New surgical techniques for the treatment of anal incontinence have given the increasing number of afflicted patients hope for a cure. Colorectal surgeons and more and more general surgeons are performing operations, yet until now they have not had a text that they can use as a reference work. The guidance and instruction that surgeons need are now available in this atlas. It describes every operation in technical detail, and the two-color illustrations clearly show the essential points of each procedure. The authors discuss thoroughly the indications for surgical treatment, its application to…mehr
New surgical techniques for the treatment of anal incontinence have given the increasing number of afflicted patients hope for a cure. Colorectal surgeons and more and more general surgeons are performing operations, yet until now they have not had a text that they can use as a reference work. The guidance and instruction that surgeons need are now available in this atlas. It describes every operation in technical detail, and the two-color illustrations clearly show the essential points of each procedure. The authors discuss thoroughly the indications for surgical treatment, its application to the individual patient, and post-operative care. The comprehensive scope of this book makes it a rich source of information for surgeons working outside highly specialized centers. For specialists, it is the only practical reference available on the subject.
1 Essential Anatomy of Anal Continence.- General Introduction.- Structural Anatomy.- Surgical Anatomy.- 2 Physiology of Anal Continence.- General Introduction.- Applied Physiology.- 3 Abdominal Techniques.- General Introduction.- Abdominal Rectopexy with Prosthetic Implant (Syn. Wells Technique).- Abdominal Rectopexy with Prosthetic Sling (Syn. Ripstein Technique).- Abdominal Rectopexy plus Colon Resection (Syn. Goldberg Technique).- Laparoscopic Rectopexy for Rectal Prolapse.- 4 Anterior Perineal Techniques.- General Introduction.- Anterior Plication of Puborectalis and Anal Sphincter (Syn. Anterior Buttress Technique, Anterior Levatorplasty).- Anterior Sling Procedure (Syn. Notaras Technique).- 5 Posterior Perineal Techniques.- General Introduction.- Post-anal Intersphincteric Repair (Syn. Parks Technique. Posterior Levatorplasty).- Post-rectal Buttress Repair (Syn. Wyatt Technique).- 6 Circum-anal Techniques.- General Introduction.- Circum-anal Wire (or Nylon) Encirclement (Syn. Thiersch Procedure).- Circum-anal Cicatrical Fixation (Syn. Saraffof Technique).- Gracilis Muscle Sling Procedure (Syn. Pickrell-von Rapport Technique).- Stimulated Graciloplasty by B.J. Mander and N.S. Williams.- General Introduction.- Indications and Selection of Patients.- Preparation.- Operative Technique.- Post-operative Care Following Stage 2.- Results.- 7 Per-anal Techniques.- General Introduction.- Anterior (Rectal) Mucosectomy.- Rectal Wall Plication (Syn. Delorme Technique).- Rectosigmoidectomy (Syn. Altemeier Technique).- 8 Technique of Anal Sphincter Repair (Syn. Overlap Technique).- Indications and Selection of Patients.- Preparation.- Operative Technique.- Post-operative Management.- Results.- 9 Techniques for Congenital Anal Deformity Encountered in Later Life.- General Introduction.- Covered Anus Deformity with Associated Perineal Fistula ("False Anus").- Anterior Ectopic Deformity.- No Definite Anal or Puborectalis Muscle.- Ectopic Opening Adjacent to an Anal Orifice ("Shot-gun Deformity").- Cloacal-type Deformity.- Post-operative Management.- Summary.- 10 Techniques for Repair of Traumatic Injury of the Anal Sphincters.- General introduction.- Acute Primary Repair of Traumatised Anal Sphincter and Pelvic Floor.- Trans-vaginal Injury to the Anus and Rectum.- Immediate Repair of Acute Trans-vaginal Injury.- Delayed Repair of Chronic Unhealed Recto-vaginal Septal Defect.- 11 Techniques for Repair of Recto-vaginal Fistula.- I: Low Recto-vaginal Fistula Repairs.- General Introduction.- Excision and Repair of Low Juxtasphincteric Fistula.- Per-vaginal Direct Repair of Low Supra-sphincteric Fistula.- Per-anal Closure of Low Supra-sphincteric Fistula by Advancement Flap.- II: High Recto-vaginal Fistula Repairs.- General Introduction.- Direct Closure Using Interposed Omental Graft.- Extended Resection with Colo-anal Anastomosis.- 12 Salvage Procedures.- General Introduction.- Silastic Sling Encirclement.- Inflatable Anal Prosthesis.- Faecal Diversion (by a Stoma).- 13 General Supportive Measures.- General Introduction.- Enhancement of Sphincter Responses to Sensory Stimuli by Biofeedback.- Improvement of Anal Sphincter Tone and Reactivity.- Enhancement of the Efficiency of Rectal Emptying.- Alteration of the Consistency of the Stools.- Reduction of Colonic Motor Activity.- Promotion of Increased Patient Awareness and Co-operation.
1 Essential Anatomy of Anal Continence.- General Introduction.- Structural Anatomy.- Surgical Anatomy.- 2 Physiology of Anal Continence.- General Introduction.- Applied Physiology.- 3 Abdominal Techniques.- General Introduction.- Abdominal Rectopexy with Prosthetic Implant (Syn. Wells Technique).- Abdominal Rectopexy with Prosthetic Sling (Syn. Ripstein Technique).- Abdominal Rectopexy plus Colon Resection (Syn. Goldberg Technique).- Laparoscopic Rectopexy for Rectal Prolapse.- 4 Anterior Perineal Techniques.- General Introduction.- Anterior Plication of Puborectalis and Anal Sphincter (Syn. Anterior Buttress Technique, Anterior Levatorplasty).- Anterior Sling Procedure (Syn. Notaras Technique).- 5 Posterior Perineal Techniques.- General Introduction.- Post-anal Intersphincteric Repair (Syn. Parks Technique. Posterior Levatorplasty).- Post-rectal Buttress Repair (Syn. Wyatt Technique).- 6 Circum-anal Techniques.- General Introduction.- Circum-anal Wire (or Nylon) Encirclement (Syn. Thiersch Procedure).- Circum-anal Cicatrical Fixation (Syn. Saraffof Technique).- Gracilis Muscle Sling Procedure (Syn. Pickrell-von Rapport Technique).- Stimulated Graciloplasty by B.J. Mander and N.S. Williams.- General Introduction.- Indications and Selection of Patients.- Preparation.- Operative Technique.- Post-operative Care Following Stage 2.- Results.- 7 Per-anal Techniques.- General Introduction.- Anterior (Rectal) Mucosectomy.- Rectal Wall Plication (Syn. Delorme Technique).- Rectosigmoidectomy (Syn. Altemeier Technique).- 8 Technique of Anal Sphincter Repair (Syn. Overlap Technique).- Indications and Selection of Patients.- Preparation.- Operative Technique.- Post-operative Management.- Results.- 9 Techniques for Congenital Anal Deformity Encountered in Later Life.- General Introduction.- Covered Anus Deformity with Associated Perineal Fistula ("False Anus").- Anterior Ectopic Deformity.- No Definite Anal or Puborectalis Muscle.- Ectopic Opening Adjacent to an Anal Orifice ("Shot-gun Deformity").- Cloacal-type Deformity.- Post-operative Management.- Summary.- 10 Techniques for Repair of Traumatic Injury of the Anal Sphincters.- General introduction.- Acute Primary Repair of Traumatised Anal Sphincter and Pelvic Floor.- Trans-vaginal Injury to the Anus and Rectum.- Immediate Repair of Acute Trans-vaginal Injury.- Delayed Repair of Chronic Unhealed Recto-vaginal Septal Defect.- 11 Techniques for Repair of Recto-vaginal Fistula.- I: Low Recto-vaginal Fistula Repairs.- General Introduction.- Excision and Repair of Low Juxtasphincteric Fistula.- Per-vaginal Direct Repair of Low Supra-sphincteric Fistula.- Per-anal Closure of Low Supra-sphincteric Fistula by Advancement Flap.- II: High Recto-vaginal Fistula Repairs.- General Introduction.- Direct Closure Using Interposed Omental Graft.- Extended Resection with Colo-anal Anastomosis.- 12 Salvage Procedures.- General Introduction.- Silastic Sling Encirclement.- Inflatable Anal Prosthesis.- Faecal Diversion (by a Stoma).- 13 General Supportive Measures.- General Introduction.- Enhancement of Sphincter Responses to Sensory Stimuli by Biofeedback.- Improvement of Anal Sphincter Tone and Reactivity.- Enhancement of the Efficiency of Rectal Emptying.- Alteration of the Consistency of the Stools.- Reduction of Colonic Motor Activity.- Promotion of Increased Patient Awareness and Co-operation.
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