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Stapled Haemorrhoidectomy-Experience With Modified Anoscope.

Sisir Kumar Nath1

  • 1Department of Surgery, International Hospital, Lotus Tower, Guwahati, Assam 781005 India ; 246, Suravi Path, Jatia, Kahilipara Road, Guwahati, 781019 India.

The Indian Journal of Surgery
|March 25, 2016
PubMed
Summary

Stapled haemorrhoidectomy (SH) is a popular procedure, but complications occur in 15%. A modified anoscope technique ensures precise purse-string sutures, leading to zero complications in 72 cases.

Keywords:
ComplicationsModified anoscopePurse-string sutureStapled haemorrhoidectomy

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Area of Science:

  • Colorectal Surgery
  • Surgical Innovation
  • Anorectal Disorders

Background:

  • Stapled haemorrhoidectomy (SH) is increasingly utilized due to its patient-friendly nature.
  • Despite its popularity, SH has not achieved "gold standard" status, with a reported complication rate of approximately 15%.
  • Effective purse-string suturing is crucial for minimizing complications during SH.

Purpose of the Study:

  • To introduce a modified anoscope designed to improve purse-string suture placement in stapled haemorrhoidectomy.
  • To evaluate the efficacy of the modified anoscope in reducing complications associated with SH.
  • To assess the depth of excision achieved with the modified technique.

Main Methods:

  • A novel semicircular hole was incorporated into the anoscope to facilitate accurate purse-string suture placement.
  • Seventy-two cases of stapled haemorrhoidectomy were performed using the modified anoscope.
  • Histopathological examination of excised tissue was conducted in the initial 20 cases.

Main Results:

  • The modified anoscope enabled precise visualization and accurate placement of the purse-string suture at the appropriate depth and distance from the dentate line.
  • No complications were reported in any of the 72 patients undergoing SH with the modified technique.
  • Histopathological analysis confirmed submucosal excision in 16 out of the first 20 cases.

Conclusions:

  • The modified anoscope technique significantly enhances the safety and efficacy of stapled haemorrhoidectomy.
  • This innovative approach minimizes complications by ensuring optimal purse-string suture placement.
  • The modified anoscope facilitates accurate submucosal excision, contributing to successful outcomes in SH procedures.