Operation Skills - Zhengzhou Safute Electronic Equipment Co., Ltd.

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Operation Skills

Operation Skills of LG2000 series of Anorectal Treating Device

1.Internal Hemorrhoids Ligation

Suitable for II, III, IV hemorrhoids. Forbidon for the anal canal and perianal infection, acute hemorrhage disease, serious heart, kidney disease disable.

1.Conventional disinfection.

2.Anethesis.

3. Expand anus.
4.Schnabel tissues(release pincer after the device is alarming).
5.Pay more attention to retain the hemorrhoid mucosal bridge, as far as possible do not Schnabel at the same level, to avoid stenosis of rectum caused by postoperative scar contracture.
6.To indivisual huge hemorrhoids,can Schnabel 8 size then transfixion.stenosis of rectum caused by postoperative scar contracture.
7.Put Hemorrhoids Suppository into anus after operation.

8.Feed routine antibiotics 3-5 days after surgery.

9.PP water anus bath after operation.

10.After the operation, no spicy food and alcohol, keep the stool clear.

2.Mixed hemorrhoids surgery

Schnabel internal hemorrhoids first,then cut the external hemorrhoids or peel off external hemorrhoids.Or cut the skin with HF pencil, peel off external hemorrhoids, then Schnabel internal and external hemorrhoids.

A: To the single or clear edged mixed hemprrhoids.If the main structure is internal hemorrhoids, can Schnabel internal and external parts together.If opposite,cut a V size wound at the bottom of external hemorrhoids with HF pencil, blunt dissection, then Schnabel both parts. To those big hemorrhoids tissues,Schnabel internal parts first then external part.

B: the treatment of circular mixed hemorrhoids should first distinguish between the original hair of hemorrhoids and secondary edema, the general primary treatment of hemorrhoids after secondary edema of the site will be on their own. On both inside and outside a lot of hemorrhoids, according to the situation with tooth line is bounded in different plane, upper and lower cross clamp, each hemorrhoid retain some skin bridge, as far as possible preservation of anal canal skin, to prevent anal stenosis. After treatment, generally do not change medicine, ask patients themselves with 1: 5000PPwarm water bath powder, bay sore anus plug 2 times / day.

3.Operation of External Hemprrhopids

A single or several well-defined clamping hemorrhoids ,Schnabel first with ESUpincer then remove with pencil. Broader, more skin flap, larger hemorrhoids cut at the botton of tissues with pencil, partial treatment, try to keep the skin bridge, longitudinal or transverse clamp based on conditions.

For the inflammation and itch, thrombotic external hemorrhoids, connective hemorrhoids, respectively take inflammatory external hemorrhoids resection, extrusion thrombotic external stasis thrombosis, thrombosis, stripping and connective tissue external hemorrhoids resection. Inflammatory external hemorrhoids can also advance herbal fumigation, reduceinflammation edema before operation.

4.Operation of Anal Fissure

Anal fissure generally includes the anal fissure and chapped, tuberculosis of breach, syphilis, Crohn's disease and ulcerative colitis induced gap. Here refers to the narrow sense of the longitudinal axis of the anus, anal mucosa. Often due to trauma, infection, disease and other factors caused by the twin sphincter anal fissure. The clinical symptoms are pain, hematochezia, defecation difficulties.

The principle of treatment of anal fissure:

a.Usually use conservative therapy for early anal fissure.

b.Thestale anal fissure, without serious complications, often choose lateral internal sphincterotomy.
c.The patients with cleft fistula and papillary hypertrophy can choose Resection of posterior internal sphincter.

Lateral internal sphincterotomy

a.routine disinfection,

b.Long term local anesthesia,
c.Knee chest position, 9clock direction 1.5 cm from the anal margin,skin incision, incision length about 0.8 cm long,
d.Split skin and under-skin tissues with small curved clamp,
e.Pick out the spasm internal sphincter through muscular sulcus,
f.Cut internal sphincter with a ESU pencil,
g.Oppression hemostasis, dressing,
h.do not suture the wound,

5.Operation of the anal abscess

Anal abscess is perianorectal acute infection of soft tissue results, caused byanal cryptitis and anal gland infection. Generally can be divided into anal cryptitis, anorectal peripheral inflammation and anal fistula three stages, often under the skin, mucous membrane, ischiorectal, pelvirectal fossa, anal, rectal abscess.

Treating priciples:
a.Abscess once formedtimely cut to open and discharge drainage,
b.Incision to large, drainage to open,
c.To be careful not to hurt the anus and rectum.
d.I stage radical resection can be used for low level abscess.

6.Operation of Anal fistula

Anal fistulais usually caused by cylinder perirectal abscess, failed to complete or correct treatment and left in the mouth, with pus cavity narrow fistula formation, also called the cylinder door rectal fistula, referred to as anal fistula. Anal fistula is one of the most difficult problems in the treatment of anorectal disease at present, mainly in the recurrence rate is high, easily lead to incontinence, has a certain canceration rate.

Treating Principles:

a.Correct treatment of infection is the key to the success the operation.
b.Correct treatment of wounds, drainage unobstructed, prevent false healing is the key to the postoperative dressing change. Find internal wound the commonly used method has touch method, probe method, injection and infusion Meilan and hydrogen peroxide etc.. A variety of methods to treat anal fistula: incision, tube, hanging line, main fistula incision, drainage and other branch fistula mouth. However, the high complex fistula is still used to hang the line, so as to avoid anal incontinence.

Low level simple fistula:

a.Routine disinfection:

b.Local anesthesia:

c.Insert the probe from outside the mouth

d.The finger guide, looking inside the mouth, then leads to probe:

e.The probe head out from inside the mouth, the replacement of grooved probe;

f. from outside the mouth incision to skin with a knife:

h.The electric knife incision and subcutaneous tissue, and communicated with the probe, probe away:

i.dge trim outside the mouth and wound of anal fistula:

j.We must clean up by curette, thoroughly clean, to prevent false healing:

k.The use of Vaseline gauze for hemostasis, fistula, and wound dressing.

Nursing after Operation

1.After treatment in 3-5 hours maybe feel falling, defecation pain and mild discomfort.

2.The 2 day after treatment with urine micro blue, is brought up by long-term anesthetic methylene blue in color, do not be nervous.

3. some patients (due to the relaxation of the muscles and the ring of hemorrhoids patients) in the treatment of local edema, which is a normal phenomenon, do not need to worry about. Local edema available 0.5% rivanol solution wet hot compress for 20 minutes, and then in the local application of fish stone fat ointment. One to two times a day. In addition, as far as possible to stay in bed, can also reduce the edema.

4 because the fullness of tissue necrosis, shedding in the process there will be a small amount of exudate, about a week away, not infected.

5. After the fall of hemorrhoids, because the wound is healed, the stool will be a small amount of bleeding, some showed a drop of blood, but as long as in the stool finished station immediately not bleeding are normal, generally about ten days disappear.

6.There will be mild low individual patient use of long-acting anesthetic, generally not more than 38 DEG C for 6-12 hours.

7 please note that after treatment, please keep the stool soft and smooth, but eat coarse fiber food, but can not eat chili and drinking.

8. Keep the anus clean, after bedtime with 1: 5000 potassium permanganate liquid immersion, and slipped into the anal Hemorrhoids Suppository a grain, generally with the ten days or so.

9. after operation, the patients can be treated by LG2000 type physical therapy instrument, and can also be used to wash the LG2000 model.

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