Special anoscope for easy purse-string suture application in stapled hemorrhoidopexy.
BACKGROUND
Internal hemorrhoids and loose rectal mucosa may block exposure during the purse-string suturing in stapled hemorrhoidopexy, and this may lead to complications.


METHODS
To retract the prolapsing rectal mucosa, we modified the purse-string anoscope of the PPH01 kit (Ethicon-Endosurgery, Cincinnati, OH, USA) and produced a special anoscope. The open part of the purse-string suture anoscope is covered by transparent acrylic (Orthoacryl, Dentaurum, Pforzheim, Germany). The covering had completely cylindrical outer and inner surfaces and was thin enough to let the anoscope easily rotate in the anal dilator and to let the 26 mm curved, round-bodied needle of the 2/0 polypropylene suture move in the anoscope. A window, 3 cm long and 3-4 mm wide, was opened at the angled part of the anoscope 2 cm to the tip. This special anoscope was used for the purse-string suture during the stapled hemorrhoidopexy procedure in five patients.


CONCLUSIONS
No postoperative complications, early or late, were encountered, and we propose that stapled hemorrhoidopexy procedure can be applied more easily by using this special anoscope.
Bozdag
Ali Dogan
AD
Third Surgical Clinic of Ataturk Education and Training Hospital, Izmir, Turkey. bozdag@egenet.com.tr
Nazli
Okay
O
Tansug
Tugrul
T
Derici
Hayrullah
H
Deniz
Vedat
V
D004867:Equipment Design; D004869:Equipment Safety; D006484:Hemorrhoids / Q000601:surgery*; D006801:Humans; D020700:Proctoscopes; D011351:Proctoscopy / Q000379:methods*; D017792:Surgical Stapling; D013536:Suture Techniques; D016896:Treatment Outcome