1. Advanced Proctology Course for Physicians Available January 1 , Order Online at :
A collective teaching experience of 5000 ambulatory proctology cases done under local Anesthesia in digital media format showing more than 200 live procedures and teaching the most advanced , yet , simplified and innovative techniques in the treatment of the four most common surgical proctology cases , in the office with no or minimal pain and excellent results.
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2. Why should you set up a proctology Unit in your office ?
Almost 50% of people will develop one of the four proctology disorders discussed in this course.
New equipments and techniques have radically changed the traditional painful treatments.
These techniques are very safe, effective and easy to learn.
The cost of establishing a proctology unit in your office is
minimal compared to its financial rewards.
The number of physicians with interest in proctology is small which makes the potential for a very busy practice for first comers much higher.
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3. The purpose of the APCourse
To acquire the skills and “the know how(s)” to treat most proctology presentations in your office, under local anesthesia, using safe, painless and effective equipments and techniques that you could learn easily from this course with excellent short and long terms results.
To learn how to set up the procedures room layout, equipments, accessories, patient and staff positions and medications.
To learn appropriate administration of local anesthesia in proctology patients
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4. Who should purchase or attend this course ?
Surgeons (General Surgeons , Colorectal Surgeons ,
Surgical Residents )
Primary Care Physician ( Family Practitioners ,
Internists, Gastroenterologists,
Interested Gynecologists and
Dermatologists )
Walk in Clinics staff
Ambulatory Surgery Centers Staff
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5. The 4 most common proctology problems presented to Physicians
Hemorrhoids
Anal fissure
Anal fistula
Pilonidal cyst
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6. Type of Anesthesia Local Anesthesia solution mix includes :
Lidocain2%, Marcain 0.5%, Sodium Bicarbonate, Adrenaline 1/1000.
Local Anesthesia solution dispenser :
Set at 40 ml/min rate , Fresh mix daily, change needle between patients
Local Anesthesia techniques :
Complete Perianal Block + Bilateral Pudendal Block for all Anorectal cases
Complete Pericystic Block for Pilonidal Cyst patients
Safe Sedation during the case :
Versed, Demerol, Fentanyl, Propofol, Diclofenac, Oxygen, full emergency
cart, monitor BP,P, O2 sat, EKG trace, have all Antitodes ready.
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7. Avoiding Complications
Good sedation and monitoring
Good local anesthesia
Sterility and antibiotics
Appropriate Anoscopes
Good lighting
Minimal manipulation principle
No tension principle
Minimal use of sutures
Good hemostasis
No rectal packing
Good follow up
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8. Long term results No rectal incontinence No anal stenosis
No recurrence
The skin tags issue ( Normal function first, cosmetic concerns second )
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9. Types of useful Anoscopes
For the LIS ( Anal Fissure patients ) this Anoscope is best, the slim blades and ease of application in stenotic anal canal and the ability to open it in a controlled fashion are key factors in its success
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10. Types of useful Anoscopes
For Ligasure patients (advanced hemorrhoids) this Anoscope is best, its large diameter helps prevent post op stenosis, its shape and smooth surface helps in its easy use.
Excellent for External hemorrhoids excision
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11. Types of useful Anoscopes
For IRC patients
(Internal hemorrhoids stage 1, 2, and early 3 patients) this is the best Anoscope available in the market.
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12. The Ellman Surgitron Unit
For most proctology cases this RF unit is pivotal and a must for any proctology practice.
This is the Ellman’s latest and improved Surgitron Unit
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13. The Redfield Infra Red Coagulator
The disposable plastic sheaths are the only disposable parts of the IRC equipment, they come individually packaged, easy to slide on the light guide and easy to clean in between applications.
The IRC unit is essential in the proctology clinic, it is safe, effective and affordable.
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14. The Valley Lab Ligasure Unit
For most advanced hemorrhoids I found the Ligasure to be a wonderful surgical tool especially after we learned how to properly use it in Proctology
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15. The procedures room layout
( from right to left to center)
The Proctology equipments cart
The monitors and meds cart
TV screen for surgical field camera
The Diode laser
The Physician’s chair
The instruments table
The light
The procedure table
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16. Advanced Proctology Course
Available by online order at :
mailed in one week by priority mail
Available by mail order at :
APCourse
P. O. Box
Clintwood, VA
All rights reserved to APC - Dr. Sarmad Aji, FACS.