Download Ambulatory Colorectal Surgery by Laurence R. Sands, Dana R. Sands PDF

By Laurence R. Sands, Dana R. Sands

A nice single-source reference encompassing all facets of colorectal surgical procedure, Ambulatory Colorectal Surgery covers topics:

  • patient evaluation
  • anorectal anatomy
  • anorectal ultrasound
  • biofeedback techniques
  • fecal incontinence assessment and management
  • wound management
  • stoma management
  • pain management
  • anal fissure
  • anorectal abscess
  • proctalgia fugax

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Extra resources for Ambulatory Colorectal Surgery

Example text

The EAS is innervated on each side by the inferior rectal branch (S2, S3) of the pudendal nerve and the perineal branch of S4. Despite the fact that the PR and EAS have somewhat different innervations, these muscles seem to act as an indivisible unit. After unilateral transection of a pudendal nerve, the EAS function is still preserved due to the crossover of the fibers at the spinal cord level. Sensory Innervation The upper anal canal contains a rich profusion of both free and organized sensory nerve−endings, especially in the vicinity of the anal valves.

The first sensation the patient perceives is recorded as the first sensation (minimal sensory volume) and the mean intraballoon pressure is noted at this volume. The balloon is continuously filled until the maximum tolerable volume is reached. This volume is recorded again with the intraballoon pressure. Using theses variables, the rectal compliance can be calculated as ( V/ P) (29). Continuous Pull-Through Method In the continuous pull-through method, the equipment includes a motor that results in automated continuous withdrawal of the catheter rather than manually pulling it out.

By obtaining 20 different measurements in each half of the sphincter, fiber density is calculated as the mean number of single muscle fiber action potentials in each position. 6. The neuromuscular jitter is the time interval between two consecutive action potentials in a single motor unit detected in the uptake area of a single-fiber EMG (44,48,49). Although this parameter is a reflection of the variability of impulse transmission across the neuromuscular end plate, its clinical relevance is unclear.

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