title: [A new accessory for the isostatic anal retractor].
abstract: The authors present the characteristics and the advantages deriving from the use of a new accessory to be fitted on the isostatic anal retractor in order to further improve visualisation of the operative field during the treatment of pelvic and anal pathologies. The isostatic anal retractor consists of a system of rotating rings and valves which are positioned with surgical stitches on the patient's buttocks. The new accessory is characterised by one or more elastic systems that can be fixed to the retractor metal ring and attached by means of curved needles to flaps of anal mucosa, affording enhanced visibility of the operative field. A total of 25 patients--15 with mucosal prolapse, 5 with haemorrhoids and 5 with anal fistulas--were treated surgically for their respective pathologies using the isostatic anal retractor and the new accessory. None of the patients observed complained of complications related to the use of the anal retractor or the accessory. In 95% of patients submitted to the procedures using the new accessory, visualisation of the operative field was improved as compared to the use of the anal retractor alone. In 5 patients it was possible to use the new accessory advantageously applied only to the external ring of the retractor. Our operative team judged the use of new accessory to be satisfactory in all cases in which greater visibility of the operative field is required. Use of the new accessory use in association with the isostatic anal retractor proved efficacious for achieving better therapeutic results with the treatments performed, permitting greater operator autonomy and enhancing visualisation of the operative field with respect for sphincter function.
authors.affiliation: Dipartimento di Chirurgia Generale e Trapianti d'Organo, Istituto Paride Stefanini, Università degli Studi La Sapienza, Roma.
authors.forename: Fabio
authors.initials: F
authors.lastname: Gaj
authors.forename: Antonello
authors.initials: A
authors.lastname: Trecca
authors.forename: Michele Gabrio
authors.initials: MG
authors.lastname: Antonelli
authors.forename: Pietro
authors.initials: P
authors.lastname: Crispino
mesh_terms: D000328:Adult; D001003:Anal Canal / Q000601:surgery*; D004867:Equipment Design; D005260:Female; D006484:Hemorrhoids / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D012003:Rectal Fistula / Q000601:surgery; D012005:Rectal Prolapse / Q000601:surgery; D013525:Surgical Instruments