rectal instruments

The operation for acute anorectal abscess with sphincterotomy through the internal abscess opening (Rygick’s method)


By • Дек 26th, 2010 • Category: Anus

This method is used in ischiorcctal and pclvirectal abs­cesses. A scmilunal incision is made to lay the abscess cavity wide open. The surgeon then introduces his index finger into the abscess cavity, while inserting his other index finger into the rectum (Fig. 62.1), This enables him to readily ascertain which rectal wall the abscess cavity adjoins, that is, to find out whether its internal opening is situated in a posterior or anterior crypt. Next, a rectal speculum is passed into the rectal lumen and a posterior (or anterior) sphincterotomy performed through the in­ternal opening of the abscess (Fig. 62,2). The rectal wound is packed with gauze soaked in Vishnevsky ointment or in ointment with Peruvian balsam, with insertion of a rubber tube into the rectal lumen (Fig. 62,3). The abscess cavity is carefully packed with heavily soaked ointment packs. Dressings are applied as in the case of subcutaneous abscess. Opium tincture is given for 8—9 days. In fermales no sphincterotomy is performed if the abscess adjoins an anterior crypt.

As a result of our operation, a strong linear scar is formed in the rectum at the site of sphincterotomy (Fig. 62,4), which precludes the formation of a fistula or abscess recurrence.

The steps in the operation for inschiorectal abscess

Fig. 62 The steps in the operation for inschiorectal abs­cess:

1. One index finger is introduced into the abscess cavity and the other, into the rectum.

2. Posterior rectal wall is incised 1 cm deep.

3. An ointment pack and tubing for gas evacuation have been inserted into the rectal lumen. (Schematic).

4. Linear scar of the rectal wall after sphincteroto­my. (Schematic)



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