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Grade I, II, and III internal hemorrhoids are common and easily treatable, leading to new opportunities for medical professionals. Physicians typically address Grade I internal hemorrhoids with a combination of over-the-counter medications, dietary changes (i.e. While some Grade I and II hemorrhoids respond to medical therapy, those with recurrent or chronic internal hemorrhoidal symptoms and Grade III hemorrhoids often require non-surgical anoscopic therapies, also known as a€?fixative treatments,a€? to control recurrent bleeding or other symptoms.
Several clinical practice guidelines and meta-analyses recommend non-surgical procedures for hemorrhoids of Grades I through III.
A surgical hemorrhoidectomy should be reserved for Grade IV hemorrhoids and for Grade III lesions that do not respond to other treatment options. This short 9-minute video demonstrates the proper techniques for using the Nexusa„? Ligator System to treat patients with hemorrhoids. This short 14 minute video demonstrates the proper techniques for using the Nexus Ligator System to treat patients with hemorrhoids. The Nexusa„? Hemorrhoid Ligator is intended to be used only by medical personnel trained in proctology procedures.
By completing this certification form, you will receive an email acknowledging receipt from inx Medical along with a confirmation number required for your initial order.
You will receive an email acknowledging receipt from inx Medical along with a confirmation number required for your initial order. The Nexus Hemorrhoid Ligator is a disposable device for the rubber band ligation of hemorrhoids. Introduce the Nexus Hemorrhoid Ligator through the anoscope, and place the tip of the ligator on the hemorrhoid to be banded.
When both triggers are released, the Nexusa„? Hemorrhoid Ligator will automatically reload the next band. If the above four criteria are not met, then digitally manipulate the band to attempt to either slightly decrease the amount of tissue that has been banded or remove the band completely. As per the discretion of the physician, one or two additional bands may be applied to other areas of the rectum by repeating steps 3 through 13. After the procedure is completed, dispose of the Nexusa„? Hemorrhoid Ligator in an approved manner. The inx Medical Nexus Hemorrhoid Ligator is a non-invasive, simple and easy to use disposable device to be used by a physician to apply latex-free rubber bands for the treatment of hemorrhoids. A skin tag is a tiny, benign, outpouching of skin that is typically connected to the underlying skin by a thin stalk. Crohn's disease (Crohn disease) is an inflammatory bowel disease (IBD), and is a chronic long-term inflammation of the digestive tract.
Crohn's disease (Crohn disease) is a chronic condition that is characterized by inflammation of the digestive tract.
Read What Your Physician is Reading on Medscape Achrocordon »An acrochordon is a small, soft, common, benign, usually pedunculated neoplasm that is found particularly in persons who are obese. Hemorrhoid Treatments vary considerably—from simple home remedies to invasive surgery, including a Hemorrhoidectomy.
Rubber band ligation is widely considered the gold standard for internal hemorrhoid treatment both because it is easy to perform and affects such a large number of patients.


This procedure is performed in a hospital or an ambulatory surgery center and requires anesthesia. The ligator is used to disrupt blood flow to hemorrhoidal tissue by means of a ligature placed around the hemorrhoid base. You only need to get certified once, and you are under no obligation to purchase the Nexus Ligator System. You only need to get certified once, and you are under no obligation to purchase the NexusTM Ligator System. If they are having pain, release the suction trigger; advance the ligator 2-3 mm further into the rectum and repeat steps 4 and 5.
The resulting ulceration stimulates a fibrous reaction which gradually adheres the mucosa to the deeper tissues of the rectum and decreases blood flow to the hemorrhoid vessels.
Rubber band ligation works by inducing necrosis and a fibrous reaction at the neck of the hemorrhoid resulting in occlusion of the hemorrhoid vessels. The ligation bands diminish the blood supply to the hemorrhoid resulting in a reduction in the size of the hemorrhoid. Introduce the Nexus Hemorrhoid Ligator through the anoscope into the anus aimed toward the hemorrhoid to be banded. Topical corticosteroids and analgesics are useful for managing perianal skin irritation, but prolonged use of potent corticosteroid preparations may be harmful and should be avoided. If internal hemorrhoids are discovered before they reach Grade IV, rubber band ligation can prevent the need for surgery later in the patienta€™s life. It is for use only by trained medical personnel in hospitals, clinics, and doctorsa€™ offices. Hence, the banding process treats the hemorrhoids by both diminishing blood flow and fixing the mucosa to deeper structures which decreases prolapse.
The fibrosis results in attachment of the rectal mucosa to deeper tissues which reduces prolapse.
The size of the tissue ligated is not important so long as there is enough tissue captured to prevent the band from falling off immediately after it has been applied.
If more than one hemorrhoid requires treatment, additional bands can be applied at one setting or the patient can return for repeat single hemorrhoid banding at 2-3 week intervals. When used in conjunction with an anoscope, the long slender suction barrel allows for optimal visualization of the hemorrhoid tissue which improves band placement accuracy. The ligation also causes inflammation and fibrosis which causes the rectal mucosa to adhere to deeper tissues which reduces prolapse. The tip of the ligator should be lightly pressed against the proximal end of the hemorrhoid. These include soft warts (although they do not represent true warts), soft fibromas, fibroepithelial polyps (FEP), fibroma pendulans, and pedunculated fibroma. A healthier, more permanent solution to internal hemorrhoids is non-surgical anoscopic treatments such as rubber band ligation. Also, the diameter of the barrel tip and the overall configuration of the suction chamber increases the likelihood of only the rectal mucosa being ligated and not the deeper muscle layers.
It is a hand held device that does not require additional equipment or personnel to operate, and it utilizes an internal plunger mechanism to suck the hemorrhoid tissue into the barrel of the device.


The suction trigger is gently squeezed which draws the hemorrhoidal tissue into the tip of the ligator. But first, let’s find out what a hemorrhoid is.Before hemorrhoid treatment is discussed, just what are hemorrhoids? With the suction trigger compressed, pull and release the band firing trigger to deploy a band onto the hemorrhoid. They are simply dilated and congested veins at the lower end of the anal canal, and are very similar to varicose veins. Once the hemorrhoid tissue is suctioned into the tip of the ligator, a firing trigger is pulled and a band is deployed. Release the suction trigger and the ligator is immediately ready to apply additional bands.
They are highly vascular “cushions" or “pads" consisting of separate masses of thick sub mucosa containing blood vessels, smooth muscle, as well as elastic and connective tissues.
The device is pre-loaded with 4 latex-free rubber bands, which will deploy one at a time, allowing the physician to easily treat multiple hemorrhoids during a single procedure.
These cushions in the anal canal are present in everyone but when they become enlarged and inflamed they become “hemorrhoids" with symptoms ranging from discomfort to substantial pain and need treatment.To further understand the hemorrhoid treatment landscape, the rest of the environment needs clarification.
In the rectal ampulla, in a space above the dentate line, there are three vascular hemorrhoidal cushions which help muscles maintain continence (preventing involuntary bowel movements). The dentate line separates the zone of internal hemorrhoids above from the zone of external hemorrhoids below.The anal canal is the 3-4 cm between the dentate line and anal verge (a transitional zone between the skin of the anal canal and the perianal skin).
The nerves here help maintain continence and discriminate between gas, fluid and solid waste, helping to avoid embarrassing solid and liquid discharges. Internal hemorrhoids are above the dentate line and covered with insensitive mucosa, while externals are below the dentate line and covered by sensitive skin-like cells. The outer aspect of a hemorrhoid is covered with skin but the inner side is mucosaBy age 50, over half the population will have some occurrence of hemorrhoid symptoms requiring treatment, with the incidence peaking between 45 and 65.
Ten to twenty million Americans have active hemorrhoids and as many as 5 million seek medical treatment each year. Consumers spend over 250 million dollars each year on over-the-counter hemorrhoid treatment products while 1.5 million use prescription medications for the treatment of hemorrhoids. 1.5 million patients undergo Colonoscopies annually as well as more than 120,000 surgical hemorrhoidectomies. Most are unnecessary.One of the main causes of developing hemorrhoids is not enough soluble fiber in your diet. Other factors that cause hemorrhoids are insufficient hydration, straining, and sitting longer than 2 minutes on the toilet (also resulting in the prolapse of anal cushions). Tendencies for hemorrhoids may be inherited, if only through behavior lifestyle and diet habits passed along from parent to offspring.



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