Advanced Proctology Course for Physicians Available January 1 , 2007 Order Online at : www.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. All rights reserved to APC - Dr. Sarmad Aji, FACS.

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

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

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

The 4 most common proctology problems presented to Physicians Hemorrhoids Anal fissure Anal fistula Pilonidal cyst All rights reserved to APC - Dr. Sarmad Aji, FACS.

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

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

Long term results No rectal incontinence No anal stenosis No recurrence The skin tags issue ( Normal function first, cosmetic concerns second ) All rights reserved to APC - Dr. Sarmad Aji, FACS.

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

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

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

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

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

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

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

Advanced 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.