rectal instruments

Archives for the ‘Rectum’ Category

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 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 […]



SPHINCTERIC FUNCTION PRIOR TO AND AFTER OPERATIVE TREATMENT IN PATIENTS WITH FISTULA

By • Дек 26th, 2010 • Category: Rectum

The function of the anal sphincter was studied using a tonometric sphincterometer and a dynamometric device fitted with a strain gauge (Fig. 89). The data obtained have enabled us to ascertain the strength of the sphinc­ter prior to and after operation, as well as to obtain average values for sphincteric strength in normal indi­viduals. In […]



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 […]



Operation for narrowing of the sphincter with silver wire

By • Дек 26th, 2010 • Category: Rectum

For this operation a curved handled needle with an eye at its point is used. Under general anesthesia and with the patient in the prone Depage’s position (see Figures 25.1 and 25.2) the surgeon introduces the fore finger with its palmar surface facing the coccyx, into the rectum previously washed out. Just lateral to the […]



OPERATION FOR PROLAPSE OF THE RECTUM IN ADULTS

By • Дек 26th, 2010 • Category: Rectum

The operation to narrow and strengthen the sphinc­ter by means of a silver wire is used in elderly or obese patients. Two small incisions are made anteroposteriorly to the anus (Pig. 112), and a silver wire 2 mm in diameter is drawn around the anal sphincter, (Fig. 114.1, 114.2 and 114.3) being tightened on the […]




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