Rubber Banding Research Articles

A Comparative Study Between Open Hemorrhoidectomy and Rubber Band Ligation for Second Degree Hemorrhoids: A Prospective Randomized Control Study

Background: The symptoms of hemorrhoids has a wide spectrum that ranges from bleeding per rectum, itching, prolapse of the hemorrhoidal cushions, thrombosis leading to pain and discomfort, incontinence especially of fluids and mucous discharge. But for surgical management, hemorrhoidectomy is more sustainable in symptom control and has been considered as gold standard. Rubber band ligation has been the most popular amongst non-surgical interventions because of its effectiveness, minimal complication rate and shorter recover period compared to operative procedures. The present study aimed at determining the efficacy and safety of rubber banding ligation procedure versus the standard hemorrhoidectomy for second degree hemorrhoids. Methods: A prospective randomised comparative study was conducted at Department of Surgery, Indira Gandhi Medical College Hospital, Puducherry for 18 months after getting institutional ethical committee clearance. A total no. of 74 cases of 2nd degree hemorrhoids were divided into two groups A (open hemorrhoidectomy) and B (banding) by simple randomization technique of 37 each. A detailed history & examination including per rectal and Proctoscopy examination was done of each patient and the data entered in the pro forma. The description of data was expressed in the form of mean±SD for quantitative data, while frequency and proportion for qualitative data. Results: Totally male patients represented 57% compared to female with 43% 78% of the patients who underwent banding did not have any immediate post-operative complications while only 4 persons reported pain and bleeding post-operatively compared to 12 patients reporting bleeding and 11 patients reporting pain after hemorrhoidectomy. The duration of hospital stay post procedures was found to be lesser in banding group compared to hemorrhoidectomy group with p value being statistically highly significant (p<0.001). Conclusion: Rubber band ligation is very simple, safe, effective outpatient procedure that can be performed for grade II hemorrhoids. It generally requires fewer expertise and instruments. It is found to improve the symptoms of the patients and making them sustain a good quality of life since it has minimal complications.

Combined rubber band ligation with 3% polidocanol foam sclerotherapy (ScleroBanding) for the treatment of second‐degree haemorrhoidal disease: a video vignette

Sclerotherapy (SCL) and rubber banding ligation (RBL) are recognised options in the treatment of second degree haemorrhoidal disease (HD) [1]. They are low-risk, inexpensive, repeatable and can be performed as office-based procedures [2][3]. The simultaneous combined use of both techniques may improve symptom control and long-term results [4][5]. However, no studies in the literature describe the use of 3% polidocanol foam as a sclerotizing agent in combination.

Therapeutic effect of endoscopic variceal ligation plus sclerotherapy for esophageal varices with liver cirrhosis: a randomized controlled trial

Objective To investigate the safety and efficacy of endoscopic varices ligation (EVL) plus endoscopic varices sclerotherapy (EVS) for esophageal varices hemorrhage in patients with liver cirrhosis. Methods Fifty-two liver cirrhosis patients with esophageal varices bleeding were randomly divided into EVL group (n=24) and EVLS group (n=28) according to random numbers generated by computer after first EVL. The EVL group continued undergoing EVL, and the EVLS group was treated by EVS. The interval of treatment was 2 weeks till varices disappeared. All patients were followed up for 18 months with endoscopy and endoscopic ultrasonography (EUS). The efficacy, changes of esophageal varices and perforating veins, varices recurrence and rebleeding were observed. Results There was no significant difference of complete cure rate between EVLS group and EVL group[67.9% (19/28) VS 62.5% (15/24), P>0.05]. The mean session of treatment (2.68±1.0 VS 1.83±0.7, P 0.05], and the varices recurrence rate was higher in EVL group than that in EVLS group[77.3% (17/22) VS 44.0% (11/25), P<0.05]. Child-Pugh class B patients in EVL group had a higher varices recurrence rate compared to that in EVLS group[75.0% (9/12) VS 31.5% (5/16), P<0.05]. Endoscopic recurrences occurred in patients with non-occlusive perforating veins. Conclusion EVL plus EVS sequential procedure is safe and effective for treatment of esophageal varices hemorrhage, especially for Child-Pugh class B patients. Perforating veins may play a key role in the development of esophageal varices and recurrence after endoscopic therapy. EUS findings can direct the endoscopic therapy and predict the variceal recurrence. Key words: Esophageal varices; Endoscopic rubber banding for esophageal varices; Sclerotherapy for esophageal varices; Endoscopic ultrasonography

Stapled hemorrhoidopexy versus Milligan-Morgan haemorrhoidectomy: a paradigm shift in the management of 3rd and 4th degree hemorrhoids

Background: Hemorrhoids being a common anorectal problem with its well known morbidity and complications is treated since long by conservative measures, injection sclerotherapy or rubber banding for 1st and 2nd degree and by open Miligan Morgan hemorrhoidectomy or closed Fergusson hemorrhoidectomy for 3rd and 4th degree. However, since 1998, the adoption of Stapled Hemorrhoidopexy has proved over time to be a better alternative in terms of lesser postoperative complication and an overall patient satisfaction.Methods: A prospective study conducted on 114 patients at Department of General Surgery, Kalinga institute of Medical Sciences, Bhubaneswar, Odisha from May 2014 to December 2016.Results: Our study showed stapled hemorrhoidopexy, significantly reduced the time taken for the operative procedure (p &lt;0.001), post operative pain (p &lt;0.01), hospital stay along with early return to work and a better patient satisfaction.Conclusions: Stapled hemorrhoidopexy is an effective alternative to open Miligan-Morgan procedure in treating 3rd and 4th degree hemorrhoids, in terms of lesser time taken for the operative procedure, post operative pain, use of analgesics, hospital stay and early return to work, better post operative patient’s satisfaction and reduced procedure related complication.

Activity Duration Analysis: Discrete-Time Approach for Recurrent Events, Competing Risks, and Multiple States

Most existing activity-based travel demand models are typically implemented on a tour-based microsimulation framework. Two approaches are available to describe people’s daily decision-making processes on activity and travel in the activity-based model framework: rubber banding and growing scheduling. The growing-scheduling approach requires a series of linked dynamic discrete choices of activity episodes, locations, and travel modes to build incrementally an entire day’s activity-travel patterns for individuals in households. To incorporate explicitly time dependencies into activity episode choice and duration, a hazard-based duration model in a discrete-time framework is introduced; this framework is essentially the same as a discrete choice model with temporal dummies as the simplest form of dynamic discrete choice models. In the application of the discrete–time duration model to activity duration analysis, complex situations of activity-travel data are considered; these include multiple states of origin activity, competing risks of destination activity, and a multilevel structure for recurrent activity episodes within individuals. In addition, a circular, or periodic, variable is introduced as a combination of sine and cosine to model time-of-day effects.

고무밴드 결속재가 조경수목 이식 후 뿌리발달에 미치는 영향 - 소나무류를 대상으로 -

This study conducted an experiment to clarify the effect of rubber bands used as a root connector during the process of transplanting landscape trees on the development of the root system and the rooting process. The research period was four years, from April 2007 to April 2011, and the test conducted for this study was performed at the experimental field located at 398-2 Bangdong-ri, Sacheon-myeon, Gangneung-si, Gangwon-do. Twenty 15-year-old Pinus densiflora Siebold & Zucc. with good growth conditions were harvested and transplanted from the forest in Jebi-ri, Gujeong-myeon, Gangneung-si, Gangwon-do for the field experiment. A completely randomized design was applied for plot design, with 10 pines without rubber bands and 10 pines with rubber bands. Pinus densiflora for. multicaulis Uyeki was selected as the official tree of the pot test and was planted in a transparent pot to observe the development of the root system. A completely randomized design was applied for plot design, with 3 pines without rubber bands and 3 pines with rubber bands. The results of this research on the effect of rubber bands used as a root connector on root system development and the rooting process are as follows. 1. The rate of height growth in the field test was 4.1% lower in the trees with rubber bands when compared to trees without rubber bands. Trees with rubber bands were 4.2% wider than those without rubber bands in root diameter. The chlorophyll content was 6.8% higher in trees without rubber bands, but the rate of height growth, root diameter, and chlorophyll content were not significantly correlated. 2. In the comparison of fresh root weight in the field test, trees with rubber banding had roots weighing 1,740.0kg and those without rubber bands had roots weighing 1,433.3kg. Root dry weight was 522.3g in trees with rubber bands and 450.0g in those without rubber bands, but showed no significant difference depending on whether the rubber band was attached. 3. In a comparison of root number between surfaces touching and not touching the rubber band in trees with rubber banding, the surface touching the rubber band was observed to have more roots growing, the difference of which was deemed significant. 4. The shoot growth rate in the pot test was 1.1% higher in trees without rubber bands when compared with trees with rubber bands. The chlorophyll content was 0.02 higher in trees with rubber bands but the difference was not significant. 5. In the pot test, no significance was found in comparison of root number, root length, and root dry weight in trees with and without rubber bands. These test results imply that removing rubber bands as a connector does not present any significant effects on the ground growth or root development of transplanted pine trees. As it is shown that surface touching rubber bands grow more roots in trees with rubber bands, more active related research must be undertaken.

Quantitative evaluation of three-dimensional reconstruction accuracy of edentulous models in centric relation

To reconstruct the centric relation of upper and lower edentulous dental models with two methods, to compare the reconstruction accuracy of the vertical and horizontal distance, and to provide some references to computer aided design and computer aided manufacture for complete denture. Dental models and rims made from five edentulous patients in clinical were obtained.Each model was stocked with 10 identical size positioning cylinders (20 cylinders on each pair models) on 5 side-surfaces of basement. Twelve center point pairs were paired between upper and lower models from 20 cylinder bottoms. The vertical and horizontal distances of 12 center point pairs were regarded as the evaluation items. Firstly, upper and lower models and rims were scanned separately. Then, models and rims (fixed in centric relation respectively with positioning articulator and rubber banding) were scanned.In software, all the data were registered to reconstruct centric relation based on common region. Digital models were measured with software tools, and real models were measured with a contact measurement arm. The differences of the homologous items between two methods were analyzed with paired-t test. The vertical distance errors for dental articulator positioning method was (0.356 ± 0.200) mm and that of the rubber band method was (0.382 ± 0.299) mm, and paired-t test between the two methods showed no significant differences (P > 0.05). The horizontal errors were (0.010 ± 0.411) mm and (0.104 ± 0.476) mm, and paired-t test showed significant differences (P < 0.05). Comparing with rubber band method, dental articulator positioning can significantly increases three-dimensional reconstruction accuracy of edentulous jaw gypsum models' horizontal relation.

High macro rubber band ligature

PurposeThe goal of a rubber band ligature is to promote fibrosis of the submucosa with subsequent fixation of the anal epithelium to the underlying sphincter. Following this principle, a new technique of ligature was developed based on two aspects:1.macro banding: to have a better fibrosis and fixation by banding a bigger volume of mucosa and2.higher ligature: to have this fixation at the origin of the hemorrhoidal cushion displacement. Methods1634 patients with internal hemorrhoidal disease grade II or III were treated by the technique called high macro rubber band. There was no distinction as to age, gender or race. To perform this technique a new hemorrhoidal device was specially designed with a larger diameter and a bigger capacity for mucosal volume aspiration. It is recommended to utilize a longer and wider anoscope to obtain a better view of the anal canal, which will facilitate the injection of submucosa higher in the anal canal and the insertion of the rubber band device. The hemorrhoidal cushion must be banded higher in the anal canal (4cm above the pectinate line). It is preferable to treat all the hemorrhoids in one single session (maximum of three areas banded). ResultsThe analysis was retrospective without any comparison with conventional banding. The period of evaluation extended from one to twelve years. The analysis of the results showed perianal edema in 1.6% of the patients, immediate tenesmus in 0.8%, intense pain (need for parenteral analgesia) in 1.6%, urinary retention in 0.1% of the patients and a symptomatic recurrence rate of 4.2%. All patients with symptomatic recurrence were treated with a new session of macro rubber banding. None of the patients developed anal or rectal sepsis. Small post-ligature bleeding was observed only in 0.8% of the patients. ConclusionsThe high macro rubber banding technique represents an alternative method for the treatment of hemorrhoidal disease grades II or III, with good results at a low cost. The analysis of the observed results showed a small incidence of minor complications, with a high index of symptomatic relief.

Dieulafoy lesion endoscopically rubber banded, with further severe haematemesis requiring emergency laparotomy – Case report

Dieulafoy lesion is a rare cause of massive gastrointestinal haemorrhage that can be fatal. We report a case of a sixty-year-old lady who presented to the emergency department with haematemesis and melaena. During oesophagogastroduodenoscopy (OGD), an active bleeding vessel was seen on the lesser curvature of the stomach, near the gastro-oesophageal junction and a diagnosis of Dieulafoy's lesion made. The lesion was managed with the application of two rubber bands. Our patient re-presented to the emergency department ten days later with severe haematemesis requiring an emergency laparotomy.A search of the entire English literature using PubMed with the phrase ‘Dieulafoy’ has been performed. Papers were reviewed in relation to management of this lesion with rubber banding via endoscopy. The current available haemostatic methods are described.

Natural history of anterior mucosal prolapse.

Case notes of 250 patients (M:F, 1:2.7; age 48.7 +/- 16.5 years) in whom anterior mucosal prolapse had been diagnosed, at one hospital between 1974 and 1976, were reviewed. The commonest symptoms were bleeding (56 per cent), pain (32 per cent) and a sense of prolapse (32 per cent). The prevalence of constipation was significantly higher among women (47 per cent) than men (29 per cent). Perineal descent was present in 20 per cent of cases and was significantly more frequently associated with excessive straining at defaecation (28 per cent) compared with patients in whom there was no history of excessive straining (12 per cent). Sixty-six patients (26 per cent) experienced recurring symptoms over the 10 year period following presentation but did not deteriorate, while 28 patients (11 per cent) deteriorated. Deterioration was associated with a history of symptoms for longer than 1 year at the time of presentation, female sex, and the presence of perineal descent on clinical examination. The risk of developing perineal descent was less than 10 per cent over the 5 years after presentation while that of developing sphincter laxity among patients who had already developed perineal descent was 30 per cent over this period. Complete rectal prolapse occurred in 20 per cent (3/15) of patients with clinical perineal descent and sphincter laxity but was not seen in the absence of these signs. The results of treatment by submucosal phenol injection, mucosal rubber banding, or glycerine suppositories were the same.

Understanding Polygons and Polyhedrons Using Flexagons

The goal of this paper is to help students understand simple polygons and simple polyhedrons. First the project within this paper involves having students look at polygons. Though much of this information should have been learned in the fourth grade it is still important to review this material. Having the students define certain shapes illustrates their true understanding of the subject. The second part to the project within this paper is to use the student’s knowledge of polygons and build polyhedrons. In this paper the students will only have to concern themselves with squares and equilateral triangles. Here they will have to build constructions known as “flexagons.” A flexagon in short is a polyhedron constructed by using tag or poster board and cutting out patterns with wings and rubber banding them together. The third part to the project within this paper is to take all of the polygons and flexagons/polyhedrons and make them into a mobile. The mobile works as a nice way to end the project by displaying the knowledge these students have attained in a creative manner.

An open environment for quantitative analysis of left ventricular function using ultrasound images

We have developed an open environment for quantitative analysis of left ventricular function using ultrasound images. The system is primarily intended for experimental purposes, i.e. clinical research and the evaluation of quantification algorithms. The modular design allows easy expansion with new analysis methods. The core of our system is the user-interface and image presentation. Image analysis methods are included as a set of tools available to the operator. Using this approach, the expensive, expert knowledge of the cardiologist is used more efficiently than in most delineation systems. During delineation, images of a complete heart cycle can be simultaneously displayed dynamically ('cine mode') in a separate window. This feature improves visual edge perception and enables accurate determination of the endocardium even in cases of very poor echogenicity. The resulting contour can be corrected locally by interactive modification using 'rubber banding'. After delineation of the images from different echocardiographic views, volume, ejection fraction, and regional wall motion are determined. Studies using contrast-enhanced echocardiography can be quantified by image intensity analysis in a region of interest in order to determine myocardial perfusion. We evaluated our method by quantifying echocardiographic studies from 12 healthy volunteers. We compared the results with magnetic resonance imaging and concluded that there was no significant difference in volume and ejection fraction calculated from both modalities. Moreover, the image display features and contour correction methods were greatly appreciated by the cardiologists who used the system.

Rubberbanding and Holding Out

Rubberbanding and Holding Out

Hemorrhoids

Hemorrhoids are vascular spaces forming cushions above the anal canal which allow the passage of gas without stool, and cause clinical problems only when they become engorged and prolapse with resulting pain, bleeding, itching or discharge. Hemorrhoids require treatment only if they cause symptoms, and should be treated only as long as symptoms persist. Techniques of treatment including injection therapy, rubber band ligation, infrared coagulation, bipolar probe, heater probe, ultroid and YAG laser are described. At present, rubber banding is the most cost effective therapy. Diet education is essential to prevent recurrence.

An unusual complication of tubal sterilization by silicone rubber banding under laparoscopic vision

A case report of the inadvertent inclusion of a small knuckle of the bowel with the fallopian tube during laparoscopic sterilization with a silicone rubber band is reported. The silicone band was cut and removed and another band was applied under laparoscopic vision without complications. In order to assure that this complication does not occur an adequate Trendelenburg position should be established so that the intestines are free from the lesser pelvic region. It is also necessary to tent the tube and to be confident of an adequate view.