Linear stapled haemorrhoidectomy-an alternative to standard haemorrhoidectomy?

To evaluate in a pilot study a new haemorrhoidectomy technique involving the use of a linear stapling device.

Twenty consecutive unselected patients (12 male, eight female; median age 64 years, range 40-81 years) underwent haemorrhoidectomy using the new technique. Fifteen also underwent pre- and post-operative endoanal ultrasound to assess the anal sphincter complex.

The operation was successfully carried out on all patients. Analgesic requirements were low, with most patients requiring no analgesia or paracetamol only. The majority of patients (n=13) were discharged on the first post-operative day. Clinically all patients remained fully continent of flatus and faeces after surgery with no recurrence of haemorrhoids. There was no morphologic evidence of internal or external anal sphincter damage in the patients who underwent endoanal ultrasound. There were no re-admissions of patients immediately after discharge. One late complication involving persistent anal discomfort from retained staples necessitated an operation to have them removed.

This study suggests that the use of a linear stapling device for haemorrhoidectomy is safe, being associated with little post-operative pain, a low complication rate and early discharge. A prospective randomized trial is required to assess this new treatment.