Why and When I Do Prefer the Stapled Hemorrhoidopexy
Stapled anopexy can be considered in patients with hemorrhoidal symptoms refractory to conservative treatments as an effective surgical option. The ideal patient will present with prolapsed piles and the concurrence of internal rectal prolapse, either mucosal or full-thickness. Resection of the redundant rectal tissue at the anorectal junction and relocation of external hemorrhoids into the anal canal are the milestones of the procedure. Complications of the procedure have been extensively reported but are presently comparable to standard hemorrhoidectomy. The slightly higher tendency to recurrence described in the first era is now counterbalanced by the almost infinite availability of devices with all ranges of diameters and casing volumes, fulfilling surgeons’ willing and patients’ need of resection. Surgeon must be aware of the existence of a wide range of devices and must be confident with and properly trained to select them appropriately, according to patients’ characteristics and prolapse size.
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