Sigmoidoscopy This chapter deals with the performance of rigid sigmoidoscopy. Flexible fiberoptic sigmoidoscopy is performed essentially as detailed in Chapter 78, except that the distance to be traversed is not…

Transsacral Approach to Rectal Lesions The transsacral approach is most commonly used for resection of benign retrorectal tumors or for removal of sessile polyps that cannot be reached by other…

Drainage of Perirectal Abscesses, Surgery for Anal Fistulas, and Lateral Internal Sphincterotomy Perirectal abscesses begin as infections in the anal glands, which empty into the anal crypts. From the anal…

Hemorrhoidectomy Hemorrhoids are dilated venous cushions that lie just inside the anal verge. Almost universally present in adults in Western cultures, their etiology is still a matter of speculation. Chronic…

Pilonidal Cystectomy Whether pilonidal cysts are congenital or acquired lesions remains a topic of debate. The frequent appearance of an epithelialized tract in the midline, leading to a cyst that…

Sentinel Node Biopsy for Melanoma of Trunk; Wide Local Excision Peter R. Jochimsen Sentinel lymph node determination in patients with truncal melanoma presents its own peculiar problems because of the…

Superficial Groin Dissection Laura A. Adam Neal W. Wilkinson A variety of terms are used to describe lymphadenectomy of the inguinal and ilio-inguinal region. In this chapter, we will use…

Laparoscopic Inguinal Hernia Repair Laparoscopic inguinal hernia repair takes a totally different approach from open repair. It is most nearly analogous to a preperitoneal open repair, sometimes termed the Nyhus…

Repair of Inguinal and Femoral Hernias The muscular and aponeurotic layers of the abdominal wall form a strong continuous barrier that supports and contains the intraabdominal viscera. This continuous barrier…