rectal instruments

Author Archive

OPERATIONS FOR FISTULAS-IN-ANO

By • Дек 26th, 2010 • Category: Rectum

By far the most common type of ana! fistula are com­plete fistulas, that is, those with one or several external openings on the skin and one internal opening at one of the crypts of Morgangi. Incomplete internal fistulas, that is, those with a single internal opening into the rectal lumen are met wth only in […]



OPERATION FOR SUBCUTANEOUS FISTULA (after Gabriel)

By • Дек 26th, 2010 • Category: Anus

This operation essentially consists in laying open the fistula into the rectal lumen with removal of a flap of surrounding skin and mucosa. Under local anesthesia or general nitrous oxide anesthesia, a 1 per cent methylene blue solution is injected into the fistula followed by the passing of a fine grooved director, he surgeon then […]



ATTENTION! A FREQUENT OPERATION LAYING OPEN THE FISTULA INTO RECTAL LUMEN WITH SUTURE OF THE WOUND BOTTOM First main operation. Rygick’s modification

By • Дек 26th, 2010 • Category: Anus

In those cases of the Gabriel operation for laying open the fistula when the surgeon has any doubt as to the subsequent function of the anal sphincter, we have sutured, beginning with 1953, the bottom and walls of the wound with catgut, leaving the skin margins unsu-tured. Figure 75.1 shows the surgeon inserting the needle […]



OPERATIONS FOR HIGH-LEVEL FISTULA

By • Дек 26th, 2010 • Category: Anus

Fistulectomy with dissection of the sphincter through the internal fistulous opening (Rygick’s method). Second main operation. Under local anesthesia (see Fig. 30,1 and 2) or gene­ral anesthesia with azeotropic mixture, a 1 per cent methylene blue solution is injected into the fistulous tract and a vertical incision of perineal skin is made so that its […]



AUTHOR’S VARIANT OF OPERATIONS FOR VERY LONG FISTULOUS TRACTS

By • Дек 26th, 2010 • Category: Anus

When an anal fistula is very long and its external opening lies on the buttock or near the trochanter we, rather than making large incisions, make use of our own procedure as shown in Fig. 80,1, 2 and 3. In this opera­tion, the fistulous tract is cut across 3—4 cm from the anus, and its […]



OPERATION FOR ANTERIOR FISTULAS IN FEMALES AND LATERAL FISTULAS IN MALES AND FEMALES

By • Дек 26th, 2010 • Category: Rectum

In female patients with an anterior high-level fistula it is not allowed to divide the sphincter through the an­terior vaginal wall because of the danger of incontinence of wind and faeces. Therefore we have developed a new ope­ration for these patients. Under local or mixed inhalation anesthesia, the fistulous tract on the perineum is excised […]



LIGATURE TECHNIQUE FOR TREATING HIGH-LEVEL FISTULAS

By • Дек 26th, 2010 • Category: Rectum

In cases with a neglected complicated anal fistula, with a dense scar tissue, it may occasionally be found impossible to perform our operation of choice (Fig. 77, p. 83). Instead, we employ the ligature technique, using local or combined inhalation anesthesia. The fistulous tract is dissected free and cut off deep within the wound (Fig. […]



OPERATIVE TREATMENT OF HORSESHOE (BILATERAL) FISTULAS

By • Дек 26th, 2010 • Category: Rectum

To cure this uncommon type of horseshoe fistula which lies on either side of the anus subcutaneously, we employ the bilateral fistulotomy according to Gabriel (Fig. 85,1). In cases of high-level horseshoe fistula we first ex­cise the fisula on one side of the anus followed by sutur­ing its remnant on the wound bottom (see p. […]



OPERATIVE TREATMENT OF RECTOVAGINAL FISTULAS

By • Дек 26th, 2010 • Category: Rectum

These fistulas occur either as a result of an anorectal abscess which ruptures into the vagina, or are due to an accidental trauma (Fig. 86,1). Under local or, more frequently, general anesthesia, the labia minora are fixed with suture out wardly and the rectovaginal septum is widely split transversely, ke­eping closely to the vagina. The […]



OPERATION FOR INCOMPLETE INTERNAL FISTULAS

By • Дек 26th, 2010 • Category: Rectum

This operation consists in dissecting the posterior rec­tal wall throught the internal fistulous opening to a depth of 1 cm (Fig. 88,1). The suppurative cavity com­municating with the rectal opening, is curetted with a sharp spoon Fig. 88,2) and painted with 2% iodine tinc­ture. The rectal wiund and the remaining pirtion of the cavity are […]