Colon and Rectal Surgery Anorectal Operations by Steven D. Wexner

By Steven D. Wexner

Grasp innovations as a rule surgical procedure: Colon and Rectal surgical procedure: Anorectal Operations is a quantity in a chain that provides universal and complex techniques within the significant subspecialities of basic surgical procedure. The sequence is overseen by way of Josef F. Fischer, MD, editor of the vintage two-volume reference Mastery of Surgery.

Master strategies normally surgical procedure: Colon and Rectal surgical procedure: Anorectal Operations is written by way of stated grasp surgeons, emphasizes surgeries, and is lavishly illustrated with unique full-color drawings. The members totally clarify their most popular ideas in step by step, completely illustrated aspect, verify symptoms and contraindications, supply guidance on preoperative making plans, and talk about results, problems, and follow-up.

Coverage contains hemorrhoidectomies, anal fistula and sphincter approaches, strategies for perineal prolapse and excision of rectal carcinoma, between others.

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1 The patient is placed in prone-jackknife position for Har· monic Scalpel8 hemorrhoidec· tomy. A Mayo table positioned at the foot of the bed serves as a convenient and accessible instru· merrt stand. Technique Using a Pratt speculum, the three hemorrhoidal complexes are examined to ensure they conform to the standard right anterior, right posterior, and left lateral configuration (Fig. 3). The external component is grasped with a hemostat and placed on gentle traction in order to "tent-up" the apex of the external hemorrhoid (Fig.

Ozer MT, Yigit T, Uzar AI, et al. A comparison of different hemorrhoidectomy procedures. Saudi Med J 2008;29(9):1264-9. Chung CC, Ha JP, Tai YP, Tsang WW, Li MK. Double-blind, randomized trial comparing harmonic scalpel hemorrhoidectomy, bipolar scissors hemorrhoidectomy, and scissors excision: ligation technique. Dis Colon Rectum 2002;45(6):789-94. Nicholson TJ, Armstrong D. Topical metronidazole (10 percent) decreases posthemorrhoidectomy pain and improves healing. Dis Colon Rectum 2004;47(5):711-16.

11). If urinary retention develops, the patient may be straightcathed, and try to void again. Alternatively, an indwelling bladder catheter may be inserted and left in place for 24 hours. There is also data to suggest that limiting intraoperative fiuid intake reduces the incidence of urinary retention. The majority of Harmonic Scalpel11 hemorrhoidectomy patients are discharged the same day. Elderly patients, patients who develop urinary retention, or those individuals with multiple comorbidities are admitted overnight for observation.

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