there was no training box at the time I use the cardboard carton the punched holes in it bore the equipment brought it up to this office that I'm sitting and would put a plant in there and practice the second plant in February of 1990 I was on call one day so I was on staff at that point and I walked by this very office where dr. Mulder used to be he was the chair of surgery at the time and I saw the light was on on a Saturday and I saw wonder why he's here you know I wonder if there's a trauma or something so I poked my head in the office to find out what was going on and he was here with a surgeon from Germany by the name of hands Troy del he was the chair of surgery in Cologne Troy dole told me that he had started to do this new operation called laparoscopic cholecystectomy and he said why don't you come to Germany stay at my home and I will train you to do this operation and it will change your career and it will change your life well we learned about it through professor hands Troy doll from Cologne he told us that we should come to Germany to learn how to do this new procedure and dr. Freid was a keen young academic surgeon at the time interested in anything new in GI surgery and he was very keen to go I was chief of general surgery at the general and I thought I should go to see if this is something we should incorporate into our surgical practice I spent a week in Cologne I went with another surgeon from here John Hinchey and we watched them do to laparoscopic cholecystectomy spurred a on for days we were allowed each of us dr. Frieden I to take the gallbladder off the liver bed after they had done the cystic duct and artery so I came back and I spoke to dr. Mulder and asked if we could get the equipment to start doing this operation and dr. hinchey and I did the first 50 cases together so we scrubbed together and then after that we started to teach other people and then eventually started to teach the residents and so on and so forth we at McGill set up probably one of the first training programs an academic training program for surgeons and over period that next year we probably trained about 120 surgeons right from right across Canada northeastern United States the advice we gave to all of them was do not believe that because you've been here for 48 hours that you can now go home and do the operation find yourself a mentor someone who can proc to you and do the operation properly the first patient we did was a patient of dark segment who knew she was number one and she accepted all the risks so we did her and it took a long time about two hours for a gallbladder and it turned out beautifully and I remember finding that perfect patient and saying this is a new operation explaining very carefully explaining who I would try to do with care and I may have to open and she looked at me she says that sounds very interesting but I prefer you get experience on someone else and I'm going to go on a holiday for two weeks I'm going to come back call me again and so I then called her again and she was the third patient but she didn't want to be the first patient I had a 21 year old model who I told before we went to Germany that I was going there to learn an operation that maybe would avoid a large scar so I went to the recovery room after at when she was waking up and I said you we did it we did it and she said she's kind of groggy said the old way and I said no no the new way the fact so she was very happy the outcome of the patients was dramatic when you know we would go to see them the next day patients were walking around they're eating like nothing ever happened to them and then they would be sent home there's something to this because it's working patients are getting out of hospital very quickly complication rates seem to be low and you know it's a lot less painful than the old standard incisions complications for example Buddha track surgery did not begin with laparoscopy bob ross was a different way of doing the procedure and done well was safe but i can tell you on my thirteenth case i had a common duct injury and it was a real setback for me personally you know it was a quote easy case in a very petite woman and I didn't realize that the size of her common duct was probably smaller than my cystic duct and so I think I was a little cavalier I think that's how and I didn't recognize the injury in the operating room I didn't know until 48 hours later when she called me and she very timidly she was nice girl and she said dr. Weiss class is it normal and I'm very yellow and my urine is like tea and my heart nearly stopped within a year of in juicing lab Coley's to this hospital if you didn't do lab cold as you didn't do cholecystectomy as they just amazing how everything changed everyone was doing them everyone knew that they had to get comfortable with them and and as time went on I'd say within about 18 months even those people who said you know it's just a fad were starting to realize that it was here to stay it also became a public demand that drove the operation patients would seek out those doing laparoscopic surgeries opposed to those who were not and the interesting thing is that i don't think the same thing could happen today because it wasn't a tested technique you know there was no evidence out there we didn't really know if it was such a great technique after laparoscopic oles kind of became routine part of practice the real excitement was well where do we go from here when you have a technique that is so exciting and has offered a lot of promise you know it should not miss that opportunity it also here at McGill was a bonding event it helped to bring a lot of different groups who traditionally had not worked together you know come together under some really you know good leadership you know it was just an exciting and very positive time here at me go you you capstone ministers songs mp3 order Montefiore Medical Center and Yeshiva University.