शैडोइंग अभ्यास: Splenectomy: step-by-step - वीडियो के साथ अंग्रेजी बोलना सीखें
पाठ बनाया जा रहा है...
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Hello and welcome to the GYO surgery series.
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This will be the first of several different explanations of individual surgeries that we perform in Gynonk,
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including some photos that I'll have referenced, as well as some handmade drawings.
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the first surgery that we'll be going over is the splenectomy
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and I only own the drawings other pictures will be referenced on individual slides
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and at the end this is for educational purposes only this is not intended to be medical advice
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so reference this lovely picture on the right the removal of
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the spleen is occasionally required to achieve optimal surgical cytoreduction in ovarian cancer
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and so knowing the relevant anatomy is important and
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so we'll go over the ligaments attaching to the spleen as well as the blood supply to the spleen
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so there are approximately five ligaments the splenophrenic ligament the splenorenal the pancreaticosplenic,
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the splenocolic, and the gastrosplenic ligaments.
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They are labeled here, 1 through 4.
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We have 1, 2, 3, 4, splenofrenic, which you can't see,
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but the diaphragm would be up here, the splenorenal, the pancreaticosplenic, the splenocolic, and then over here we have the gastrosplenic.
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Each of these ligaments are transected during a splenectomy.
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And then as far as our blood supply goes, it's a little bit easier.
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You just have the splenic artery and the splenic vein.
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As you can see here, these come off the celiac trunk.
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The artery comes off the celiac trunk, and the celiac trunk, as you may remember, is the splenic artery, the left gastric,
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and the common hepatic, and then the splenic vein coming back into the portal vein.
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the basic steps of a splenectomy are entering the lesser sac mobilizing the spleen
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and then ligating the vessels
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which sounds very easy however in practice is definitely scary for gynonks there is an anterior
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or posterior approach
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and the choice depends on the distribution of disease whatever approach would be easier based on disease
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and i will be going over the anterior your approach in this short lecture.
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So first entering the lesser sac of the omentum, you want to identify the gastrocolic ligament.
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This lies between the stomach's greater curvature and the transverse colon.
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The anterior leaf of the omentum attaches to the greater curvature of the stomach via the gastrocolic ligament, and the posterior leaf attaches to the margin of the transverse colon.
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And the lesser sac is kind of between these two leaves.
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So identifying the ligament and then transecting this in order to open the lesser sac.
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The dissection, then this is another depiction of opening the lesser sac, but the omentum is no longer there.
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And as you can see here, this is the gastrocolic ligament here.
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The dissection continues along the transverse colon with mobilization of the
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entire splenic flexure of the colon to eventually reach the splenocolic ligament,
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highlighted here, and then you're also dissecting upward to the greater curvature of the stomach towards the gastrosplenic ligament.
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That's here.
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once mobilized you can grasp the spleen
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and elevate it medially this will expose the splenophrenic ligament here
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and you can continue to dissect the spleen from the gastrosplenic ligament as well as the splenocolic ligament
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so you can see the gastrosplenic ligament in this picture as well as the splenocolic ligament here you'll continue dissecting
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that and then also the splenofrenic ligament, with this being the diaphragm.
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The gastrosplenic ligament is the most vascular and contains those short gastric arteries, so we are very careful in ligating and dividing these.
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And then finally, the spleen is elevated to the incision.
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You do some blunt dissection in order to identify the splenic artery and the splenic vein.
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Each one of these vessels are individually ligated and the artery is ligated first in order to prevent engorgement of the spleen.
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You can use, as depicted here, a right angle placed underneath the artery or individual
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vein artery or vascular pedicle
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and you can use a 2 -0 silk you will then place a second 2 -0 silk
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and then on the proximal end you can either tie
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or clip this end and then divide the artery vein
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or other vascular pedicle and then
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if you're done with the artery you do the vein and that is the end of the splinectomy.
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इस पाठ की शब्दावली और बोलने के सुझाव
यह स्पीकिंग पाठ वीडियो “Splenectomy: step-by-step” पर आधारित है। सबसे ज़्यादा दोहराए गए शब्द ये हैं: ligament, artery, spleen, splenic, vein। इस वीडियो में शैडोइंग के लिए 54 वाक्य और 709 शब्द हैं। बोला गया हिस्सा 5:25 लंबा है। वक्ता लगभग 131 शब्द प्रति मिनट की स्थिर गति से बोलता है, जो शैडोइंग के लिए आरामदायक है। केवल 72% शब्द अंग्रेज़ी के 3,000 सबसे आम शब्दों में से हैं, इसलिए शब्दावली कठिन है।
इस वीडियो की मुख्य शब्दावली
वीडियो के 15 सीखने लायक शब्द, उच्चारण और अर्थ के साथ:
| शब्द | उच्चारण | अर्थ |
|---|---|---|
| artery संज्ञा | /ˈɑɹ.təɹ.i/ | धमनी |
| vein संज्ञा | /veɪn/ | शिरा |
| lesser विशेषण | /ˈlɛsɚ/ | लघुतर |
| colon संज्ञा | /ˈkoʊ.lən/ | कोलन, अपूर्ण विराम |
| leaf संज्ञा | /lif/ | पत्ता, पत्ती |
| trunk संज्ञा | /tɹʌŋk/ | तना, स्कन्ध |
| stomach संज्ञा | /ˈstʌmək/ | आमाशय, पेट |
| vessel संज्ञा | /ˈvɛsəl/ | पोत |
| divide क्रिया | /dɪˈvaɪd/ | बांटना |
| silk संज्ञा | /sɪlk/ | कौशेय, रेशम |
| explanation संज्ञा | /ˌɛkspləˈneɪʃən/ | स्पष्टीकरण, समझाना |
| label संज्ञा | /ˈleɪ.bəl/ | लेबल |
| angle संज्ञा | /ˈæŋ.ɡəl/ | कोण |
| scary विशेषण | /ˈskɛə.ɹi/ | भयानक, डरावना |
| removal संज्ञा | /ɹɪˈmuː.vəl/ | बहिष्कार |
ध्यान देने योग्य उच्चारण
वक्ता 7 बार संक्षिप्त रूपों का प्रयोग करता है, जैसे we'll, you're, can't। इन्हें वैसे ही छोटा बोलें जैसा आप सुनते हैं।
- “sh” और “zh” की ध्वनियाँ: explanation /ˌɛkspləˈneɪʃən/, occasionally /əˈkeɪʒənəli/, dissection /dɪˈsɛkʃən/, depiction /dɪˈpɪkʃən/, flexure /ˈflɛkʃə(ɹ)/
- लंबे शब्द — बलाघात सही रखें: anterior /ænˈtɪɹ.i.ɚ/, explanation /ˌɛkspləˈneɪʃən/, occasionally /əˈkeɪʒənəli/, anatomy /əˈnætəmi/, individually /ˌɪndɪˈvɪd͡ʒ(u)əli/
हिंदी भाषियों के लिए मुश्किल ध्वनियाँ:
- /v/ और /w/ का फ़र्क़ — /v/ में ऊपर के दाँत निचले होंठ को छूते हैं, /w/ में होंठ गोल होते हैं: vein /veɪn/, vascular /ˈvæskjələ/, vessel /ˈvɛsəl/, divide /dɪˈvaɪd/, removal /ɹɪˈmuː.vəl/
- /z/ — इसे “ज” (/dʒ/) न बनाएँ: expose /ɪkˈspoʊz/, mobilize /ˈməʊbɪlʌɪz/
- शब्द की शुरुआत में s + व्यंजन — पहले “इ” न जोड़ें: stomach /ˈstʌmək/, scary /ˈskɛə.ɹi/, slide /ˈslaɪ̯d/, spleen /spliːn/, splenic /ˈsplinɪk/
इस वीडियो से अभ्यास कैसे करें
- पहले बिना बोले पूरा वीडियो एक बार सुनें और जो शब्द नहीं आते उन्हें लिख लें।
- सामान्य गति पर एक-एक वाक्य की शैडोइंग करें और हर वाक्य तब तक दोहराएँ जब तक आपकी लय वक्ता से न मिल जाए।
- अपनी आवाज़ रिकॉर्ड करें और मूल से तुलना करें, ख़ासकर artery, vein, lesser जैसे शब्दों पर ध्यान दें।
शैडोइंग तकनीक क्या है?
शैडोइंग (Shadowing) एक विज्ञान-समर्थित भाषा सीखने की तकनीक है जो मूल रूप से पेशेवर दुभाषिया प्रशिक्षण के लिए विकसित की गई थी। विधि सरल लेकिन शक्तिशाली है: आप मूल अंग्रेज़ी ऑडियो सुनते हैं और तुरंत इसे ज़ोर से दोहराते हैं — जैसे वक्ता की छाया 1-2 सेकंड की देरी से। शोध से पता चलता है कि यह उच्चारण सटीकता, स्वर, लय, जुड़ी हुई ध्वनियाँ, सुनने की समझ और बोलने की प्रवाहशीलता में काफ़ी सुधार करता है।