Download Atlas of Rectoscopy and Coloscopy by Prof. Dr. Peter Otto, Prof. Dr. Klaus Ewe (auth.) PDF

By Prof. Dr. Peter Otto, Prof. Dr. Klaus Ewe (auth.)

The first part of this paintings is dedicated to a attention of the sensible features of the proctoscopic exam and hence offers the symptoms for appearing a proctologic assessment, the data which may be received from the patient's scientific heritage, an instance of a preprinted info shape to be used within the recording of the physician's findings, the instruction and positioning of the sufferer, and the initial exam of the anus together with the electronic rectal exam. The tools had to practice proctoscopy are easy, and the elemental instruments are low-cost. The tools presently on hand don't fairly vary from one another other than in minor info. within the textual content, accordingly, now we have purely defined the prototype tools, and information about the professional­ posed merits of any specific tool may be bought from its manufac­ turer. The concluding element of the textual content describes how the proctoscopic and colonoscopic examinations are played. The atlas itself is a topographical stratification of a few of the ailments which could contain the perianal zone, the anus, and the adjoining parts of the big bowel in addition to their category in keeping with morphologic standards, for instance, inflammatory bowel ailments and tumors. on account that many pathologic findings within the rectum and sigmoid colon are similar to these within the top parts of the big bowel, a duplication of those proctoscopic and colonoscopic illustrations has been avoided.

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22). High-frequency diathermy instruments (Erbe, Tiibingen, FRG; Martin, Tuttlingen, FRG) offer a mixture of spark gap and conductive current. 34 Fig. 21. ). Fig. 22. ). Fig. 23. ). The same instrument is also available from ACMI, Machida, Wolf, and Storz. 3 Examination Technique The examination is conducted with the patient recumbent. For sigmoidoscopy some examiners also recommend the knee-elbow or knee-chest position. It is preferable to have two people conduct the examination with the assistant slowly introducing the instrument while observing the field through the teaching attachment (see Sect.

A knowledge of both basic types of sigmoid configuration (very often '1 and considerably less often r;) facilitates the straightening of the instrument and spares the patient much discomfort (Fig. 24). Display of the bowel is accomplished through air insufflation and rotation of the patient on the examining table. To avoid abdominal spasm, the amount of air insufflated should be held to a minimum; it is also very difficult to undo a loop formation when the colon is tightly filled with air. Partial stiffening for straightening of the instrument should be achieved in the sigmoid area through the use of a stiffening wire or through insertion of a 40-cm long plastic sheath over the bent colonoscope.

2 Magnification Attachments (Lumina, Hopkin's Optics) Even stronger magnification may be obtained with lens systems that can be inserted into the rectoscope. Special types of lens attachments are the Wolf operative device with a bayonet-form, angled optic that enlarges the view of the biopsy area and the Storz optical system using an angled biopsy forceps. 20 a ----=========-====~=======~ b c d ----~======================~ce:n ~===c:::=n e Fig. 9a--c. Hemorrhoid syringes and canulae. ). 10 Documentation by Photography (Fig.

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