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Acquired anorectal disorders: Prolapse, fistula, and hemorrhoids
Published in Mark Davenport, James D. Geiger, Nigel J. Hall, Steven S. Rothenberg, Operative Pediatric Surgery, 2020
The lithotomy position is used. Rigid sigmoidoscopy is performed to exclude other diagnoses; rectal polyp may mimic prolapse. A Park's or Killian's retractor is placed in the anal canal. Submucosal injection above the dentate line is performed in three positions (away from the posterior midline), raising a visible bleb (Figure 50.1).
Hirschsprung disease: Definitive repair with transanal pull-through
Published in Alejandra Vilanova-Sánchez, Marc A. Levitt, Pediatric Colorectal and Pelvic Reconstructive Surgery, 2020
Jacob C. Langer, Chris Westgarth-Taylor, Victor Etwire, Stuart Hosie
The patient can be positioned in either the prone or the lithotomy position, according to the surgeon's preference. Prone positioning provides better exposure of the anus, but the patient must have a total body prep in order to do the preliminary leveling biopsies in the supine position prior to flipping into prone position. The advantage of the lithotomy position is that the child does not require a total body prep, and it is easier to do the leveling biopsies and any additional colonic mobilization.
Bladder cancer: superficial
Published in J Kellogg Parsons, E James Wright, The Brady Urology Manual, 2019
Lithotomy position (complications and prevention): Sciatic nerve injury: inability to flex knee – avoid excessive external hip rotationFemoral nerve injury: inability to flex hip or extend knee – avoid excessive external hip rotationCommon peroneal nerve: foot drop – avoid compression of lateral knee at the fibular headObturator reflex: stimulated by electrocautery, especially along lateral bladder wall.
Postoperative peroneal nerve palsy after ENT surgery: A case report
Published in Acta Oto-Laryngologica Case Reports, 2023
Yangzhou Huang, Daobin Zhu, Qing Ye, Minghe Lin
Postoperative peroneal nerve palsy is more common following spinal and lower extremity surgeries. Since it mostly occurs in the lithotomy position, it occasionally occurs after colorectal and gynecological surgery and is rare in other surgeries [7]. Postoperative peroneal nerve palsy is the most common lower extremity position-related peripheral neuropathy, mainly manifesting as decreased or lost sensation in the anterolateral and dorsum of the lower extremity, foot drop, and gait disturbance [8]. The lithotomy position is a non-physiological position. However, both lower limbs are in a neutral position (physiological position) in the supine position. If the lower limbs are not immobilized properly, there may be a pathological position in which the lower limbs are excessively abducted or one leg compresses the other leg. The peroneal nerve is prone to compression and traction.
Clearance of HR-HPV within one year after focused ultrasound or loop electrosurgical excision procedure in patients with HSIL under 30
Published in International Journal of Hyperthermia, 2022
Yi Qin, Qing Li, Xunyu Ke, Yan Zhang, Xiaoling Shen, Wenping Wang, Qiuling Shi, Chengzhi Li
FUS group: FUS treatment was performed using the Model-CZF Ultrasound Therapeutic Device (Chongqing Haifu Medical Technology Co., Ltd, Chongqing, China) with the therapeutic power of 3.5–4.5 W and working frequency of 9.8 MHz and impulse of 1000 Hz. Certified doctors trained in FUS treatment technology performed the procedure. Patients were in the lithotomy position. Their cervixes were disinfected and fully exposed with a speculum. The surface of the cervix was coated with ultrasound coupling gel prior to treatment. The treatment probe was placed in close contact with the cervix and moved around continuously with the cervix as the center and against the skin over the diseased area with 2 mm more of healthy tissue at a speed of 5–10 mm/s, using the uniform linear or circular irradiation mode. The treatment lasted until the lesion presented as a depressed area and the external cervical aperture was moderately introverted.
Comparison between radiofrequency ablation combined with mifepristone and radiofrequency ablation for large uterine fibroids
Published in International Journal of Hyperthermia, 2021
Ning Hai, Qingxiang Hou, Xiangping Dong, Ruijun Guo
In the combined treatment, RFA was performed one month after the withdrawal of mifepristone. The radiofrequency generator used in this study (Ban Bian Tian Medical Apparatus and Instruments Company, Xi An City, China) was operated at 50 Hz with a transmitting power of 300 W. The radiofrequency electrode used (Ban Bian Tian Medical Apparatus and Instruments Company) was 35 cm long with a 1.5 cm exposed distal tip. The output energy was set at 30–50 W.A. The procedure was performed under intravenous conscious sedation. Patients were placed in the lithotomy position. In all the cases, a biopsy of the lesion was performed with an 18-gauge core needle for pathological diagnosis before ablation. A radiofrequency electrode was introduced transvaginally under transabdominal ultrasound guidance. The electrode was penetrated through the endometrium and was inserted into the lesion. Once the hyperechogenic signal covered nearly 80–90% of the entire lesion on real-time ultrasound, the ablation was discontinued [16]. Absence of vascularization was confirmed at the end by contrast-enhanced ultrasound. All patients received oral antibiotic prophylaxis for 3 d after the treatment. The doctors who performed RFA were blinded to mifepristone use.