No abstract

We concluded that the incidence of punctures in gloves during surgical procedures was high, and occurred mostly with surgeons.

A case of diagnostic difficulty facing the patient with colonic polyposis secondary to Peutz–Jeghers syndrome, but without family history and pathognomonic clinical features of the disease, is illustrated. The exams, including biopsy, led to diagnostic uncertainty and the definitive diagnosis was characterized in therapeutic of exception.

. Atualmente através do desenvolvimento tecnológico com melhora na qualidade das imagens, nos procedimentos diagnósti-cos e terapêuticos como biópsias, polipectomias, mucosectomias, tatuagem de lesões suspeitas para posterior ressecção ou revisão endoscópica, coloração de mucosa a fim de identificar limites de lesão, magnificação de superfícies para melhor caracterização 1,2,3 , este se tornou o método principal na busca do diagnóstico das doenças colorretais, principalmente tumores e suas lesões precursoras, os pólipos 1,3,4 . Considerando isso, o uso da colonoscopia tem aumentado no decorrer dos anos acompanhado pelo aumento da incidência de complicações 5 , apesar de ser exame invasivo seguro 1 . Mesmo com este aumento, a literatura considera que o risco é menor que o ganho que o exame traz na investigação de tumores colorretais e lesões precursoras 5,6 . Porém a literatura é, por vezes, benevolente com as complicações menos

Introduction Hemorrhoidal disease is associated with the theory of arterial blood hyperflow causing swellings in hemorrhoids and, consequently, hyperplasia and venous congestion. The technique helps to promote the obliteration of the terminals of the superior rectal artery branches without the need for anesthesia by electrofulguration with diode fiber LASER. The objective of this study is to describe the results of 55 patients with hemorrhoidal disease treated by the Hemorrhoidal LASER Procedure technique. Method Without the need of anesthesia, terminal arterioles of the upper rectal artery are identified by a Doppler transducer (20 MHz probe 3 mm) placed on a specially designed proctoscope. After identification, it promotes arteriolar electrofulguration at 980 nm fiber laser diode, causing interruption of hemorrhoidal flow. This procedure is repeated circumferentially, following the clockwise positions. Results Between 2011 and 2014, 55 patients underwent the Hemorrhoidal LASER Procedure technique for hemorrhoidal disease grades I, II and III. There was no need for anesthesia and only two patients required sedation for the procedure. The overall satisfaction rate was 89%, with symptom resolution in 84% and a decrease of at least one grade in hemorrhoidal disease in 80% of cases. Conclusion Hemorrhoidal LASER Procedure is a painless outpatient technique that does not require anesthesia, in addition to being safe and easy to perform. It is effective in reducing symptoms and complications of the hemorrhoidal disease grades I and II, with high satisfaction rates.