anal ring reduction

Anal ring reduction is used for surgical treatment of rectal prolapse. In 1891, Thiersch introduced silver wire into the subcutaneous tissue around the anus, tightening the relaxed sphincter and treating rectal prolapse. Later, Turell simplified the operation. The advantage of this method is that the operation is simple, the damage is small, and it can be performed under local anesthesia, but this is only a kind of palliative operation, and there are certain complications, so there are not many applications. Recently, it has been proposed to use silicone rubber or nylon mesh belt, because of a certain elasticity, can expand and contract, which is beneficial to prevent fecal incontinence and rectal prolapse. Treatment of diseases: rectal prolapse Indication Anal ring reduction applies to: 1. Anal contraction is weak or the anus has been relaxed rectal prolapse. 2. Elderly and debilitating rectal prolapse. 3. Often used in conjunction with other methods of treatment prolapse. Preoperative preparation According to the surgical requirements, prepare a 30 gauge silver wire, polyester or silicone rubber mesh belt. Surgical procedure 1. Make a 3cm long curved incision 1~2cm from the anal margin in the anterior median position and cut the subcutaneous fascia. 2. Using a curved vascular clamp, bluntly separate around the anal canal to the perineal shallow, deep muscle. 3. The left index finger is inserted into the rectum, and the right finger finger continues to bluntly separate to the pelvic floor (the male is at the lower edge of the prostate, the female is at the lower edge of the cervix), and the right finger is separated from the left and right sides of the anal canal, and each makes a tunnel. 4. Change the left hand glove, make a 2cm long longitudinal incision between the coccyx and the anal margin, and use the curved vascular clamp to bluntly separate the external sphincter muscle space to the anal ligament. 5. Use the right index finger to enter the posterior rectal space, separate the two sides of the anal canal, make a tunnel, and make a ring, so that it can pass the index. 6. Use a large curved vascular clamp to enter from the anterior incision, through the right tunnel, through the posterior incision, clamp one end of the polyester mesh belt, and draw it out from the anterior incision. 7. According to the same method, the other end of the polyester mesh belt, from the rear incision, through the left tunnel, from the front incision flat out, meet the front incision. 8. Insert the large anus mirror (2~2.5cm in diameter) into the anal canal as the basis for the diameter of the postoperative anal canal. Tighten the mesh belt around the anoscope, the ends are overlapped by 1cm, and the mesh belt is used for two interruptions. Stitch and then remove the anoscope. 9. Pull the front and back incisions with the hooks, and fix the needles on the upper and lower poles of the mesh with the muscle wall of the intestinal wall with the non-absorption line to prevent the mesh belt from being displaced and folded. 10. Finally, the tissue around the anal canal and the skin are sutured layer by layer with the gut and the fine non-absorbent line. complication 1. Subcutaneous infection If the infection is serious, the polyester mesh belt should be taken out. 2. The stool of the stool is mostly related to the tightening of the anus. Generally, it should be no less than the index finger. The use of anal canal expansion and enema can solve the fecal impaction.