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Journal of Indian Association of Pediatric Surgeons
     Journal of Indian Association of Pediatric Surgeons
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LETTER TO EDITOR
Year : 2005  |  Volume : 10  |  Issue : 2  |  Page : 116
 

Plastic pens as substitutes for metallic dilators


Department of Pediatric Surgery, Kalawati Saran Children's Hospital, Lady Hardinge Medical College, New Delhi - 110 001, India

Correspondence Address:
S R Choudhury
Department of Pediatric Surgery, Kalawati Saran Children's Hospital, Lady Hardinge Medical College, New Delhi - 110001
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-9261.16478

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How to cite this article:
Choudhury S R, Sahu P, Singh D, Chadha R. Plastic pens as substitutes for metallic dilators. J Indian Assoc Pediatr Surg 2005;10:116

How to cite this URL:
Choudhury S R, Sahu P, Singh D, Chadha R. Plastic pens as substitutes for metallic dilators. J Indian Assoc Pediatr Surg [serial online] 2005 [cited 2019 Sep 15];10:116. Available from: http://www.jiaps.com/text.asp?2005/10/2/116/16478


Sir,

Dilatations are generally recommended after reconstruction of the anorectum and vagina in children with anorectal and genital malformations.[1],[2] The commonly used dilators, e.g. Hegar's dilators, are metallic in nature. We perform a large number of operations for anorectal and genital malformations in our institution. Following such reconstructions, we recommend dilatation starting from the 10th to 14th postoperative day, initially twice per day for a period of 2 months and then daily for a period of at least 6 months. One or both the parents are taught the procedure in the clinic and then dilatations are done by them at home. The size of the dilators also needs to be increased periodically.[2],[3] In our follow-up clinic, we often face the problem of finding a suitable-size dilator for the patient. The relatives of the patients, often from poor socioeconomic class, find it difficult to get the metallic dilators from the market.

We have adopted a novel technique by using the end of plastic pens for anal and vaginal dilatation. Plastic pens of various sizes are nowadays easily available; they are inexpensive and disposable. The pens should have a smooth conical contour at the end for the procedure to be minimally traumatic. We have created a 'pen bank', a collection of plastic pens [Figure - 1] in our follow-up clinic and give an appropriate-size pen to the relatives and thus find it easy to handle a large number of patients requiring such procedure. No dilation-related complication has been reported so far.

Therefore, plastic pens are an easily available and cheaper substitute for metallic dilators for anal and genital dilatation in children.

 
   References Top

1.Ray AK, Singhania AK, Mukherjee S. Post PSARP anorectal manometry - experience of 115 cases of imperforate anus. J Indian Med Assoc 2004;102:253-5.  Back to cited text no. 1  [PUBMED]  
2.Kiely EM, Pena A. Anorectal Malformations. In O'Neill JA, Rowe MI, Grosfeld JL, Fonkalsurd EW, Coran AG, editors. Pediatric Surgery 5th Ed. St. Louis, Missouri: Mosby; 1998. p. 1425-48.  Back to cited text no. 2    
3.Jackson CR, de la Hunt MN, Backwith R. A new hollow anal dilator. Ann R Coll Surg Engl 2003;85:428.  Back to cited text no. 3    


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  2005 - Journal of Indian Association of Pediatric Surgeons | Published by Wolters Kluwer - Medknow 

Online since 1st May '05