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in
Colorectal
Surgery
Colon Cancer
Sessile polyp
Abnormal Colonoscopy
DIAGNOSTIC TESTS
Barium enema
Endorectal and Endoanal Ultrasonography
Recurrent fistula-in-ano with posteriorly
located tract and internal openning
Recurrent Fistula in Ano with posteriorly located track
visualized after instillation of hydrogen peroxide
Hemorrhoids
Recommended Treatment
for Hemorrhoidal Disease
Grade I - Conservative treatment
Grade II - Conservative or
Rubber band ligation
Grade III - Rubber band ligation or
Hemorrhoidectomy
Grade IV - Hemorrhoidectomy
(excision or stapled)
• Mostly outpatient except for
complicated cases
RUBBER BAND LIGATION
Banded Internal Hemorrhoid
Infrared
Photocoagulation
STAPLED
HEMORRHOIDECTOMY
STAPLED
HEMORRHOIDECTOMY
HARMONIC SCALPEL
hemorrhoidectomy
Harmonic scalpel – Ultrasonic activated instrument
(Ultracision)
-Vibrates at 55,000/sec
-Minimal lateral thermal injury
< 1:5 mm
Ligasure Hemorrhoidectomy
•Vessel Sealing System Sutureless Closed
Hemorrhoidectomy