Anal sphincter incontinence surgery

Anal sphincter incontinence orthopedic surgery is a surgical treatment for incontinence caused by anal sphincter relaxation, aimed at tightening the anal sphincter. Treating diseases: anal incontinence Indication 1, sphincter damage extensively. 2. Nerve damage causes loss of sphincter function. 3, neurological developmental defects or nerve damage caused by sphincter dysfunction. Contraindications 1. Local skin soft tissue is severely damaged. 2. There are obvious infections in the local area. 3. Local scar hyperplasia is not softened. 4, poor overall condition can not tolerate surgery. Preoperative preparation 1. The genital area is cleaned several times a day. Prepare according to routine bowel surgery, clean the enema, and take oral antibiotics. 2, urinary incontinence patients with catheters. Surgical procedure 1. Take the lithotomy position, epidural anesthesia or general anesthesia. Routine disinfection, sterile towels. 2, in the lower pubic humerus to the tibia trochanter below the line 1/4 and the lower thighs l / 3 each length about 5cm longitudinal incision. In the incision of the thigh root, it is separated behind the depression between the gracilis muscle and the long adductor muscle, revealing the gracilis muscle, making blunt separation and free muscle. Take care to protect the vascular bundle that enters deep muscles. 3, in the upper part of the knee incision separation, free muscles, tendons, together with the periosteum of the tibia cut. Tension the muscles in the thigh root incision and pull the entire thin muscles out of it. 4. Make a small vertical incision of about 2 cm at 2 o'clock, 4 o'clock, and 8 o'clock from the anus. Insert the incision with scissors and bluntly separate under the skin. At the front and rear mid-slit, through the deep layer, forming a trochle, and finally separated into a tunnel around the anal canal, so that it can accommodate the passage of fingers, and as close as possible to the anal rim. 5, the gracilis muscle (right side) clockwise direction in the subcutaneous tunnel through the upper and lower two pulleys, around 1 week. A 4 cm incision was made in the skin of the contralateral ischial tuberosity to reveal the nodules and levator ani muscles. Make a pulley at the subperiosteal levator ani muscle. 6. Tighten the gracilis tendon and fix the two bifurcations of the tendon to the periosteum and levator strop. The anal tension is just right through the fingertips. All the incisions were sutured, the thighs were pressure-wrapped in the muscle flap area, and the cotton pad was wrapped in the perineal area, and exposed after 1~2 days.

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