rectal instruments

OPERATIONS FOR PROLAPSE OF THE RECTUM IN CHILDREN


By • Дек 26th, 2010 • Category: Rectum

We make use of the following two techniques: the Thiersch operation, i. e. narrowing and reinforcing the anus with silk ligature; and the fixation of the posterior rectal wall with silk ligature through the skin (Eke-gorn’s method). Neither of these operation is applicable for treating adults.

Thiersch operation. Under local or general (in chil­dren under 7 years of age) anesthesia two short ver­tical incisions each 0.5 cm long, are made 1.5 cm from the anus along the posterior (coccygeal) and anterior (scrotal) raphes through the skin and fat (Fig. 112,1).A large curved needle with a stout silk thread is then passed from the anterior incision to circumscribe the anus on the left. The needle is brought out through the inferior incision with a length of thread to be rein­serted into the inferior incision to circumscribe the anus on the right (Fig. 112,2) and emerge through the ante­rior incision. The surgeon then introduces the index fin­ger into the rectum, while the assistant draws the liga­ture taut and ties it up in the anterior wound with a triple knot (Fig. 112,3), The pressure of the ligature on the surgeon’s finger should be light. After the ligature has been cut off, both skin incisions are closed with cat­gut

Operation for narrowing the anal canal by means of silk ligature

Fig. 112 Operation for narrowing the anal canal by means of silk ligature:

1. Linear incisions of skin and subcutaneous fat an­teriorly and posteriorly to the anal canal.

2. Passing a curved needle with ligature around the anus.

3. The ligature surrounding the anus, is tied over the surgeon’s finger introduced into the rectum.



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