A modified stapled hemorrhoidectomy technique to optimize mucosectomy specimen and improve outcomes

Area of Science:

• Colorectal Surgery
• Surgical Innovation
• Hemorrhoidal Disease Treatment

Background:

• Hemorrhoidal disease treatment has evolved, with stapled hemorrhoidopexy offering less painful recovery.
• However, stapled hemorrhoidopexy is linked to higher recurrence rates compared to excisional methods.

Purpose of the Study:

• To present a technical modification for mechanical hemorrhoidopexy.
• The modification aims to achieve a more extensive mucosectomy, potentially reducing recurrence.

Main Methods:

• A novel technique involving a circumferential submucosal suture with two traction points was developed.
• The procedure was implemented in two hospitals in São Paulo, Brazil.

Main Results:

• The modification ensures more uniform rectal mucosa enters the stapler head.
• This results in a greater height of the resected mucosal strip, potentially improving prolapse reduction.

Conclusions:

• The modified technique is simple and aims to enhance postoperative outcomes by increasing mucosal resection height.
• This may lead to a reduction in long-term hemorrhoid recurrence.