This document provides information on hemorrhoids, including definitions, anatomy, causes, symptoms, diagnosis, and treatment options. It defines hemorrhoids as dilated veins in the anal canal and discusses four main theories for their formation. Conservative treatments like diet changes, medication, and hot baths are recommended initially. More advanced options include sclerotherapy, which involves injecting chemicals to scar hemorrhoidal tissue, and rubber band ligation to cut off blood supply to hemorrhoids. The document provides detailed descriptions of techniques for both procedures.
Ventral hernia is protrusion of peritoneal sac through anterior abdominal wall defects except Groin hernias. In this presentation I have discussed Epigastric, Umbilical, Para umbilical, Incisional, Spigelian and Lumbar hernias.
Haemorrhoids and its Management: How can Ayurveda have the upper hand...AshishSharma1838
Haemorrhoids are the pathological enlargement of the vascular cushions present in submucosal layer of anal canal which otherwise act as a hermetic seal in maintaining the continence. Ayurveda aim at to treat the hemorrhoids at the basic pathological level and offers a wide range of treatment options ranging from medical management to the use of parasurgical as well as surgical measures.
Femoral hernia is the third common hernia after inguinal and incisional hernias. The swelling in femoral hernia is below and lateral to pubic tubercle. It is more common in females. Strangulation is very common in this hernia.
Please find the power point on Hemorrhoids. I tried present it on understandable way and all the contents are reviewed by experts and from very reliable references.
An anorectal abscess is a collection of pus in the anal or rectal region.
It may be caused by infection of an anal fissure, sexually transmitted infections or blocked anal glands.
An anorectal abscess is a collection of pus that builds up in the rectum and anus.
With prompt treatment, client with this condition usually recover very well.
Complications tend occur when treatment is delayed.
PROCTOLOGY AND USE OF LASER SURGERY.
CLINICAL EXAMINATION
RELEVANCE OF PR AND PROCTOSCOPY
HAEMORRHOIDS
FISTULA ANO
PILONIDAL SINUS
FISSURE
ROLE OF LASER SURGERY
PER RECTAL EXAMINATION
PROCTOSCOPY
Ventral hernia is protrusion of peritoneal sac through anterior abdominal wall defects except Groin hernias. In this presentation I have discussed Epigastric, Umbilical, Para umbilical, Incisional, Spigelian and Lumbar hernias.
Haemorrhoids and its Management: How can Ayurveda have the upper hand...AshishSharma1838
Haemorrhoids are the pathological enlargement of the vascular cushions present in submucosal layer of anal canal which otherwise act as a hermetic seal in maintaining the continence. Ayurveda aim at to treat the hemorrhoids at the basic pathological level and offers a wide range of treatment options ranging from medical management to the use of parasurgical as well as surgical measures.
Femoral hernia is the third common hernia after inguinal and incisional hernias. The swelling in femoral hernia is below and lateral to pubic tubercle. It is more common in females. Strangulation is very common in this hernia.
Please find the power point on Hemorrhoids. I tried present it on understandable way and all the contents are reviewed by experts and from very reliable references.
An anorectal abscess is a collection of pus in the anal or rectal region.
It may be caused by infection of an anal fissure, sexually transmitted infections or blocked anal glands.
An anorectal abscess is a collection of pus that builds up in the rectum and anus.
With prompt treatment, client with this condition usually recover very well.
Complications tend occur when treatment is delayed.
PROCTOLOGY AND USE OF LASER SURGERY.
CLINICAL EXAMINATION
RELEVANCE OF PR AND PROCTOSCOPY
HAEMORRHOIDS
FISTULA ANO
PILONIDAL SINUS
FISSURE
ROLE OF LASER SURGERY
PER RECTAL EXAMINATION
PROCTOSCOPY
haemorrhoids are the most common tyoe of gastroenterological disease. it is a nutritive disease. here is a quick review on hemorrhoids, its pathophysiology, clinical features, classification, diagnosis and management.
The esophagus is a muscular tube that connects the pharynx to the stomach.
It begins in the neck where it is continuous with the laryngopharynx at the pharyngo-esophageal junction.
The esophagus consists of striated (voluntary) muscle in its upper third, smooth (involuntary) muscle in its lower third, and a mixture of striated and smooth muscle in between.
Inthis playlist, i discussed various causes for Lower GI Hemorrahage like Hemorrhoids, Fissure in ano, diverticulosis, inflammatory bowel disease and colorectal cancer
In the recent years, there is a rise in the number of people suffering from piles, a condition medically termed as Haemorrhoids. Since time immemorial haemorrhoids have plagued humankind, yet many misunderstandings regarding haemorrhoidal complaints and disease still exist. Proportionately, there is a hike in the advertisements in different media on various patent products that are supposed to cure piles. But the fact is, majority of the piles patients we come across are self diagnosed cases. Most of them suffer from occasional burning pains or soreness in the anal region and diagnose themselves as piles without a medical consultation. Thereafter, they go on taking patent preparations over the counter without a doctor’s prescription. The present article focuses on homoeopathic approach to a case of haemorrhoids.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
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New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
3. Hemorrhoid
Haema – blood
Rhoos – flow
Hemorrhoids means flow of blood.
Piles – pila (ball)
Means swelling (round mass)
4. Defination -
These are dilated veins within the anal
canal in the subepithelial region formed by
radicles of the superior,middle and inferior
rectal veins.
Hemorrhoids are vericosities of veins in
anal canal
5. 1. Varicosity - varix or varicose
condition in which a vein is swollen
and tortuous. varicose vein - a vein
that is permanently dilated.
11. Muscles :
Treitz’s muscle,
Conjoined longitudinal muscle,
Internal anal sphincter
External anal sphincter,
Mucosa, and the
Pelvic floor muscles
Submucosa are CUSHIONS
That play an important role in the
formation of prolapsed hemorrhoids.
12. Treitz’s muscle
Treitz’s muscle passes
through the internal sphincter
and fixes the submucosa
tissue (cushion) to the
conjoined longitudinal
muscle..
Therefore, it is the most
important muscle in the
formation of hemorrhoids.
Mucosal suspensory ligament
Anal submucosal muscle
Internal sphincte
conjoined longitudinal musc
External sphincter
13. Longitudinal Muscle
The longitudinal
muscle is
presumed to
perform the same
role as the bone,
as it combines and
supports the
internal and
external sphincter
complex
It is thought to play
the most important
role together with
treitz’s muscle in
the formation of
Medial longitudinal muscle
Intermediate
longitudinal muscle
Lateral longitudinal muscl
Trietz’s muscle
Corrugator cutis ani
14. What are hemorrhoids?
4 theories:
1. Varicose veins theory
2. Vascular hyperplasia theory
3. Internal anal sphincter
hypertonia
4. The sliding anal theory
15. 4. The Sliding Anal Lining
(Cushion) Theory
In 1975, Thomson announced that
hemorrhoids result from the sliding
down of the anal cushion (anal
endothelial lining)on the basis of his
anatomical studies which is now
widely accepted.
Hemorrhoids can develop from the anus
with loose and coarse connective tissue
degradation.
16. The anal cushion functions as the
continence mechanism and changes the
width of the anal canal.
1. Straining
2. increase venous pressure
3. the anal cushion is dilated and
protrudes out of the anal canal.
4. The Treitz’s muscle stretches and
disintegrates with the force of repeated
straining causing the permanent
prolapse of the anal cushion.
Mechanism
17.
18. Internal hemorrhoids into
1. Vascular internal hemorrhoids
2. Mucosal prolapses
External hemorrhoids into
1. Vascular external hemorrhoids and
2. Skin tags.
22. The three main cushions are located
at left lateral (3o’clock), right anterior
(11 o’clock), and right posterior
(7o’clock) in the anal canal.
The tissues in the cushion are fixed to
the internal sphincter and the
conjoined longitudinal muscle with
collagen connective tissue and
become weak and loose with age.
23. Causes of Hemorrhoids:
Hemorrhoids are caused by
the disruption of the mucosal
suspensory ligament (Treitz’s
muscle)
The anal cushion protrudes
out of the anal canal by
repetitive straining, resulting in
disintegration of the ligament.
24. What are hemorrhoids?
4 theories:
1. Varicose veins theory
2. Vascular hyperplasia theory
3. Internal anal sphincter
hypertonia
4. The sliding anal theory
25. 1. Defecation with
Prolonged Straining
Everyone’s anal cushion descends on
defecation.
Posture for defecation is held for a
long time,
The mucosal suspensory ligament
relaxes and does not return to its
original
Defecation should be completed in a
short time, within 3 min, if possible.
26. 2. Constipation with a
Low-Fiber Diet
With constipation or a low-fiber diet,
hemorrhoids will develop as a result of
prolonged straining
During defecation, reading a
newspaper or books which prolongs
defecation time is also not
recommended.
27. 3. Diarrhea
Diarrhea also is apt to descendent of
anal cushion resulting in prolapse,
because the frequency of bowel
movement increases.
28. 4. Pregnancy
Abdominal distension and backward
posture of the buttocks - abdominal
pressure increases
The enlarged uterus tends to
compress the vena cava, which
disturbs venous circulation - cause the
engorgement and aggravate
hemorrhoids.
29. 5. Occupation
Hemorrhoids are frequent for those
who sit for a long period of time while
working,
Such as drivers, or
Those who work in a squatting
position.
30. 6. Psychological
Problems and Spinal
Paralysis
The frequency of hemorrhoids is also
high in those with psychological
problems or spinal paralysis
31. 7. Hereditary
Failure of the mucosal suspensory
ligament to return after relaxation
causes hemorrhoids to prolapse
easily.
These can be hereditary factors
contributing to the development of
hemorrhoids.
32. 8. Alcohol
Diuretic
Dehydration
Body needs water to make stools soft
Liver cirrhosis - leads to swollen and
engorged veins within the rectum
called varicose veins.
Liver cirrhosis – Ascitis – increase
intra abdominal pressure –
hemorrhoids.
33. SUP RECTAL
VEIN
A.D OF
INTERANL
ILIAC VEIN
INTERAL
PUDENDAL
VEIN
MIDDLE
RECTAL VEIN
INF RECTAL
VEIN
SPLENIC VEIN
INF
MESENTRIC
VEIN
PORTAL VEIN
IVC
COMMON ILIAC
VEIN
INTERAL ILIAC
VEIN
PORTA VACAL
ANASTOMOSIS
MEDIAN
SACRAL VEIN
LEF
T
VENOUS
DRAINAGE
34. 9. Sports and Leisure
Activities
Golf,
Cycling,
Horse riding,
Climbing,
Weight lifting,
Being
The catcher in baseball,
Wrestling,
Fishing,
Card playing,
Driving,
Sitting for a long period of time
36. Bleeding
Bleeding is the most frequent
symptom
Fresh red colour
spurting and dripping to just
staining on the toilet paper.
Dark Red-colored Blood,- Colon
Disease, Such As Colon Cancer
Or Ulcerative Colitis, Can Be
Suspected.
39. Anal Pain
Internal hemorrhoids usually do not
cause pain.
Anal disorders distal to the dentate
line of the anal canal,
Thrombosed external hemorrhoids or
Anal fissures,
In the internal hemorrhoids, the
incarcerated form can cause severe
anal pain.
40. Discharge
Mucoid discharge is from the mucosa
proximal to the dentate line.
It can appear with prolapsed
hemorrhoids.
Can also occur in other conditions such
as
Rectal polyps,
Anal fistula,
Ulcerative colitis,
Crohn’s disease, and
Irritable bowel syndrome.
41. Itching Sensation
With mucosal
prolapse, the
amount of
perianal
discharge
increases
This stimulates
perianal skin
with itching
sensation.
44. Inspection:
A comfortable
atmosphere is
needed to relax
the patient
A well-equipped
side lamp and
A height
controllable bed.
The treatment procedure, including
operation, is decided after inspection
45.
46. First Step
Palpate the anus by
inserting up to the distal
joint of the index finger
To check from the anal
verge to the dentate line.
1. Internal sphincter tone,
2. External hemorrhoids,
3. Anal fissure,
4. Perianal abscess,
5. Anal cancer
6. The thumb is
sometimes used
together to palpate to
confirm the existence of
47. Second Step
Insert the index
finger up to the
middle joint.
Palpate 2–3 cm
upward from the
dentate line.
By rotating the finger
360°, the
hemorrhoid is
palpated - degree of
prolapse.
If a fistula is present
internal opening are
also palpated.
48. Third Step
•This step involves
inserting the full
length of the index
finger.
•If it were not
performed properly,
rectal cancer may not
be noticed.
49. Anoscopic Examination
Cylindrical
anoscope
1. Insert the anoscope
2. Insert the gauze through
the anoscope and
remove the anoscope
only
3. Pressure as usual on
defecation and observe
the site and degree of
the prolapse while
withdrawing the
previously inserted
50. Specular Anoscope
The specular
anoscope is used to
inspect the anal canal
by inserting and
opening the anoscope
sideways.
Then withdraw the
anoscope widening
slowly.
This makes the
hemorrhoid to be
pushed out of anal
canal.
Colonoscopic Examination
51. Differential Diagnosis
Hypertrophied
Anal Papillae
It is considered
normal
Usually there are
no symptoms
But if it grows
excessively
large, it
protrudes below
the dentate line
which is called a
fi brous anal
52. Rectal Prolapse
When the entire
layer of the
rectal wall
prolapsed
circumferentially,i
t is called a
complete rectal
prolapse.
53. Rectocele
the suspensory
tissue of anterior
rectal wall is relaxed
and distended
toward the vagina
which results in
defecation
difficulties and
bleeding problem.
60. Conservative Treatment
of Hemorrhoids
Conservative treatment is basic
treatment that should be performed,
regardless of their severity.
Early internal or external hemorrhoids
can be treated with the conservative
method including the following:
1. Hot sitz bath
2. Medication
3. Diet
4. Defecation counseling
61. Hot Sitz Bath
For the conservative treatment,
postoperative management, and
prevention
40–42 °c
5-10mins
Relieves pain by lowering anal
pressure,
Helps to keep anus clean, and
Improves anal blood circulation that
relieves congestion and edema.
62. Medical Treatment of
Hemorrhoids
Oral medications for hemorrhoids
include the following:
1. Agent to improve circulation by
strengthening the vein and capillary
like, DAFLON (compounds help blood
circulation around the anus to settle
edema and relieve congestion.)
1. Anti-inflammatory agent, and
2. Stool softener
63. Medicine for bleeding.
1. Tranexamic Acid is an anti-fibrinolytic
2. Ethamsylate is a haemostatic medication. It works by
increasing the ability of platelets to stick together and
form blood clots.
64. Ointment
Applied around the anus
Anti inflammatory agent to relieve
1. Inflammation and
2. Itching sensation.
Mostly Steroidal Preparation
65. Suppositories
Suppositories are inserted into lower
rectum
It acts like an ointment but also has
the effect of oral medication.
Suppositories have a lasting effect
66. Dietary Treatment:
High Fibers
For hemorrhoid patients, fluid and fiber
intake should be increased for the stool
to be soft and easy defecation.
Bowel Movement Education
67. 1. SCLEROTHERAPY
Injecting chemical agent on the
hemorrhoidal plexus
submucosally.
Phenol In Almond Oil (PAO)
Polidocanol Injection
INDICATIONS:
First, second and early third
degree internal hemorrhoids.
68. 2 TYPES OF SCLEROSING AGENT:
1. Oil based
2. Water soluble
Previously the chemical used to be
oil-based which has its own
advantage, limitation and
complications.
Nowadays water-soluble chemicals
have minimized the complications
and have results on table.
69. Technique: (water soluale)
1. Dilute in 1:1 ratio with normal
saline.
2. With 26/27 long 1 1/2 inch
needle.
3. It is to be injected in aseptic
precaution
4. Above the dentate line,
parallel to anal canal,
submucosally above the
70. Technique: (water
soluale)
5.Till up to the whole mass
converted from pinkish
to whitish colour
6. Inject 1-2 pile masses
only.
7. Repeated after 15 to 20
71. Technique: (in short)
1. Above the dentate line
2. Parallel to anal canal
3. Lift the mucosa
4. Gentally inject till sunshine
phenomenon and avoid trauma
to mucosa
74. COMPLICATION:
1. It has only one complication, if you
inject more than 1 ml solution in
veins, it can lead to deep vein
thrombosis, cirrhosis of the liver,
chemical reaction and very rare
infection.
RESULTS:
1. The success rate is very quiet and
painless. It is been known as cure for
hemorrhoids without pain and
surgery.
75. 2. RUBBER BAND
LIGATION:
INDICATION:
This technique is usually indicated in
pedunculated first, second and early third
degree internal hemorrhoids
77. Technique:
1. Position comfortable to surgeon
and patient.
2. Introduce split anoscope with light
source.
3. Place 1 or 2 elastic bands at a
time.
4. Catch the pile mass with a
instrument and confirm the
pedunculated hemorrhoids and fire
78. • Technique:
6. Strangulation of the blood
vessel, cut off the blood supply,
necrosis and slough out to the
hemorrhoids.
7. In 5 to 7 days it falls off
eventually.
8. It leaves small ulcer which
heals by its own.
9. Maximum you can ligate 2 &
84. COMPLICATIONS:
6. Urinary retention
7. Secondary bleeding from ulcer
due to infection
8. Pelvic and perineal sepsis
9. About 2.5 % patients require
hospitalization due to massive
hemorrhage, severe pain and
perineal sepsis.
85. RESULTS:
Result is 70-80% by experts
with proper protocol.
Within 1 – 10 years patient
requires repeat of the
procedure.
After 5 to 10 years it requires
new modalities of treatment.
89. Technique:
4. Time set – 1 – 1.5 sec
5. 2 hemorrhoids at a
time, repeat after 15 –
21 days
6. 5 – 6 sittings required
for prolapse
90.
91. MODE OF ACTION:
CONVERTING
INFRARED LIGHT
INTO HEAT
SCARRING AND
FIBROSIS
WATER EVAPORATION
& ESCHAR FORMATION
COAGULATION
OF TISSUE
PROTEIN
92. Complications:
1. Ulceration
2. Proctocolitis
3. Bleeding
Result:
1. In acute emergency to stop
bleeding, results are good. (If the
bleeder is small and from the mucosa it
stops immediately)
2. Long standing results are
unsatisfactory.
93. 4. CRYOTHERAPY:
Cryotherapy, is use of low temperatures
in medical therapy.
Also known as cryosurgery or
cryoablation.
94. PROCEDURE:
1. Position comfortable to the patient
& surgeon
2. without anesthesia
3. Requires special cold temperature
control photo coagulation
instrument
4. Time set – 1 – 1.5 sec till mucosa
becomes white
5. 2 hemorrhoids at a time, repeat
after 15 – 21 days
95. MODE OF ACTION:
BURNS THE MUCOSA
CREATE FIBROSIS
WHICH STOPS BLEEDING
AND REGRESSION OF PILE
MASS
99. TECHNIQUE:
1. Under local anaesthetic, with
or without sedation.
2. A lubricated proctoscope is
inserted into the
3. Local anaesthetic is injected
into tissue surrounding the
haemorrhoid
100. TECHNIQUE:
4. Probe connected to a radiofrequency
generator is inserted into the
haemorrhoid, or a ball electrode is
rolled over the surface of the
haemorrhoid.
5. The tissue within the haemorrhoid
heats up and the haemorrhoid
shrinks.
6. The haemorrhoids may be treated in
several sessions,each taking up to
20 minutes.
101. MODE OF ACTION:
FREQUENCY IS RELEASED FROM
GENERATOR
FOCUSED ON AFFECTED
AREA
TISSUE RESISTANCE IN THE PATH
OF WAVE
MAKE INTRACELLULAR
FLUID BOIL
INTURN PRODUCES COAGULATION AND
SHRINKAGE OF TISSUE
103. 5. DG-HAL – DOPPLER
GUIDED HEMORRHOIDAL
ARTERY LIGATION
This procedure is a non-
invasive procedure for the
treatment of hemorrhoids.
Ligation of terminal branches
of Superior Hemorrhoidal
Artery under Doppler
guidance is known as DG-
107. TECHNIQUE:
1. Doppler ultrasound mounted to a
specially designed proctoscope is
inserted in the anal canal.
2. After this identification of the branches
of superior hemorrhoidal artery with
the help of readings on a specially
designed monitor.
3. After identification of the hemorrhoidal
artery, put a stitch with absorbable
material and then sound disappears.
109. TECHNIQUE:
4. All the branches should be ligated
about 2-3 cms above dentate line.
5. Ligation of all the hemorrhoidal
artery results in reduced blood
pressure inside the plexus with
subsequent reduction of bleeding
and swelling of tissue.
6. Maximum 6 ligatures can be taken
at 11, 12, 2, 5, 7, 9 o clock
position.
110.
111. COMPLICATIONS:
If procedure is not done properly results in
1. Pain
2. Bleeding
3. Stricture
RESULTS:
1. Complaints of bleeding stops in 95 % of
cases with no pain.
2. In 78% improvement in prolapsed related
symptoms.
3. Procedure is cost effective, expertization is
required to perform this procedure.
112. 6. LASER IN
HEMORRHOIDS:
This procedure produce good
coagulation, it is relatively easy
with less bleeding and pain.
This is because of specific wave
length of this type of laser.
Carbon dioxide laser is the most
adequately used laser in
surgical proctology.
115. TECHNIQUE:
1. In lithotomy position, under local
anesthesia or general anesthesia or
spinal anesthesia this procedure can
be performed.
2. The laser beam light is applied with a
dedicated handle and is slowly moved
on the area to be treated, until total
tissue destruction.
3. It can be done on all hemorrhoids in
one sitting.
4. Procedure can be performed in 20-30
mins.
116.
117. COMPLICATIONS:
1. Pain
2. Hematoma
3. Secondary bleeding
4. Very rare infection
RESULTS:
1. Long standing results are awaited.
2. It is a costly procedure.
3. Nowadays computerized special
proctology software and machines are
widely used.