Internal Hemorrhoid Circumcision

1. The number of annular internal hemorrhoids or internal hemorrhoids is more than 4 and combined. 2. The internal hemorrhoids are accompanied by rectal mucosal prolapse. Treating diseases: hemorrhoids Indication 1. The number of annular internal hemorrhoids or internal hemorrhoids is more than 4 and combined. 2. The internal hemorrhoids are accompanied by rectal mucosal prolapse. Preoperative preparation 1. Do a good physical examination, pay attention to pregnancy, portal hypertension, intra-abdominal tumor or rectal cancer. Local examination should pay attention to the abnormality of the sphincter function, the local condition of the sputum and the presence or absence of arterial pulsation. 2. Enter the low slag diet 1 day before surgery. 3. Oral antibiotics should be taken 3 days before surgery. The enema needs to be cleaned before surgery. Surgical procedure 1. Position: The position of the stone. 2. Insert the cork and pull out the ring: after the surgical field is disinfected, expand the anus. Select a cork with a handle with a diameter similar to that of the anus after expansion. After being lubricated with liquid paraffin, slowly insert it into the rectum about 6cm, then gently rotate and pull out 2~3cm. All the nucleus can be released with the cork. . 3. Fixing ring : The nucleus of the nucleus which will be taken out is near the top end, and is fixed on the cork with a pin in a ring shape, and the distance between the needles is about 1 cm. 4. Circularly cut the outer skin: Hold the cork in the left hand, and cut the outer skin in the ring at the lower edge of the nucleus, on the side of the anal canal (as close as possible to the tooth line). 5. Isolation of the nucleus: the submucosa was sharply separated by scissors, and the epithelium was pushed up, and the external sphincter was pushed up, so that all the nucleus and its attached lower mucosa were fixed on the cork. 6. Fix the inner mucosa: pull out the cork and pull out the rectal mucosa (but do not let the cork out of the rectum). At the highest point of the mucosal sleeve that is scheduled to be removed, the inner layer of mucosa is additionally fixed in a row with a pin above the first row of pins (the spacing between the two rows of pins is generally about 2.5 cm). 7. Cut the inner layer of the mucous membrane and suture the two ends: 0.5cm below the upper row of pins, cut the inner layer of the mucosa, then suture the upper and lower edges of the mucosa with 3-0 gut, cut, sew, edge Pull out the upper row of pins until the loop is finished. 8. Remove the ring: Remove the cork and remove the ring. If there is bleeding, you can fill the needle. A hose with a Vaseline gauze placed in the rectum.

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