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General Surgery
Large Intestine and Anorectum New Methods of Investigation
Built from Skandalakis' Surgical Anatomy: The Embryologic and Anatomic Basis of Modern Surgery
What’s inside
6 sections · 70 slides
Overview
- Scope of this topic
- Rationale for new investigative methods
- Anal canal and pelvic floor: the structures being tested
Fecoflowmetry
- Limitations of conventional anorectal investigation
- Defecometry and the balloon expulsion test
- The fecoflowmeter: principle and apparatus
- Technique of fecoflowmetry: enema administration
- Technique of fecoflowmetry: evacuation phase
- Parameters obtained from a single fecoflowmetric study
- Physiologic basis of the normal flow curve
- Normal defecation flow curve
- Fecoflowmetric findings in chronic constipation
- Flow curve morphology in chronic constipation
- Defecation flow curve in chronic constipation
- Sequence of a fecoflowmetric study
Reflex studies and the water enema test
- Reflexes used in anorectal assessment
- Value of reflex evaluation in anorectal disorders
- Technique of reflex testing
- Interpretation of the evoked response
- Water enema test: technique
- Water enema test: interpretation and role
- Levator ani and the pelvic floor under test
Inguinal pelviscopy
- Inguinal pelviscopy: principle
- Technique of inguinal pelviscopy
- Route into the pelvic cavity through the inguinal canal
- Deep inguinal ring: the gateway used
- Advantages of the inguinal approach
- Intraperitoneal extension of the technique
- Therapeutic applications and follow-up
Rectometry and electrorectography
- Rectometry: principle and technique
- Data yielded by a rectometrogram
- Rectometrogram of normal evacuation
- Diagnostic value of the rectometrogram curve
- Two types of chronic constipation
- Electrorectography: technique
- Normal electrorectographic values
- Electrorectogram in inertia and obstructive constipation
- Electrorectogram in proctitis and Hirschsprung's disease
- Percutaneous recording of visceral electrical activity
Anatomic complications of anorectal surgery
- Manual anal dilatation for chronic anal fissure and haemorrhoids
- Anorectal bandotomy versus eight-finger dilatation
- Complications of internal anal sphincterotomy
- Complications of haemorrhoidectomy
- Recurrence after fistula-in-ano surgery
- Continence after fistula surgery
- Fistulotomy versus fistulectomy
- Pathogenesis of rectal procidentia
- Pudendal neuropathy in advanced prolapse
- Complications of operations for rectal prolapse
- Repair of the levator ani in prolapse surgery
- Continence after surgery for rectal cancer
- Sagittal relations of the rectum and anal canal in the male pelvis
- Injuries during abdominal dissection of the rectum
- Abdominoperineal resection: three classes of complication
- Vascular injury in abdominoperineal resection
- Organ injury and other complications of abdominoperineal resection
- Nerve injury and the fascia of Waldeyer
- Abdominal phase: technical points
- Perineal phase: structures encountered
- Closure and drainage of the perineum
- Key points: the investigations
- Key points: the complications
- Reference cited in the text
- Skandalakis' Surgical Anatomy: The Embryologic and Anatomic Basis of Modern Surgery
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