An inexpensive and effective retractor for transanal surgery

An extremely effective retractor for use in transanal surgery can be produced by removing the polyethylene bag from a standard colostomy appliance and cutting notches in the outer circumference. The resultant pliable ring serves as a frame to which heavy silk sutures can be attached after placement tangentially at the dentate line. This creates a retractor that conforms to the contour of the buttocks, frees the hands of the assistants, and definitively marks the dentate line. By everting the anus circumferentially, key landmarks are accurately exposed and unnecessary crowding of the anal field is avoided.