Thursday, December 11, 2014

Thiersh procedure Rectum


Thiersch Procedure
Objective
In case of rectal prolapse:
•   A circumferential device or mesh around rectum to restrict downward movement of rectum.
Position
Supine (Lithotomy) or jacknife.
Anesthesia
General.
Procedure
1.  Two incision, 1 cm each are made opposite one another around the anus.
2.  Curved hemostat is passed deep in the perianal tissues external to the sphincter (avoiding the vagina), encircling the sphincter, and exiting the opposite incision.
3.  The prosthetic material is passed through the tunnel created by the clamp.
4.  Repeated for the other side (prosthesis completely encircles the anal canal).
5.  The prosthetic ends are sutured.
6.  The wounds are closed.
Instruments
•   Rectal set
•   Rectal retractors, including Sims, Hill-Fergusson and Sawyer (Fig. 9.17)
•   Prosthesis.
Any questions be sent to drmmkapur@gmail.com
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