Modified stapled haemorrhoidopexy for the treatment of massive circumferentially prolapsing piles

Jayne, David; Seow‐Choen, Francis

doi:10.1007/s101510200042

Cited by 18 publications

(18 citation statements)

References 12 publications

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“…The surgeon starts by placing the pursestring suture at a distance of 3-4 cm above the dentate line and just deep enough to take the mucosa and submucosa, however, if internal haemorrhoids obscure the surgical field and if the tip of the needle causes bleeding while passing through the mucosa, further bites of the suture may not pass at the same distance and at the same depth [10,13,14] . This may result in an uneven purse-string suture which is closer to the dentate line, goes through deeper tissues, or which skips the mucosa in some parts.…”

Section: Discussionmentioning

confidence: 99%

“…This may result in an uneven purse-string suture which is closer to the dentate line, goes through deeper tissues, or which skips the mucosa in some parts. Consequently, some parts of the stapler line may be closer to the dentate line, or some parts of the donut may be thicker, or it may not be intact [4,5,14] . A stapler line close to the dentate line may cause acute or persistent pain, or bring about a risk of incontinence [15,16] .…”

Section: Discussionmentioning

confidence: 99%

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Comparison of a modifed anoscope and the purse-stringanoscope in stapled haemorrhoidopexy

Bozdağ¹,

Yaman²,

Derıcı³

et al. 2009

WJG

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AIM:To compare the results of the anoscope of the PPH kit and a modified anoscope during stapled haemorrhoidopexy. METHODS:The hospital records of 37 patients who underwent stapled haemorrhoidopexy between 2001 and 2006 were reviewed. The purse-string suture anoscope in the PPH kit was used on 15 patients (Group 1), and the modified anoscope was used on 22 patients (Group 2). Demographic characteristics of the patients, operation time, surgeon's performance, analgesic requirement, and complications were compared. RESULTS: Operation time was significantly longer inGroup 1 (42.0 ± 8.4 min vs 27.7 ± 8.0 min, P = 0.039).The surgeons reported their operative performance as significantly better in Group 2 (the results of the assessments were poor in ten, medium in four and good in one in Group 1, while good in all patients in Group 2, P < 0.001). The need for haemostatic sutures was significantly higher in Group 1 (six cases) and was needed in two cases in Group 2 (P = 0.034). CONCLUSION:Operation time decreased and the surgeon's satisfaction increased with use of the modified anoscope, and fewer haemostatic sutures were required if the surgeon waited longer before and after firing the stapler.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Comparison of a modifed anoscope and the purse-stringanoscope in stapled haemorrhoidopexy

Bozdağ¹,

Yaman²,

Derıcı³

et al. 2009

WJG

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“…While most surgeons agree that, the convalescence after SH is shorter (27,28). few others could not demonstrate an earlier return to work (29).…”

Section: Discussionmentioning

confidence: 99%

“…The defecation though painful, was easy and effortless. 19 (13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32) Values are mean (range). -Duration of incapacity to work.…”

Section: Resultsmentioning

confidence: 99%

Radioablation and suture fixation of advanced grades of hemorrhoids: An effective alternative to staplers and Doppler guided ligation of hemorrhoids

Gupta¹

2006

Rev. esp. enferm. dig.

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Background: for advance grades of symptomatic hemorrhoids (grade III and IV) the author has innovated a procedure called radiofrequency ablation and fixation of hemorrhoids. The procedure is performed as a day care surgery.Patients and methods: the surgical technique and clinical follow-up of patients operated by this technique are presented. An Ellman dual frequency radiofrequency generator was used for ablation, which was followed by suture fixation of the hemorrhoids. Patient satisfaction score was assessed using a visual analogue scale. The results of this procedure are presented and are compared with the results of published data of stapled hemorrhoidopexy and Doppler guided hemorrhoidal artery ligation procedures.Results: between 1998 and 2005, 2,376 patients were operated with this technique. Patient's mean age was 34 years and 1,438 patients were males. The postoperative complication rate was 3.5%, which included secondary bleeding, retention of urine and perianal thrombosis. The recurrence rate was less than 1.5%. The satisfaction score was 9.2 on VAS.Conclusions: radiofrequency ablation and fixation of hemorrhoids is a technique that results in less postoperative pain, shorter hospital stay, and early return to normal activity. It seems to be a better alternative to stapled hemorrhoidopexy or Doppler guided hemorrhoidal artery ligation with regard to effectiveness and symptomatic relief on long term.

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“…While most surgeons agree that the convalescence after SH is shorter [24, 25], a few others could not demonstrate an earlier return to work [26]. The operation is defined as ‘easy’ by some authors [27] whereas for a few others it was ‘demanding’ [26].…”

Section: Discussionmentioning

confidence: 99%

Hemorrhoidal Ablation and Fixation: An Alternative Procedure for Prolapsing Hemorrhoids

Gupta¹

2005

Digestion

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Background: Many new techniques have been evolved to curb the problem of post-operative pain after hemorrhoidectomy. Stapler hemorrhoidopexy and Doppler-guided hemorrhoidal artery ligation are the two methods gaining popularity amongst proctologists. The author proposes another technique called radiofrequency ablation and fixation of hemorrhoids to add to this list. Patients and Methods: The surgical technique and clinical follow-up of 410 patients operated by this technique are presented. An Ellman radiofrequency generator was used for hemorrhoidal ablation at the output power intensity of 80. Post-defecation pain and pain at rest were assessed using a visual analogue scale. Patient satisfaction score was calculated at the mean follow-up of 60 months (range 48–72). The results in terms of mean hospital stay, post-operative pain, post-operative complications, and period of incapacity for work were compared with the published data of results of stapled hemorrhoidopexy and Doppler-guided hemorrhoidal artery ligation. Results: Pain score at first evacuation was 6. The post-defecation pain score in the first week was 4 (range 3–6) and it was 3 (range 2–5) in the second week. The mean pain score at rest in the first week was 2 (range 1–4) and 1 (range 0–2) in the second post-operative week. In the long-term follow-up at a mean of 60 months, this procedure was found in most of the cases to control prolapse, discharge, and bleeding, with no stenosis or incontinence. The recurrence rate was less than 2%. The patient satisfaction score was high. Conclusion: The results of this technique of radiofrequency ablation and fixation of hemorrhoids hold positive promises in terms of less post-operative pain, early discharge from the hospital and faster return to work. The results are comparable to stapled hemorrhoidopexy and are better than Doppler-guided hemorrhoidal artery ligation in terms of effectiveness and symptomatic relief on a long-term basis.

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Modified stapled haemorrhoidopexy for the treatment of massive circumferentially prolapsing piles

Cited by 18 publications

References 12 publications

Comparison of a modifed anoscope and the purse-stringanoscope in stapled haemorrhoidopexy

Comparison of a modifed anoscope and the purse-stringanoscope in stapled haemorrhoidopexy

Radioablation and suture fixation of advanced grades of hemorrhoids: An effective alternative to staplers and Doppler guided ligation of hemorrhoids

Hemorrhoidal Ablation and Fixation: An Alternative Procedure for Prolapsing Hemorrhoids

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