Helicectomy (closed)
Excisio closed hexectomyNaal hemorhoidectomy-closed technique, also known as ferguson's closed helicectomy, was systematically described and promoted by ferguson in 1959。
In response to the core issue of severe pain and long healing cycles following the traditional open surgery, the technique introduces an innovative concept of “one-time suture”, which, while ensuring a cure, significantly increases the patient's post-operative experience and recovery rate, through a close-up of anatomy and creation. After decades of clinical validation, it has become one of the classics in the field of helium surgery that goes hand in hand with open surgery, especially in the case of well-defined inner and mixed helium. Based on ferguson's original statement and authoritative teaching materials, such as " coronary surgery " , this paper will provide a systematic account of the specific surgical steps and operational points。
Prepare for surgery
Anaesthesia is usually anaesthesia, anaesthesia of a trachea or a general anesthesia。
Positions: the most common quarries can also be used for detours。
Sterilization and plastering: routine vaginal and anal rectum disinfection。
Anal amplification: after a successful anaesthesia, the anal amplification is carried out gently by the performer, which can accommodate 4-6 fingers and fully expose the surgical field。
Cut off the helium
An elliptical or diamond-shaped cut-off along a marking line; first, the skin and mucous membrane are severed with an tissue shear or an electric knife, and the muscular vein is removed completely from the inside of its inner slab surface。
This step is the key to the operation and it is important to ensure that it is carried out at the correct anatomical level, with the complete removal of the stove and the avoidance of damage to the deep sphincter。
Handle the nuclei
Up to the top of the helium core (tea), it is sewn through the vertebrae with absorbible stitches, and the bleeding is completely stopped。
It's closed
After a complete stoppage of the surface, a continuous or intermittent suture begins at the top of the cut (inside the anal tube) and continues to be sewn to the bottom of the cut (anal skin)。
Note: sutures should consist of partial mucous sub-organism to remove the dead, but it is not appropriate to be too deep to sequester the staves. Ultimately, the openings are fully aligned, forming a thready stitch。
Handle other helium cores
Repeat the above steps and deal with other herrings requiring removal. Similarly, there must be sufficient mucous bridges between the helium removed to prevent anal narrowness。
Parks surgery
Ferguson's surgery is completely closed, while parks' surgery is partial closed surgery, with similar procedures, the main difference being that when it is closed, parks' surgery is part of a mucous face above the closed denture, but the austic side is not stitched. If it is considered to have a higher risk of haemorrhaging or a greater extent of removal, a small lead bar (e. G. Rubber blades) may be temporarily placed in a partially sutureded cavity from the open anal tube and removed 24-48 hours after the operation。
Hawkins at, davis br, bhama ar, fang sh, dawes aj, feingold dl, lightner al, paquette im; clinical practice commissions of the american society of cThe american society of cI don't know, i don't knowOlon rectum. 2024 may 1; 67(5): 614-623. Doi:10. 1097/dcr. 0000000003276. Epub 2024 jan. Pmd: 38294832. Pillant-le moult h, aubert m, de parades v. Classical treatment of hemorrorhoids. J viscer surg. 2015; 152 (2, suppl.): s3-s9doi: 10. 1016/j. J. Jviscsurg. 2014. 09. 012 j. A. Ferguson, et al. The closed technique of hemoradicto surgery, 70 (3) (1971), pp. 480-484 a. G. Parks. The surgical treatment of habitat, br sirg, (1956)
