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Indian Journal of Surgery
Medknow Publications on behalf of Association of Surgeons of India
ISSN: 0972-2068
Vol. 68, Num. 6, 2006, pp. 336-336

Indian Journal of Surgery, Vol. 68, No. 6, November-December, 2006, pp. 336

Letter To Editor

Is rectal lubrication the key to non surgical removal of rectal foreign bodies?

Department of Surgery, Frenchay Hospital, Bristol BS16 1LE
Correspondence Address:Department of Surgery, Frenchay Hospital, Bristol BS16 1LE Email: hemantz1001@yahoo.co.uk

Code Number: is06099

Related Article: is06061

Sir,

We read the Case Report of Dr. Bhanot et al ,[1] with great interest. The paper highlighted the adjunct use of laparoscopy but we are concerned that the authors have not emphasized the importance of rectal lubrication for removal of foreign bodies of rectum (FBR). In our understanding, if rectal lubrication is used in ample amounts, it can make nonoperative FBR removal more successful. We would like to present our view in this aspect.

Blocki et al[2] had hypothesized the development of proximity forces on interaction of two objects/surfaces. In our understanding these are the forces that come into play on contact of FBR and rectal mucosa. The subsequent vigorous defecatory attempts by the patient accentuate the van der wall forces between the two surfaces and also create a negative intraluminal pressure. This results into impaction and difficult removal.

Physicists have proved that dynamic wetting of surfaces (lubrication) creates a kinetic slip by decreasing intermolecular interactions.[3] Similarly physiologically in lungs, surfactant facilitates decrease in surface tension and glycoproteins assist free chest movement by providing ample lubrication.[4],[5] This in simple terms may be interpreted as slipping of body membranes.

If these concepts are applied for FBR removal, we opine that rectal lubrication should provide decrease in intersurface forces between rectal foreign body and mucosa, creating a slip on manual abdominal pressure and defecatory efforts thus making removal of FBR easy by nonoperative means.

References

1.Bhanot A, Patel GR, Bachani M, Gohil VD. Laparoscopic assisted removal of rectal foreign body. Indian J Surg 2006;68:216-8.  Back to cited text no. 1    
2.Blocki J, Randrup J, Swiatecki WJ, Tsang C. Proximity forces. Ann Phys 1977;105:2.  Back to cited text no. 2    
3.Pismen LM, Rubinstein BY. Kinetic Slip Condition, van der Waals Forces and Dynamic. Contact Angle Langmuir 2001;17:5265.  Back to cited text no. 3    
4.Miki H, Hida W, Kikuchi Y, Chonan T, Satoh M, Iwase N, et al . Effects of pharyngeal lubrication on the opening of obstructed upper airway. J Appl Physiol 1992;72:2311-6.  Back to cited text no. 4    
5.Wang NS. Anatomy of the pleura. Clin Chest Med 1998;19:229-40.  Back to cited text no. 5  [PUBMED]  

Copyright 2006 - Indian Journal of Surgery

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