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Internal hemorrhoids and loose rectal mucosa may block the exposure during the purse string suturing in stapled hemorrhooidopexy, and this may cause some complications. To retract the prolapsing rectal mucosa we modified the purse string anoscope of the PPH01 kit (Ethicon-Endosurgery, Cincinnati, O...H, USA) and produced a special anoscope. The open part of the purse string suture anoscope is covered by transparent acrylic (Orthoacryl�, Dentaurum, Pforzheim, Germany). The covering material had complete cylindrical outer and inner surfaces and was thin enough to let the anoscope easily rotate in the anal dilator and to let the 26 mm curved, round bodied needle of the 2/0 polypropilene suture move in the anoscope. A window, 3 cm long and 3-4 mm wide, was opened at the angled part of the anoscope 2 cm to the tip of the anoscope. This special anoscope was used for the purse string suture during stapled hemorrhoidopexy procedure in five patients. No postoperative complications, early or late, were encountered, and we propose that stapled hemorrhoidopexy procedure can be applied more easily by using this special anoscope.
What is a Whipple procedure?
Also called a pancreaticoduodenectomy, the Whipple procedure is performed to address chronic pancreatitis and cancer of the pancreas, ampulla of Vater, duodenum, and the distal bile duct. The Whipple procedure involves removing the cancerous parts of the pancreas, duodenum, common bile duct, and if required, part of the stomach.
Purpose The complication rate in patients treated with the Linton procedure was unacceptably high. SEPS is minimal invasive treatment modality for chronic venous insufficiency and venous ulcers. Materials and Methods252 limbs of 229 patients who underwent SEPS procedure and/or safenous vein ablati...on from May 2003 to January 2008. Tourniquet was not used and two-port technique was preferred for operation. Skin graft was not used. Honeysoft (medical honey) was used for wound care in selected cases. Results According to CEAP clinical Classification 112 limbs were class 6, 70 limbs (class 5), 70 limbs (Class4) respectively. Greater saphenous vein stripping and/or high ligation, and varicose vein excision accompanied SEPS in 241limbs who had combined Sapheno-femoral junction and perforator vein insufficiencyand SEPS was performed alone 23 limbs who had recanalised deep venous thrombosis (19) and PVI alone(4). Mean patient follow-up was 35 months. No early deaths or thromboembolism occurred. Complications included severe subcutaneous emphysema(1), neuralgia (7), 1 year later cellulites (1). Ulcers healed in 124 limbs in two months and 58 limbs in 3 months. ulcer recurrence was seen on 12(%6.6) limbs. Clinical severity and disability scores improved significantly after surgery. Conclusion All venous ulcers healed with SEPS combined or not ablation of superficial venous reflux and remain healed 5 year period and symptom-free except recurrent ulcers during the long-term follow-up. SEPS is an effective and safety treatment modality.
Most corneal transplants performed in the U.S. involve replacing the entire thickness of the diseased cornea with a healthy donor cornea (called penetrating keratoplasty or PK). In partial-thickness corneal transplants (LK), only the anterior (surface) layers of the cornea are removed. The donor cornea is then attached to the host corneal bed, containing only posterior (deeper) layers. LK is less risky, but tends to result in somewhat inferior vision vs. PK and cannot be performed if the disease process (e.g. scar) involves the deeper layers of the cornea.
Brachytherapy or localized radiation treatment can be used in certain patients with breast cancer. Depending on tumor size and other factor, physicians may use APBI or accelerated partial breast irradiation. Dr. Elizabeth Tapen, a radiation oncologist, reviews brachytherapy for breast cancer.