title: Adaptation of the pursestring suture anoscope with a small hole in a case of stapled hemorrhoidectomy.
abstract: OBJECTIVE
  Stapled hemorrhoidectomy has become more popular with the general surgeon, mainly because of reduced postoperative pain and shorter hospital stays. However, we have faced some complications caused by irregular pursestring suture of the rectal mucosa.
  
  
  METHODS
  To secure pursestring suture in the rectal mucosa layer, we placed a small hole in the Pursestring Suture Anoscope.
  
  
  RESULTS
  Since 2001, we have experienced more than 200 cases of stapled hemorrhoidectomy and in the last two years we have performed pursestring suture by using a Pursestring Suture Anoscope with a small hole in 60 cases. Rectal mucosa was resected without irregular defect in all the cases.
  
  
  CONCLUSIONS
  Stapled hemorrhoidectomy can be performed easily and safely with this modification.
authors.affiliation: Department of Surgery, Chibanishi General Hospital, Matsudo-City, Chiba, Japan. jojiyamamotomd@yahoo.co.jp
authors.forename: Joji
authors.initials: J
authors.lastname: Yamamoto
authors.forename: Motoki
authors.initials: M
authors.lastname: Nagai
authors.forename: T Barry
authors.initials: TB
authors.lastname: Smith
authors.forename: Satoshi
authors.initials: S
authors.lastname: Tamaki
authors.forename: Tadao
authors.initials: T
authors.lastname: Kubota
authors.forename: Ken
authors.initials: K
authors.lastname: Sasaki
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Ohmori
authors.forename: Kiyotaka
authors.initials: K
authors.lastname: Maeda
mesh_terms: D004867:Equipment Design; D006484:Hemorrhoids / Q000601:surgery*; D006801:Humans; D017792:Surgical Stapling / Q000295:instrumentation* / Q000379:methods