Twenty patients with benign anal strictures and five patients with mucosal ectropion were treated with island flap anoplasty. U-shaped or diamond-shaped islands of perianal skin were created, without undermining, and advanced into the anal canal to remedy the stricture or site of ectropion. Over a postoperative follow-up period that averaged 19 months, 16 patients judged their clinical results as excellent and 7 as good. There were two failures. In all patients the skin flaps survived, even in the elderly patients. Island flap anoplasty is a simple, effective alternative to other forms of anoplasty such as Y-V advancement or S-plasty.

Muscle fragment welding is a safe, readily available, and highly effective method of controlling massive presacral bleeding.

No abstract

A four year experience with the adaptation of the flexible fiberoptic endoscope to the intraoperative environment is presented in 30 patients. The technique of intraoperative endoscopy was utilized in a wide variety of difficult gastrointestinal surgical problems to include the location of the site and cause of bleeding of obscure etiology; resolution of intraoperative dilemmas without the necessity of opening abdominal viscera; resection of lesions during operations conducted for other pathological processes; and enhancement of diagnosis at laparotomy. There were no complications from the use of intraoperative endoscopy and the technique was beneficial in 28 of the 30 patients (93.3%). Limiting factors in the full utilization of the endoscope at celiotomy were dense adhesions with a shortened mesentery and massive hemorrhage with blood obscuring the intestinal lumen.