Special anoscope for easy purse-string suture application in stapled hemorrhoidopexy

Area of Science:

• Colorectal Surgery
• Surgical Instrumentation

Background:

• Internal hemorrhoids and loose rectal mucosa can obstruct surgical views during stapled hemorrhoidopexy.
• This obstruction poses a risk for potential complications during purse-string suturing.

Purpose of the Study:

• To develop and evaluate a modified anoscope for improved visualization and ease of purse-string suturing in stapled hemorrhoidopexy.
• To address the challenge of blocked surgical exposure caused by prolapsing rectal mucosa.

Main Methods:

• A specialized anoscope was designed by modifying the PPH01 kit's purse-string anoscope with a transparent acrylic covering.
• A 3 cm long, 3-4 mm wide window was incorporated into the angled part of the anoscope.
• The modified anoscope was utilized for purse-string suture placement in five patients undergoing stapled hemorrhoidopexy.

Main Results:

• The modified anoscope facilitated easy rotation within the anal dilator.
• The design allowed unimpeded movement of the 2/0 polypropylene suture needle.
• No early or late postoperative complications were observed in the patient cohort.

Conclusions:

• The specially designed anoscope effectively retracts rectal mucosa, enhancing surgical field exposure.
• This modified instrument simplifies the stapled hemorrhoidopexy procedure.
• The use of this specialized anoscope is proposed as a method to reduce complications in stapled hemorrhoidopexy.