Rubber band ligation of internal hemorrhoids

The principle of apron ligation in the treatment of internal hemorrhoids is to insert a small apron into the root of the ankle through the instrument, and use the strong elasticity of the apron to block the blood supply of the internal hemorrhoid, so that the ischemic, necrotic, and shedding can be self-healing. The internal ligation device has two types: a pull-in ligature and a suction ligature. Take the pull-in hood as an example. The ligature is made of stainless steel and has a length of 20cm. It is divided into three parts: the front end of the ring is a ferrule ring, the diameter is 1cm, there are two inner and outer rings, and the inner ring is sleeved into a small rubber ring (special or with a bicycle valve core rubber hose) After that, the cuff is smashed and the outer ring can move back and forth. The 2 rod is a metal rod with a handle of about 20 cm in length, which is divided into upper and lower rods. The upper and outer rings are connected to the inner ring and are inactive. 3 expand the cone of the rubber ring, in order to fit the small rubber ring into the inner ring. Treating diseases: guilt Indication The internal malleolus ligation is suitable for the internal hemorrhoids of the sputum and mixed sputum in each period, and the internal sputum of the second and third phases is most suitable. Contraindications Complications of internal hemorrhoids, such as embolism, infection or ulceration. Surgical procedure 1. Insert a diagonal anal mirror in the lateral position to reveal the internal hemorrhoids that need to be ligated. After local disinfection, the assistant fixes the anoscope, the operator holds the ligation device with the left hand, and the right hand holds the forceps (or bent pliers), extends into the anus from the ferrule, clamps the sputum, and pulls it into the ligator. In the circle, push out the apron and tie it to the root of the block, then loosen the forceps and take it out together with the ligature, and finally take out the anoscope. Generally, 1 to 3 blocks can be tied at a time. After 1 week, the necrotic shedding was seen. 2. If there is no ligature, you can use two curved vascular clamps instead. complication Bleeding Generally, there is a small amount of blood in the stool when the internal hemorrhoids fall off, but in some cases, secondary hemorrhage occurs within 7 to 15 days after the ligation. If a small amount of hardening agent, such as 4% alum solution, is injected into the crotch block after ligation, it can prevent postoperative bleeding and prevent the apron from slipping off. Some people also inject a small amount of anesthetic into the ligation block to relieve pain. 2. Perianal skin edema It occurs mostly in mixed helium and ring helium. The prevention method is to perform high ligation, away from the tooth line, to reduce pain and perianal skin edema. When tying the mixed sputum, it is advisable to first cut the outer scorpion into a V shape. 3. Serious complications after the treatment of gingival ring ligation Retroperitoneal infection: The literature has reported that a total of 7 cases of internal sacral acupuncture after the treatment of severe retroperitoneal infection, including 5 deaths, 2 cases were cured. In the other 3 cases, severe pelvic cellulitis occurred after the acupuncture of the axillary ring, and one of them died. Therefore, in addition to the emphasis on intraoperative aseptic operation, the treatment of the rubber ring should be carefully observed for adverse reactions.