ArticleSao Paulo medical journal = Revista paulista de medicina2025
A modified stapled hemorrhoidectomy technique to optimize mucosectomy specimen and improve outcomes.
Article in Sao Paulo medical journal = Revista paulista de medicina, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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5 authors.
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Abstract
backgroundSurgical treatment of hemorrhoidal disease has undergone numerous modifications in recent decades. Among the technical options, stapled hemorrhoidopexy is currently considered an optimal alternative because it provides a less painful recovery. However, many reports have associated this technique with higher recurrence rates than excisional techniques.
objectivesThis manuscript presents a technical modification that aims to provide more extensive mucosectomy with mechanical hemorrhoidopexy. DESIGN AND
settingThe present technical modification was developed and has been recently used in two hospitals in São Paulo (SP), Brazil.
methodsTo achieve this, we placed a circumferential submucosal suture at the 3 o'clock position in the clockwise direction. When the left lateral position (9 o'clock) was reached, a loop of 2-0 non-absorbable suture thread was passed around the continuous suture and retracted to the left. Subsequently, the original suture progressed towards the point on the right lateral side, where it was started.
resultsSpecifically, the modification consists of establishing two traction points from the pursestring suture; thus, the rectal mucosa entering the stapler head will be more uniform, and the retrieved mucosal strip will present a greater height. These features may play a role in effectively reducing mucosal prolapse and alleviating the symptoms.
conclusionsThe proposed modification of the original operative technique is simple and aims to improve postoperative results by increasing the height of the mucosal specimen to be resected, thereby reducing long-term recurrence. In the future, this hypothesis will be tested in a randomized study comparing the mucosectomy height and postoperative outcomes of both technical options (classical and present).
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