Dr Luis Felipe Cabrera Vargas MD FACS MACC MACCVA
@PipeCabreraV
Followers
16,528
Following
2
Media
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Statuses
18,553
Vascular Surgeon @FSFB_Salud @futuroscirascol Prd @UniJaveriana @U_ElBosque Prof Ass Edit @SurgJournal @AmJSurgery @Cirbosque @MISIRG1 @Grincircar @AISChannel
Bogotá, D.C., Colombia
Joined June 2011
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The sliding, square and self locking knots 🪢 in slow motion: step by step ⤵️🔑🔪🪡🗣️!
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Basic surgical tip: How to convert a square 🪢 knot into a slip 🪡 knot using the pole maneuver 💡🔊🔥🧤🖐️🔪!
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@pferrada1
@SWexner
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Step 👢 by step 🥾 : The Self locking knot 🪢!
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@Cirbosque
@DrThawaba
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Gracz arteriovenous fistula technique: step by step 🔑⤵️💥🔪!
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5
179
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Saturday surgical tip: how to hold the needle holder ⤵️🪡! Finger grip technique: useful for precise and atraumatic suture of critical structures! Palm grip technique: ideal for sutures that requires more strength and power!
#SoMe4Surgery
#aortaed
9
202
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The haemostatic X suture: how to do it ⤵️💡🚨🗣️🩸!
#SoMe4Surgery
@pferrada1
@rbarbosa91
@SWexner
@juliomayol
@drdevirgilio
@Cirbosque
@MISIRG1
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Two-handed 🤚 🖐️ surgical knot 🪢 or the surgeons knot 🪡🧤💡: how I to do it !
#SoMe4Surgery
@pferrada1
@rbarbosa91
@SWexner
@juliomayol
@Cirbosque
@MISIRG1
@LiangRhea
@sminaev2015
@NeilFlochMD
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226
1K
Vascular Surgical tip: be careful with the vascular clamps 🗜️ only use one clip of the ratchet, two could be to much for the vessel ⤵️ and damage the endothelium 🔑🩸🔪💥🗣️!
#SoMe4Surgery
#aortaed
16
148
948
Weekend surgical knot 🪢 tying tip: tying the knot down! How to do it! The wrong and the right way to do it!
#SoMe4Surgery
@Cirbosque
@pferrada1
@MISIRG1
@juliomayol
@SWexner
@drdevirgilio
@DrThawaba
@LiangRhea
@rbarbosa91
@sminaev2015
@neilfochmd
10
154
829
Pneumoperitoneum creation! How I do it: Hasson open technique! Introduced in 1971 by Dr Hasson H to eliminate the risks of Veress technique of bowel injury! Advantage: peritoneal cavity is accessed under direct vision! Tip: Always return the scalpel to the scrub nurse!
8
174
811
Vascular 🩸surgical tip: Never repair a vascular anastomosis leak under pressure because the tissue will teared and the defect will get bigger and bigger! The best option is identify the leak and them put again the clamps and repair the leak without pressure!
#aortaed
@pferrada1
20
120
817
Fasciostomy technique: how to do it by Drs
@isabellxgaravis
and
@gabrielaayalav
medical illustrator of
@Cirbosque
🔑⤵️💥🗣️🩸!
#SoMe4Surgery
7
144
761
Saturday surgical advice: never forget that operate an open abdomen is to open the Pandora’s 📦 box and you must be ready for everything! This is one of the main advantages of the Borraez 💼 bag: allows to see directly the bowel and to evaluate its state and perfusion ⤵️💡‼️🗣️🚨
9
121
711
How to secure 🪡a chest 🩻tube using a novel 💡and easy technique: accomplishing the principles of haemostasis, secure fixation, airtightness and automatic closure of the orifice 🔥🪢✂️!
#SoMe4Surgery
@pferrada1
@TomVargheseJr
@SWexner
@juliomayol
@MISIRG1
@Cirbosque
@NicoForeRa
9
170
691
Tying the knot 🪢 down ⤵️! How to do it 💡🗣️! The wrong ❌and the right✅ way to do it!
#SoMe4Surgery
@pferrada1
@SWexner
@juliomayol
@Cirbosque
@rbarbosa91
@TomVargheseJr
@NeilFlochMD
@JJcolemanMD
5
152
674
Surgical challenge: severe destructive ulnar artery trauma with radial pulse 4/4 and patent palmar arc ⤵️🔑🩸WWYD?
#SoMe4Surgery
@pferrada1
@docmartin22
@JJcolemanMD
@DrThawaba
7
112
680
Palming: how to do it 🔥💥🧨🏥🪡! The ideal way to cut using the Mayo scissors ✂️ and the left hand 🫲 !
#SoMe4Surgery
@pferrada1
@Cirbosque
@SWexner
@juliomayol
@rbarbosa91
@DrThawaba
@MISIRG1
@drdevirgilio
@LiangRhea
19
118
652
How to avoid suture cuts ✂️ in your non dominant hand🪡fingers: don’t put the passive loop of the suture on the back of your finger 🖐️ but on the tip of the finger to prevent the friction of the suture from cutting 🧵!
#SoMe4Surgery
@pferrada1
@rbarbosa91
@drdevirgilio
@Cirbosque
7
130
652
Laparoscopic surgical knot challenge: what is the name of this surgical knot? Clue: its a knot developed in
#LatAm
! 🇲🇽
#SoMe4Surgery
@juliomayol
@SWexner
@pferrada1
@MISIRG1
@almagoch
@DrThawabeh
@sminaev2015
@morenominilap1
@elopezgavito
@NeilFlochMD
@Cirbosque
@drdevirgilio
30
163
628
Surgical ergonomics: posture and pre/intra-operative micro-breaks stretch! How to do it ⤵️🔑🧤🔪🗣️!
#SoMe4Surgery
#aortaed
6
171
627
Vascular surgical tip: always take out the air 💨🌬️of your vascular anastomosis ⤵️ with a jet of flow before complete the last two stitches of it! Specially during carotid surgery! Eversion carotid endarterectomy example 🩸📌✂️!
#SoMe4Surgery
#AortaEd
@pferrada1
@Cirbosque
2
102
619
The Double knot! Two hand 🤚 technique 🆚 One hand 🖐🏽 technique! how to do it ⤵️💥🔪🪢🔝!
#SoMe4Surgery
@NicoForeRa
@SWexner
@juliomayol
@pferrada1
@rbarbosa91
@almagoch
@NeilFlochMD
@TomVargheseJr
@Cirbosque
9
145
612
How not to perform ⤵️💡surgical knots 🪢 : 1. Speed is not a probe quality 2. Always tying the knot down using the index finger 3. Never forget to perform post with your non dominant hand 4. You must cross your hands to perform square knots!
#SoMe4Surgery
@rbarbosa91
@pferrada1
1
146
593
How to avoid eversion of the skin edges when performing a Sarnoff suture (vertical mattress suture): Far - Far but try to perform the Near - Near part with a subcuticular (intradermal) technique ⤵️🔑🔪!
#SoMe4Surgery
7
98
588
How it started: My 1st open rAAA repair when I was a 1st year graduated general surgeon / How it goes: My last week open rAAA repair as a 1st year graduated vascular surgeon!
#AortaEd
🔑: persistence, resilience and mentorship!
@pferrada1
@drdevirgilio
@VasculonR
@XavierBerardMD
7
85
592
The Olliver Nuñez
@HerniayTraumaCx
technique to improve the laparoscopic ports skin closure: step by step ⤵️💡! 1. Inverted 2. Subcuticular 3. Buried 🪢📌🚨!
#SoMe4Surgery
@pferrada1
@SWexner
@juliomayol
@Cirbosque
@rbarbosa91
@NeilFlochMD
@TomVargheseJr
@LiangRhea
11
93
580
The wrong 🚫and the right ✅ way to mount a silk suture to perform a vascular ligation in the Halsted (mosquito 🪰 ) or Kelly forceps 💡🎯The 🔑: silk suture tip in the forceps tip🚨!
#Some4surgery
#aortaed
@pferrada1
@rbarbosa91
@drdevirgilio
@SWexner
@juliomayol
@NeilFlochMD
5
121
557
The Aberdeen knot 🪢 was called that way when Sir James Learmonth at
@aberdeenuni
@AbdnLifeScience
use it because he noted that it used less thread than the surgeon’s knot and now is the ideal knot for end a closure of a laparotomy!
#SoMe4Surgery
@rbarbosa91
@SWexner
@pferrada1
13
158
546
Step 👟 by step 🥾 : The Kocher maneuver 🪢🔪🧨💥💡!
#SoMe4Surgery
@pferrada1
@SWexner
@juliomayol
@MISIRG1
@rbarbosa91
@DissanaikeMD
@Cirbosque
1
125
537
The correct angle 📐 of the needle 🪡 in the needle holder 🗜️can make all the difference ⤵️🗣️💡🔪🔑!
#SoMe4Surgery
@pferrada1
@SWexner
@juliomayol
@Cirbosque
@JCoselli_MD
@rbarbosa91
@LiangRhea
6
122
537
Abbreviated laparotomy or damage control laparotomy maneuvers ⤵️🔑! How to do it 🩸☝🏽!
#SoMe4Surgery
2
115
529
The Connell Mayo suture: how to do it ⤵️👨🏼⚕️💥🔪 Surgical mnemonics: The drunk man 🍺 🕵️♀️!
#SoMe4Surgery
@pferrada1
@juliomayol
@SWexner
@Cirbosque
@rbarbosa91
@drdevirgilio
@TomVargheseJr
@NeilFlochMD
🧵⤵️⬇️
8
116
530
Although we love the ratchet sound of the needle holder, we must just use a clip of it ⤵️🔑🔪🪡💡🫡!
#SoMe4Surgery
#aortaed
9
85
524
A surgeon can never get tired of doing two things: learning and teaching!
#SoMe4Surgery
#AortaEd
8
79
527
3 ways of how to use the tissue scissors ✂️ (Metzenbaum): vertical for deep tubular surgical fields, dissection and palming 🥋! (For the example we used a Mayo scissor because in that moment we didn’t have Metzenbaum scissors) Only in the
@BBASS_skills
by
@David_ukan
!
@pferrada1
6
101
526
Surgical tip: If you are performing a surgical suture and you need to put a stitch back, you can change the direction of the needle immediately just by using the surrounding tissue and the needle holder🔪⤵️🪡! How I do it 🪢🔑🥊!
#SoMe4Surgery
@pferrada1
@rbarbosa91
@debby_keller
7
109
516
How to approach the inferior vena cava IVC (the big blue): Kocher plus Cattell-Braasch maneuvers! From the texto book to the surgical practice 💥⤵️⚡️🪡!
#SoMe4Surgery
@pferrada1
@Cirbosque
@AmJSurgery
8
112
517
How to go down surgical knots 🪢: always use your index finger and don’t forget to perform the post with your non-dominant hand 🤚 and cross your hands 🙌!
#aortaed
#SoMe4Surgery
@pferrada1
@BBASS_skills
@David_ukan
@rbarbosa91
5
81
511
Remember: silk suture 🪡 (biologic, non absorbable, braided without memory) only requires 3 knots 🪢 due to its highly friction coefficient!
#SoMe4Surgery
@pferrada1
@Cirbosque
5
85
509
Saturday morning surgical tip: Loading the needle at 45° angle, reduces wrist strain and allows more needle angles compared to simply loading it at a 90° angle 🔪💥👇👁!
#SoMe4Surgery
@pferrada1
@drdevirgilio
@SWexner
@juliomayol
@rbarbosa91
@Cirbosque
@futuroscirascol
23
88
507
The difference between the Vertical 🆚 the Horizontal mattress suture 🪡⚡️💥!
#SoMe4Surgery
@pferrada1
@juliomayol
@SWexner
7
114
513
Applying
@BBASS_skills
@rbarbosa91
surgical skills concepts during open AAA repair: back stitch, Cambridge twist and the push and pull needle technique handle 💡! How to do it 💥!
#AortaEd
#SoMe4Surgery
@pferrada1
@David_ukan
@XavierBerardMD
@VasculonR
@docpark
@AWBeckMD
22
104
498
Purse-string 👜 💼 suture: how to do it ⤵️💡🗣️⏰!
#SoMe4Surgery
@SWexner
@pferrada1
@juliomayol
@rbarbosa91
@JJcolemanMD
@docmartin22
@DissanaikeMD
@Cirbosque
@AmJSurgery
8
92
488
How to fix a drain ⤵️🔑🔋🪫💥📖⚡️: step by step! What technique do you use?
#SoMe4Surgery
@pferrada1
@rbarbosa91
@TomVargheseJr
@juliomayol
@SWexner
@Cirbosque
8
98
480
Finger grip technique to handle needle holder and clamps: always use 1st finger but if you use 2nd finger you lost precision and direction, if you use 3rd finger gain just a little bit of precision so you must use 1st and 4th finger to have the best precision and direction!
9
86
442
Basic tip: Surgical 🪢 using the needle holder! Remember, two initial turns and then only one turn to one side and then to the other side of the needle holder making it in an alternately way!
#SoMe4Surgery
2
111
445
Surgical scissors: The Metzenbaum tissue scissors, for delicate cuts and blunt dissection developed by Dr Myrion Metzenbaum, ear, nose and throat specialist at
@MountSinaiNYC
. He was a national authority in reconstructive surgery!
#aortaed
@pferrada1
@drdevirgilio
@jmills1955
5
95
442
The Buried 🧟♂️ ⚰️ knot 🪢: how I do it ⤵️💡🖐️🤚🔥✅📌!
#SoMe4Surgery
@pferrada1
@SWexner
@juliomayol
@Cirbosque
@rbarbosa91
@NeilFlochMD
@sminaev2015
@MISIRG1
@LiangRhea
@almagoch
11
62
438
Finger grip 🆚 Palm grip ✋ to handle the needle holder ⤵️💥! What’s your favorite technique?
#SoMe4Surgery
@pferrada1
@BBASS_skills
@David_ukan
@rbarbosa91
@Cirbosque
@AmJSurgery
16
89
431
Surgical ergonomics advice: the right and the wrong position to operate using loupes 👨🏫🔪💥👇👁! This is vital to avoid cervical spine injuries!
#SoMe4Surgery
@MISIRG1
@jmills1955
@pferrada1
@drdevirgilio
@farkomd
@SWexner
@juliomayol
@TomVargheseJr
@SocSurgErgo
@AmJSurgery
3
116
426
Thursday surgical challenge: what’s the name of this technique to approach adhesive small bowel obstruction 🔪💥⤵️👇💩?
#SoMe4Surgery
@herbchen
@pferrada1
@TomVargheseJr
@almagoch
@SWexner
@juliomayol
@MISIRG1
@TopKniFe_B
@DeliaCortesGuir
@LiangRhea
@sminaev2015
@Cirbosque
45
102
422
The Gambee suture pattern: how to do it 💥⤵️✂️⚡️! Gastrointestinal anastomosis! With the amazing collaboration of Drs
@CiroPedraza
and
@lauraqr
!
#SoMe4Surgery
@pferrada1
@SWexner
@TomVargheseJr
@NeilFlochMD
@LiangRhea
@Cirbosque
@JSurgEduc
@AmJSurgery
0
98
421
Surgical trick: if you have your both hands 🙌 occupied, you can change the position of your needle using the needle holder and the back of you non dominant hand to perform a reverse stitch ⤵️🔑💥🪢!
#SoMe4Surgery
#aortaed
@pferrada1
@BBASS_skills
@David_ukan
@Cirbosque
11
69
421
Sliding knot plus square knot 🪢: how to do it ⤵️💥⚡️💡🤖!
#SoMe4Surgery
@rbarbosa91
@pferrada1
@BBASS_skills
@David_ukan
@Cirbosque
@AmJSurgery
5
109
415
Laparoscopic common bile duct exploration: Nelaton and Fogarty catheters 🔑🔪⤵️! How to do it 💉🪡! Graphical explanation!
#SoMe4Surgery
@pferrada1
@SWexner
@juliomayol
@TomVargheseJr
@JJcolemanMD
@Cirbosque
@AmJSurgery
7
96
412
Extracorporeal endo loop for low cost laparoscopic appendectomy: how to do it 💥🔪⤵️🪢! Learned from professor
@anhanssen
👁🔑🧑🏫!
#SoMe4Surgery
@pferrada1
@SWexner
@Cirbosque
@MISIRG1
@juliomayol
@DrThawaba
@sminaev2015
@NeilFlochMD
@Grincircar
3
105
408
Happy new year and the best wishes for this 2024 to all the futures surgeons and surgeons in the world! Remember you are the exponents of the art and science of surgery!
#SoMe4Surgery
9
91
404
The importance to have the wrist and elbow at the same level for the angle of the needle ⤵️🔑🗣️🧤🔪! By Professor
@David_ukan
!
#SoMe4Surgery
2
103
402
How to tighten knots in surgery following the principles of tissue resistance, surgeons strength or power and the suture friction 💥⤵️🪡⚡️🦾! To avoid tissue tears or suture rupture!
#SoMe4Surgery
@pferrada1
@rbarbosa91
@BBASS_skills
@David_ukan
2
87
411
Daily surgical tip: Loading the needle at 45° angle, reduces wrist strain and allows more needle angles compared to simply loading it at a 90° angle 🔪💥👇👁⤵️🩸!
#SoMe4Surgery
@pferrada1
@drdevirgilio
@LiangRhea
@SWexner
@juliomayol
@salo75
5
77
399
Surgical Consideration! The Hypoglossal Nerve 🧠 is the 12th Cranial Nerve! It is mainly an efferent nerve for the tongue musculature! The hypoglossal nerve is at high risk of injury during carotid endarterectomy and carotid body tumor resection 🫀🩸!
#SoMe4Surgery
@pferrada1
3
78
396
The Blair Donati’s suture (vertical mattress suture) has a far-far-near-near configuration where the far-through stitches seize the subcutaneous tissue and the near-through stitches seize only the dermis: how I do it 🪡🪢🔊💡!
#SoMe4Surgery
@pferrada1
@rbarbosa91
@drdevirgilio
5
96
393
Basic surgical tip: never tie too hard an active soft drain as a Jackson Pratt because you will have a total occlusion of the drain and a malfunction of it 🪢! Post cholecystectomy, Parkland V, bile leak due to necrotic cystic duct (Strasberg A bile duct injury)!
#SoMe4Surgery
3
60
384
The Cambridge twist technique using the needle holder with palm grip to avoid torsion and rupture of monofilament synthetic suture 🔑⤵️🪢💥☝🏽!
#SoMe4Surgery
@BBASS_skills
@pferrada1
3
78
381
Horizontal mattress suture: how to do it ⤵️💥💡⚡️🩸!
#SoMe4Surgery
@pferrada1
@BBASS_skills
@David_ukan
@Cirbosque
@AmJSurgery
2
68
388
How I do it: vascular ligation ⤵️💡Step by step🚨🗣️🔪! From the text book to the surgical real life 🩸🪡🎯!
#SoMe4Surgery
#aortaed
@drdevirgilio
@rbarbosa91
@pferrada1
@SWexner
@juliomayol
@Cirbosque
@LiangRhea
@NeilFlochMD
@mj_pucci
@DissanaikeMD
2
113
384
Low cost surgical simulation 💥✂️⤵️! Using silk sutures and curved threadable needles 🪡 ! The final test🤞🏼👊! Leak or no leak 🧐😬! Only in the new simulation center of
@Cirujaverianos
@DptoCirugiaPUJ
@UniJaveriana
@MedicinaPUJ
!
#SoMe4Surgery
@lilitorregrosaa
@Sebasti19059022
4
70
386
The Anchor ⚓️ stitch technique: teach to me by professor
@Ciruvillarreal
! An excellent technique to perform the stitch to fix the mesh to the cooper ligament during an open Nyhus pre peritoneal posterior groin hernia no tension repair ⤵️☝🏽🗣️!
#SoMe4Surgery
4
91
377
Graphical and in situ explanation of the difference between the Cushing 🆚 Lembert suture patterns ⤵️Only in
@BBASS_skills
by Prof
@David_ukan
✂️! With the amazing collaboration of Drs
@CiroPedraza
@lauraqr
!
#SoMe4Surgery
@pferrada1
@SWexner
@TomVargheseJr
@LiangRhea
@JSurgEduc
2
90
374
How to secure a chest tube: step by step ⤵️🪢💥🔪🥊! How do you do it?
#SoMe4Surgery
@TomVargheseJr
@SWexner
@docmartin22
@pferrada1
@juliomayol
@DrThawaba
@MISIRG1
@Cirbosque
@almagoch
@TopKniFe_B
9
88
370
Monday basic surgical tip: be careful when you perform knots with the instruments in your hands and the needle holder with the needle in it ⤵️🪡💥! Because you can turn the needle easily in to a stab and have you or generate in your surgical staff an accidental needle puncture!
3
74
373
Locations of the vermiform appendix ⤵️🔑: Subhepatic appendicitis is a very uncommon entity (0.08 %)! The 1st case of subhepatic appendicitis was reported in 1955 by King! The 1st description of the subhepatic appendix was done by Dr Turner in 1863 at autopsy!
#SoMe4Surgery
11
116
375
Monday Surgical tip: as in open surgery you can use the Maryland dissector to gently push and modify your needle 🪡 position and adapt it to perform suture in difficult angles during minimally invasive surgery 💥⤵️✂️⚡️!
#SoMe4Surgery
@pferrada1
8
59
359
Mesh locations in the abdominal wall ⤵️‼️💡🚨🧰🔪!
#SoMe4Surgery
@pferrada1
@SWexner
@juliomayol
@misirg1
@Cirbosque
@futuroscirascol
@ericpaulimd
@RicardoRGlz
@herniasrosario
8
44
350
0
73
349
Surgical scissors: The Mayo scissors, for heavy duty work, to cut sutures and synthetic materials, developed by Drs William and Charles Mayo, surgeons, founders of
@MayoClinic
and
@JAMASurgery
!
#SoMe4Surgery
@pferrada1
@BBASS_skills
@David_ukan
2
77
347
How to do it 💥 : The semi palm grip technique to handle the needle holder of Professor
@rbarbosa91
with the advantages of palming but more easier to open the ratchet ! ⤵️🪡⚡️!
#SoMe4Surgery
@pferrada1
@Cirbosque
@AmJSurgery
1
76
349