BACKGROUND: Although stapled mucosectomy has several advantages over hemorrhoidectomy for hemorrhoidal prolapse, complications such as hemorrhage, pain, and life-threatening pelvic sepsis may occur, often due to poorly executed purse-string suture. We describe a simple new anoscope that makes it easy to correctly perform and position the purse-string suture that is an integral part of stapled mucosectomy. METHODS: The apex of the middle part of the new anoscope consists of digitiform projections separated by spaces. After insertion of the instrument into the anus, the inner part is removed, allowing strips of rectal mucosa to protrude through the spaces between the digitiform projections. The purse-string suture is made through these protrusions. The suture catches the mucosa and submucosa but not the deeper muscle layer, which does not protrude through the spaces. CONCLUSION: Preliminary histologic studies in the pig suggest that the design of the anoscope prevents inclusion of the muscular layer in the pursestring.

A new anoscope for transanal surgery / C. Rebuffat, M. Della Porta, F. Ciccarese, R. Rosati. - In: THE AMERICAN JOURNAL OF SURGERY. - ISSN 0002-9610. - 196:3(2008 Sep), pp. e12-e15. [10.1016/j.amjsurg.2007.05.060]

A new anoscope for transanal surgery

C. Rebuffat;F. Ciccarese;R. Rosati
2008-09

Abstract

BACKGROUND: Although stapled mucosectomy has several advantages over hemorrhoidectomy for hemorrhoidal prolapse, complications such as hemorrhage, pain, and life-threatening pelvic sepsis may occur, often due to poorly executed purse-string suture. We describe a simple new anoscope that makes it easy to correctly perform and position the purse-string suture that is an integral part of stapled mucosectomy. METHODS: The apex of the middle part of the new anoscope consists of digitiform projections separated by spaces. After insertion of the instrument into the anus, the inner part is removed, allowing strips of rectal mucosa to protrude through the spaces between the digitiform projections. The purse-string suture is made through these protrusions. The suture catches the mucosa and submucosa but not the deeper muscle layer, which does not protrude through the spaces. CONCLUSION: Preliminary histologic studies in the pig suggest that the design of the anoscope prevents inclusion of the muscular layer in the pursestring.
Anoscope; Hemorrhoidopexy; Hemorrhoids; Stapled mucosectomy
Settore MED/18 - Chirurgia Generale
THE AMERICAN JOURNAL OF SURGERY
Article (author)
File in questo prodotto:
Non ci sono file associati a questo prodotto.
Pubblicazioni consigliate

Caricamento pubblicazioni consigliate

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2434/44069
Citazioni
  • ???jsp.display-item.citation.pmc??? 0
  • Scopus 2
  • ???jsp.display-item.citation.isi??? ND
social impact