Anoscope:
A simple diagnostic procedure to investigate the anal canal using an anoscope in order to assess:
anal pain,
anal bleeding
anal swelling
itching
and unpleasant discharge.
It can also be performed post-surgery to assess the effectiveness of surgery
Requires an enema before the examination
Duration: 5 minutes
- Patient is awake
- Lying in a lateral position.
The lighted endoscope is gently inserted and the anal canal is examined under direct vision.
Manometry:
- A simple diagnostic procedure for assessment of anal sphincter muscles and the nervous reactions required for normal defecation in patients suffering from:
Constipation
Difficulty emptying the rectum
fecal incontinence
chronic pain.
It can also be performed post-surgery to assess the effectiveness of surgery
Requires an enema before the examination
Duration: 20 minutes
- The patient is awake
- In a lateral lying position.
- A small flexible tube with a balloon at the end is inserted into rectum.
- tube is connected to an apparatus that measures pressure.
- small balloon which connected to catheter is insufflated into rectum to evaluate defecation prosses.
- Doctor asks patient to squeeze his sphincter, relax and strain at different times to assess the functioning of sphincter and rectum
Hemorrhoids:
Excision of anal hemorrhoids by open technique:
dissection of the hemorrhoidal piles
ligate pile neck
excision hemorrhoidal pile
Excision of hemorrhoids by ligation of the artery assisted by Echo Doppler (THD):
This technique is based on ligation of perianal arteries which feeding the hemorrhoids
Mucopexy for prolapsed mucosa.
The position of perianal arteries can be easily reached with the assistance of Echo Doppler.
LASER ablation for hemorrhoidectomy:
dilated hemorrhoidal piles are exposed to a laser ablation, which allows them to shrink and reduce their size to a minimum.
Stapler hemorrhoidectomy:
This technique is used when there are several hemorrhoidal piles protrude outside the anus, or when there is a rectal prolapse,
Circumferential ring of the entire mucosa is excised using stapling, which allows repair of prolapse
Anal fissure surgery:
Excision of the anal fissure
Lateral sphincterotomy:
to decrease sphincter pressure on the mucosal tear (anal fissure) allowing it to heal.
a small incision is made on the side of anus down arriving to the muscle fibers of anal sphincter where about 30% of fibers are cut to relieve tension and pain and enhance chances of recovery
Botox injections:
helps to relax the anal sphincter, allowing mucosal tear to heal quickly
Anal fistula surgery:
fistulectomy:
all fistula tract is totally removed
fistulotomy:
lay open fistula tract and left to heal
Closing the fistula by LASER ablation:
fistula tract is probed
internal orifice of the fistula is closed
fistula tract is closed through the LASER ablation
Closure of the fistula with the assistance of video VAAFT:
Fistula tract is probed with a rigid scope,
internal orifice of the fistula is closed
fistula tract is closed through the LASER ablation under a complete tract detection with scope
SETON placement and mucosal closure:
In complex cases
seton (or sutures) is placed through fistula tract and tied
seton remains for several weeks to avoid any collection or abscesses
the fistula is closed later with a rectal mucosa flap.
Stapler for rectal prolapse:
Circumferential ring of the entire mucosa is excised using stapling, which allows repair of prolapse
