Shmaisani Clinic for Colon & Rectum Surgery

07/01/2016

THIS IS US ..... SURGEONS

18/03/2013

New: doppler-guided hemorrhoidal artery ligation is a technique under study.
Stapled hemorrhoidectomy (like laser therapy twenty years ago) has NOT proven to be superior to common techniques.

Lifestyle and dietary modifications obviate the need for further treatment in half of patients. Treat constipation and teach patients not to read on the toilet! Many available topical treatments improve symptoms.

Office techniques for treating hemorrhoids include rubber band ligation, energy devices, sclerotherapy. The key of all these techniques is fixation of internal hemorrhoidal tissue to the apex of the a**l ca**l, aided by the scarring which follows the procedures. With all techniques, watch for sepsis which is heralded by pain, urinary retention, and fever.

Rubber band ligation is a favored technique (ligate at least 2 cm above dentate line).

Reserve surgical excision for patients refractory to (or unable to tolerate) office techniques and for those with substantial external component to hemorrhoids.

Circumferential stapled hemorrhoidectomy, despite reported successes, has substantial shortcomings. The technique is associated with extropion (wet a**s) and a higher incidence of life-threatening sepsis requiring colostomy. Not recommended.

Conventional excisional hemorrhoidectomy remains the gold standard for treatment

01/03/2013

http://www.youtube.com/watch?feature=player_embedded&v=GeuoV3Y-HnE

A good meditoon first establishes the normal anatomy and function, and then shows the development of the disease process. Meditoons are left without audio on...

01/03/2013

http://www.youtube.com/watch?v=tCec_4lmQgc

A good meditoon first establishes the normal anatomy and function, and then shows the development of the disease process. Meditoons are left without audio on...

01/03/2013

http://www.youtube.com/watch?v=aA0wqcoeI_g

A good meditoon first establishes the normal anatomy and function, and then shows the development of the disease process. Meditoons are left without audio on...