Rectum and Anus

Freeman, David E.

doi:10.1016/b978-0-323-48420-6.00039-9

Cited by 1 publication

(3 citation statements)

References 21 publications

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“…36 A rectal laceration can induce fistula formation, cellulitis, peritonitis, 17,37 retroperitoneal faecal impaction or perirectal abscess. 24 In our study, full and partial thickness lacerations had occurred retroperitoneally in the rectal ampulla when the axis of trocar insertion was parallel to the long axis of the rectum. Although imperfect square stances of some cadavers could have affected portal placement and thus rectal damage, the most plausible explanation could be the position and shape of the rectal ampulla.…”

Section: Discussionmentioning

confidence: 52%

“…Penetration of gastrointestinal viscera classify the surgical wound as clean contaminated to contaminated, increasing the risk of surgical site infection 36 . A rectal laceration can induce fistula formation, cellulitis, peritonitis, 17,37 retroperitoneal faecal impaction or perirectal abscess 24 . In our study, full and partial thickness lacerations had occurred retroperitoneally in the rectal ampulla when the axis of trocar insertion was parallel to the long axis of the rectum.…”

Section: Discussionmentioning

confidence: 56%

“…Grade III and IV which are the most amenable to surgical repair were reported to occur most often along the dorsolateral wall at a mean length from the external anal sphincter of 31 cm for grade III and 26 cm for grade IV 22 . Closure of rectal tears can be performed by direct suturing per rectum blindly 21–23 with long handle instruments 24 or after sphincterotomy and rectal prolapse 25 . Direct suturing can also be performed through a caudal midline celiotomy under general anaesthesia 20,23,25,26 .…”

Section: Discussionmentioning

confidence: 99%

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Retroperitoneoscopy of the presacral space in horses: Surgical access and anatomy

Meurice,

Pujol,

De Fourmestraux

et al. 2023

Equine Veterinary Journal

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BackgroundSurgical approaches to the equine rectum and perirectal area are described in the literature. However, surgeries in this region can be challenging.ObjectiveTo describe the surgical anatomy of the presacral space and to evaluate its access using a retroperitoneoscopic approach.Study designEx vivo experiment.MethodsPreliminary dissections were performed in two cadavers to define the boundaries of the presacral space and to determine portal locations for the surgical approach. After that, nine cadavers were used for experimental presacral retroperitoneoscopic procedure in a standing position. Following retroperitoneoscopy, cadavers were dissected to confirm the anatomical structures observed during the endoscopic procedures, to control the location of each portal and to record iatrogenic trauma.ResultsThe presacral space was bordered by the vertebral column from the ventral aspect of lumbosacral promontorium to the first coccygeal vertebra dorsally and by the presacral fascia and peritoneum ventrally. Lateral limits were composed of the sacrosciatic ligament and transversalis fascia. Cranial and caudal borders were composed of the peritoneum and coccygeal and levator ani muscles respectively. Retroperitoneoscopic portals were placed between the external anal sphincter and semimembranosus muscles and between the base of the tail and the external anal sphincter muscle through the anococcygeal fascia to enter the space by its caudal border. The retroperitoneal space was reached in all cases and the dorsal and lateral aspects of the rectum were visualised after creation of a working space.Main limitationsUse of cadaver specimens do not permit to evaluate the tolerance in living animals and the surgical complications such as rectal damage, haemorrhage and infection.ConclusionThis study provides an anatomical description and surgical access of the presacral space with a minimal invasive approach. Retroperitoneoscopy allows access to the rectum and the dorsal aspect of the pelvis.

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Section: Discussionmentioning

confidence: 52%