Intervertebral disk – a structure that separates the vertebrae. It serves to absorb the movements of the vertebrae. Intervertebral disc consists of the so-called pulpal core special jelly mass and envelops the fibrous ring, which consists of fibers. Fibrous ring partially fixed to the adjacent vertebral bodies, and partially – to the adjacent intervertebral ligaments. Some parts of the ring are “free” and there may be some stretching of it. Excess load on the fibrous ring leads to the fact that the nucleus breaks pulpal core break fibrous ring at a greater or lesser extent. This leads to the formation of disk herniation .
Maybe you've had this scenario described to you by a customer: About an hour after dinner she begins to notice an uncomfortable sensation in her abdomen. She says the pain is cramplike, builds in intensity and shoots back toward her right shoulder blade. Nausea follows. She takes an antacid but wonders whether she has symptoms of appendicitis, food poisoning or an ulcer. A visit to her doctor reveals that she is actually suffering from complications of cholelithiasis, also known as gallstones.
So how does NOTES differ from NOS? The "T" in NOTES stands for "trans" or "across". So this approach involves making an internal incision across (through) the wall of the structure that is approached through the natural orifice. It is an attempt to avoid making any external incisions at all, either in the abdomen or the chest, and is being advocated primarily for cosmetic purposes . An example of a NOTES procedure would be removing the gallbladder through a naturally occurring orifice. The surgeon could gain access to the gallbladder through the mouth (but that would require cutting across the wall of the stomach), through the anus (but that would require cutting across the wall of the colon), or in a woman, through the vagina. However, to make an incision through the wall of the colon (or stomach, or vagina) simply to avoid the small external puncture-like incisions in the abdominal wall associated with laparoscopic surgery puts the patient at risk for complications that would otherwise be avoidable . The "additional" internal incisions made in the bowel, stomach or vagina not only have to be closed securely but those incisions must heal without incident or complication if one is to advocate for this approach .