Arcalion (Sulbutiamine)
| Online Pharmacy: | Minimal Price: | Best Buy: | Shipping: | Payment | Delivery to: |
|---|---|---|---|---|---|
| medixresources | Not available for sale | 14/free |      | most countries | |
| tl-pharmacy | Not available for sale | 10-21 days/free |    | every country | |
| medrx-one | Not available for sale | 10 days/free | | most countries | |
| leadmedic | Not available for sale | 14-21days/$10
5-7 days/$25 | | every country | |
| Medph | Not available for sale | FedEx next day/$24 |  | USA only | |
| med-pen | Not available for sale | 14-20 days/$10
7-14 days/$20 |   | most countries | |
| ourpharmacyrx | Not available for sale | 14-21 days/$15
5-12 days/$30 | | most countries | |
| RxPharms | Not available for sale | 14-24 days/free | | worldwide | |
| RxMedShop | Not available for sale | 8-16 days/$20
5-9 days/$30 3-6 days/$40 | | most countries | |
HIGH-TECH MEDICINE AND SURGERY
Within 3 years, a tiny TV camera has turned the world of surgery inside out, allowing doctors to see inside their patients’ abdominal or chest cavities without having to cut them open. Surgery on the organs in either cavity now can be done without massively invading the patients’ flesh, bones, nerves, and muscles.
With video surgery, there are only three or four small wounds, which generally heal without ugly scars and are small enough to be covered by a Band-Aid. Rather than having to spend an expensive week or more in the hospital and a painful month recovering, a patient often returns home the same day and is back to work in a week.
Because the doctor has not cut muscle or bone and has cut flesh so minimally, the convalescent suffers little of the post-operation pain that savages people who have undergone major abdominal or chest surgery performed in the traditional way. Consequently, no heavy doses of drugs for pain relief are needed.
Brian Mendelson, 53, of Reistertown, Maryland, owns an automobile repair shop in Baltimore. Here’s how he benefited from the new video surgery in late 1990: “It was the day after Thanksgiving,” he relates. “I had pains in the stomach – really bad pains. Two days later, I was almost dead. I could not walk, I had no strength. I was sweating. The pains were getting worse.”
The cause of all this proved to be his gallbladder.
In search of help, Mr. Mendelson found his way to Dr. Robert Bailey, an assistant professor of surgery at the University of Maryland Medical Center in Baltimore. Dr. Bailey was one of the first physicians in the United States to try the new video surgery method. Through a small hole in Mr. Mendelson’s midriff, Dr. Bailey removed the gallbladder.
Mr. Mendelson says he had little postoperative pain and adds, “I went back to work in 1 week. I had only four small incisions, but I’ve talked to other patients who had [conventional] gallbladder surgery that left them with 8-inch scars. They took at least 6 weeks to recover from their surgery,”
After the French surgeon Dr. Phillipe Mouret published a report in 1989 stating how he had removed a gallbladder using video cameras, the rush was on.
Estimates are that 70 percent of all gallbladders now are removed by video surgery and that the total has now reached approximately 600,000 such operations each year in this country. Driven by patient demand, 25,000 American surgeons have learned the video technique in just 2 years. Rarely does the surgical community adopt a new technique so rapidly.
The operation seems simple, but it requires training and practiced skill. Several surgeons liken the hand-eye coordination demanded by video surgery to playing a medical version of a Nintendo video game. As the surgeon’s hands manipulate the instruments inside the patient, the surgeon’s eyes watch a TV screen displaying every move that’s made for the operation.
Dr. Avram Cooperman, formerly the chief surgeon at St. Clare’s Hospital in Manhattan and a video surgery pioneer, has removed a gallbladder in as little as 8 minutes. He says, half in jest, that the upcoming crop of surgeons, who grew up playing video games as kids, probably will cut the time in half.
Here’s how the video docs perform gallbladder surgery.
With the patient anesthetized, four small holes are incised in the abdomen. Through the puncture nearest the navel, a plastic tube called a trocar is inserted. A pipe is then slipped through the trocar, and carbon dioxide is pumped into the abdomen, causing the skin and muscles there to rise, tent-like, over the internal organs. This makes room for the surgeon to operate.
Next comes the video camera, which in size and shape resembles a pocket-size cylindrical cigarette lighter. It sits at the outside end of a bundle of glass fibers that conduct light. To illuminate the dark interior of the tent, a high-intensity light beam travels down those glass fibers, as the images it makes visible travel up the fibers to the camera.
On the TV screen can be seen the organs of the abdominal cavity-the bowel, liver, and gallbladder. Everything on the screen is enlarged up to 18 times, making visible the nerves and small blood vessels that ordinarily can be seen only with difficulty.
Through the other openings made in the patient’s abdomen, the surgeon inserts the tools for cutting, sewing, stapling, and the like. The surgeon can clamp the gallbladder, cut and seal the blood vessels attached to it, and then remove the gallbladder through the navel.
Today’s video surgery method did not arise full-grown with Dr. Mouret’s first gallbladder operation. As early as 1910, doctors were performing minor surgery through a tube inserted in the abdomen. But that method never caught on because, without the magnification provided by TV, it was like peeping through a keyhole. Gynecologists long have used the tube (called a laparoscope, because it crosses the soft part of the body between the ribs and the hips, termed lapara in Greek). With it, they can look at the ovaries or draw fluid from the fetal sac to test an unborn baby’s cells for genetic data.
*29/266/5*
