Stapled hemorrhoidopexy: a new device and method of performance without using a pursestring suture

Area of Science:

• Surgical Innovation
• Gastrointestinal Surgery

Background:

• Stapled hemorrhoidopexy is a common procedure for hemorrhoidal disease.
• Current techniques may involve pursestring sutures, which can add complexity and potential complications.

Purpose of the Study:

• To develop and evaluate a novel device and technique for sutureless stapled hemorrhoidopexy.
• The goal is to achieve safer, more reproducible, and consistent surgical performance.
• To ensure surgeons can control tissue volume within the stapler during the procedure.

Main Methods:

• A porcine model was utilized to refine a mucosal impaction device and technique.
• A custom washer with spikes was fitted to a hemorrhoidal circular stapler (PROXIMATE PPH01).
• The procedure was performed on nine animals without the use of a pursestring suture.

Main Results:

• Successful stapled hemorrhoidopexy was achieved in all porcine subjects, yielding circumferential mucosal donuts.
• The obtained donuts were comparable in size, height, and volume to those from human procedures.
• Each procedure was completed rapidly, averaging approximately one minute.

Conclusions:

• A safe, reliable, and rapid sutureless stapled hemorrhoidopexy technique and device were successfully developed and validated in a porcine model.
• The new method, utilizing a mucosal impaction device, demonstrated consistent performance under simulated clinical conditions.
• The procedure is easily teachable and learnable, with significant potential for human clinical application.