rectal instruments

ELECTROCOAGULATION OF POLYPS THROUGH PROCTOSCOPE


By • Дек 26th, 2010 • Category: Rectum

If the polyp lies 11 to 25 cm from the anus, we usually perform electrocoagulation of the polyp through a proctoscope.

An adapter, either fenestrated or cup-shaped (in some cases having the shape of sharp grasping forceps (Fig. 123) is screwed onto the steel holder of bronchoesophagoscopy forceps. The indifferent diathermy electrode, a 200 sq. cm lead plate, is wrapped in moist gauze and bandaged to the patient either in the sacral region or the exterior sur­face of the thigh. A proctoscope tube 20 cm long (in rare instances 25 cm long) is then introduced into the rectum, with the assistant fixing the proctoscope in the selected position with a gloved hand. A forceps is next inserted into the tube. The forceps should be open and thrust as far as the polyp (Fig. 124,1). The surgeon then pulls out the steel wire by taking hold of the ring attached to it and grasps the tumour with the forceps tip moving the forceps 1—2 cm forward, since by pulling out the wire, he thereby moves the forceps tip away from the polyp At this point the assistant approaches the tip of the dia­thermy apparatus to the handle of the bronchoesophagos­copy forceps (Fig. 124,1). Cauterization lasts for 1 to 2 seconds. If the polyp is held fast in the rectum, cauteri­zation should be repeated one or two times more. If the polyp is large and has a long pedicle, it first should be moved back with a cottonwool swab (Fig. 124,2) so as to draw taut the polyp pedicle.

Polyp electrocoagulation through a proctoscope

Fig. 123. Adapters or tips commonly used for polyp caute­rization: fenestrated, cuped or having the form of sharp grasping forceps.

Fig. 124. Polyp electrocoagulation through a proctoscope:

1. The polyp is between the blades of an open tip.

2. Separation of the long pedicle of a large polyp by means of a cotton-wool swab.



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