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Stapled Hemorrhoidopexy: A New Device and Method of Performance Without Using A Pursestring Suture

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  • Published:
Diseases of the Colon & Rectum

Purpose

This study was designed to develop a more reliable device and technique that will allow for the safer and reproducibly consistent performance of a stapled hemorrhoidopexy without using a pursestring suture. This device and technique must allow the surgeon to be able to control the volume of tissue drawn into the stapler center chamber during the performance of the procedure.

Methods

A porcine model was used to evaluate and perfect a mucosal impalement device and technique for use during the performance of a stapled hemorrhoidopexy. A specially manufactured washer with spikes on one side was fitted onto the center shaft of a PROXIMATE® PPH01 Hemorrhoidal Circular Stapler and was used in each of nine animals. A pursestring suture was not needed and was not used in any of the procedures.

Results

After performing the stapled hemorrhoidopexy, a mucosal donut was obtained from each animal. On gross inspection, each donut was of similar size, height, and volume compared with that of a human stapled hemorrhoidopexy donut. Each was completely circumferential (except for the final specimen, which was purposely incomplete after having performed a single quadrant resection). The performance of each procedure required approximately one minute.

Conclusions

A procedure and device have been developed that allow for the rapid, safe, and reliable performance of a sutureless stapled hemorrhoidopexy by using a new mucosal impalement device and technique in the porcine model. It was used successfully in the porcine model under simulated diverse clinical circumstances. The procedure is easy to teach and learn and has potential applicability for use in humans.

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References

To the Article

  1. G Allegra (1990) ArticleTitleExperiences with mechanical staplers: hemorrhoidectomy using a circular stapler G Chir 11 95–97 Occurrence Handle2223506 Occurrence Handle1:STN:280:By6D38jgs1Q%3D

    PubMed  CAS  Google Scholar 

  2. A Longo (1998) Treatment of hemorrhoidal disease by reduction of mucosa and hemorrhoidal prolapse with a circular suturing device: a new procedure. Sixth World Congress of Endoscopic Surgery, Rome, Italy Monduzzi Publishing Co. Bologna 777–784

    Google Scholar 

  3. PPH Physician Brochure. ©Ethicon Endo-Surgery Inc., ENDO 748. July 3, 2000.

To the Invited Commentary

  1. A Longo (2002) ArticleTitleStapled anopexy and stapled hemorrhoidectomy: two opposite concepts and procedures [letter] Dis Colon Rectum 45 571–572 Occurrence Handle12006945

    PubMed  Google Scholar 

  2. LM Pernice B Bartalucci L Bencini A Borri S Catarzi K Kröning (2001) ArticleTitleEarly and late (ten years) experience with circular stapler hemorrhoidectomy Dis Colon Rectum 44 836–841 Occurrence Handle11391144 Occurrence Handle1:STN:280:DC%2BD3MzhvFOqtA%3D%3D Occurrence Handle10.1007/BF02234704

    Article  PubMed  CAS  Google Scholar 

  3. S Esser I Khubchandani M Rakhmanine (2004) ArticleTitleStapled hemorrhoidectomy with local anesthesia can be performed safely and cost-efficiently Dis Colon Rectum 47 1164–1169 Occurrence Handle15148647 Occurrence Handle10.1007/s10350-004-0550-y

    Article  PubMed  Google Scholar 

  4. MJ Cheetham NJ Mortensen PO Nyström MA Kamm RK Phillips (2000) ArticleTitlePersistent pain and faecal urgency after stapled hemorrhoidectomy Lancet 356 730–733 Occurrence Handle11085693 Occurrence Handle1:STN:280:DC%2BD3M%2FjvVKquw%3D%3D

    PubMed  CAS  Google Scholar 

  5. L Brusciano SM Ayabeca M Pescatori et al. (2004) ArticleTitleReintervention after complicated or failed stapled hemorrhoidopexy Dis Colon Rectum 47 1846–1851 Occurrence Handle15622576 Occurrence Handle1:STN:280:DC%2BD2cnktlKgtg%3D%3D Occurrence Handle10.1007/s10350-004-0721-x

    Article  PubMed  CAS  Google Scholar 

  6. PJ Nisar AG Acheson KR Neal JH Scholefield (2004) ArticleTitleStapled hemorrhoidopexy compared with conventional hemorrhoidectomy: systematic review of randomized, controlled trials Dis Colon Rectum 47 1837–1845 Occurrence Handle15622575 Occurrence Handle10.1007/s10350-004-0679-8

    Article  PubMed  Google Scholar 

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Acknowledgement

The author acknowledges the support of Ethicon Endo-Surgery Inc. (Cincinnati, Ohio) for providing the PROXIMATE® PPH01 Hemorrhoidal Circular Staplers and for the use of the animal laboratory.

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Authors and Affiliations

  1. Department of Surgery, Cedars Sinai Medical Center, Los Angeles, California, USA

    Gary H. Hoffman M.D.

  2. 9400 Brighton Way Suite 307, Beverly Hills, CA, 90210, USA

    Gary H. Hoffman M.D.

Authors
  1. Gary H. Hoffman M.D.
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Hoffman, G.H. Stapled Hemorrhoidopexy: A New Device and Method of Performance Without Using A Pursestring Suture. Dis Colon Rectum 49, 135–142 (2006). https://doi.org/10.1007/s10350-005-0209-3

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  • DOI: https://doi.org/10.1007/s10350-005-0209-3

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