EndoWorld PRO 2-2-E/03-2010 Proctology Proctology Approximately 50% of adults suffer from an anorectal disease and its related symptoms at least one time in their lives. The disease can be identified by reviewing the patient’s medical history thoroughly, thereby allowing a tentative diagnosis to be made. An inspection and rectal digital exploration are the obligatory preliminary medical examinations, which are then followed by instrumental diagnostic procedures. The correct indication for a method of treatment and operation can only be given once careful and precise proctological investigation has been carried out. A wide range of improvements in the techniques for inpatient and outpatient proctological operations in the last 2 decades, not to mention the innovations in accompanying diagnostic examinations, have led to much greater acceptance and satisfaction amongst the patients concerned. The most significant indications for a proctological examination are: • anal bleeding • skin changes in the anal region • pruritus • anal pain Many diagnoses can be reached upon inspection of the anal region. In this case, the detection of fissures, scar changes or fistula openings indicates a requirement for further examination using an ARNOLD fistula hook. After a digital examination, rectoscopy and proctoscopy are performed using rigid tubes. Depending on the findings and symptoms, various tube sizes can be used for proctoscopy and rectoscopy. A significant aspect of the day-to-day work in proctology includes diagnosing and treating hemorrhoidal complaints. Sclerotherapy and rubber band ligation can be implemented successfully in the treatment of hemorrhoidal diseases which are still in the early stages. A variety of ligation devices can be used for this purpose. Many of the instruments used in ligation treatment require the aid of an assistant, although this is generally not the case when suction ligation instruments with an integrated suction pump are applied. After use, the suction ligation instrument can be dismantled easily and the hygienic preparation performed efficiently. The hand instruments presented here for the diagnosis and treatment of proctological diseases are highly robust and easy to take care of. This guarantees a long service life. The metal and plastic parts can be prepared hygienically in the thermal disinfection device and sterilized in the autoclave. Dr. med. H. Meffle / Dr. med. J. Thoss Colo-proctological Clinic Sophienstrasse 39 70178 Stuttgart, Germany 2 3 Proctoscopy 24954 MORGAN Proctoscope Tube, outer diameter 24 mm, working length 6.5 cm, with obturator 24954 O 24960 Fiber Optic Light Carrier, with connector to fiber optic light cable 25195 ARNOLD Fistula Hook, total length 19 cm 24980 25220 25210 24980 MEFFLE/THOSS Ligature Working Attachment Cone for loading rings Rubber Ligature Ring, extra heavy, package of 100 Hemorrhoid Grasping Forceps, angled, for use with Ligature Working Attachment 24980 L Adaptor L KA RP F 24980 A 4 5 Rectoscopy 25211 NS Suction Ligature Instrument, for treatment of hemorrhoids, with integral vacuum-pump, suction opening size 10 mm, consisting of: 25211 A Ligature Attachment 25210 GA Handle with integral vacuum-pump 25211 KA Cone 25210 RP Ligature Rings, extra strong, package of 100, contents latex optional:: 25210 RL 24912 Rubber Ligature Ring, package of 100, latexfree HEINKEL Rectoscope Tube, outer diameter 20 mm, working length 20 cm, with obturator 24912 O Rectoscopy 24920 Illumination Head Unit, for HEINKEL Rectoscope Tubes, with fiber optic light transmission, LUER-Lock hub for rubber insufflation bulb, including glass window plug 24920 FK Optional: 40924 Rubber Insufflation Bulb, with detachable tube, with LUER-lock 34431 B c Rotating Biopsy Forceps, size 5 mm, length 43 cm, with medium spoon-shaped jaws 3.0 mm, single action jaws, consisting of: 33131 Metal Handle, without ratchet 33400 Outer Tube, insulated 34410 B Insert 6 7 Illumination KARL STORZ has developed a new cold light source, LED NOVA 100, for use in proctology, which is based on LED technology and has the following properties: • • • • • Lamp service life > 23 000 hours White light with 5 600 K color temperature No operating noise (as no fan is required) Suitable for all KARL STORZ standard light cables Compact, lightweight design 20 1610 01 KARL STORZ Cold Light Source LED NOVA 100, with one LED lamp and one KARL STORZ light outlet power supply: 230 VAC, 50/60 Hz consisting of: 20 1610 20 LED NOVA 100 400 A Power Cord 495 NL Fiberoptic Light Cable, diameter 3.5 mm, length 180 cm EndoWorld® www.karlstorz.com Gemeinschaftspraxis Dr. med. H. Meffle Specialist in internal medicine Dr. med. J. Thoss Surgical specialist Outpatient operations Beds available in Bethesda Hospital Karl Storz GmbH & Co. KG Mittelstraße 8, 78532 Tuttlingen, Germany Postfach 230, 78503 Tuttlingen, Germany Phone: +49 (0)74 61 708-0 Fax: +49 (0)7461 708-105 E-Mail: info@karlstorz.de www.karlstorz.com KARL STORZ Endoscopy-America, Inc. 2151 East Grand Avenue El Segundo, CA 90245-5017, USA Phone: +1 424 218-8100, +1 800 421-0837 Fax: +1 424 218-8526 E-Mail: info@ksea.com EW PRO 2-2-E/03-2010 Sophienstrasse 39 70178 Stuttgart (city center), Germany Phone: +49 (0)711 - 62 61 22 Fax: +49 (0)711 - 6 15 95 15