All rights reserved to APC - Dr. Sarmad Aji, FACS. Advanced Proctology Course for Physicians...

All rights reserved to APC - Dr. Sarmad Aji, FACS.

Advanced Proctology CourseAdvanced Proctology Course for Physicians for Physicians

Available January 1 , 2007 Available January 1 , 2007

Order Online at : Order Online at : www.APCourse.orgwww.APCourse.org

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.


Why should you set up a Why should you set up a proctology Unit in your office ?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.


The purpose of the APCourseThe 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


Who should purchase or attend this Who should purchase or attend this course ? 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


The 4 most common proctology The 4 most common proctology problems presented to Physiciansproblems presented to Physicians

HemorrhoidsAnal fissureAnal fistulaPilonidal cyst


Type of AnesthesiaType 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.


Avoiding ComplicationsAvoiding 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


Long term resultsLong term results

No rectal incontinence

No anal stenosis

No recurrence

The skin tags issue ( Normal function first, cosmetic concerns second )


Types of useful AnoscopesTypes 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



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



For IRC patients (Internal hemorrhoids stage 1, 2,

and early 3 patients) this is the best Anoscope available in the market.


The Ellman Surgitron UnitThe 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


The Redfield Infra Red CoagulatorThe 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.


The Valley Lab Ligasure UnitThe 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


The procedures room layoutThe 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


Advanced Proctology CourseAdvanced Proctology Course Available by online order at : www.APCourse.org

mailed in one week by priority mail

Available by mail order at : APCourse P. O. Box 1920 Clintwood, VA 24228

All rights reserved to APC - Dr. Sarmad Aji, FACS. Advanced Proctology Course for Physicians...

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