Tech Coloproctol 2006 Mar 15; (Read article online)

Lim YK, Eu KW, Ho KS, Ooi BS, Tang CL

BACKGROUND: Stapled hemorrhoidopexy is an established treatment for hemorrhoidal disease. We evaluated our experience with stapled hemorrhoidopexy using the new Procedure for Prolapse and Hemorrhoids (PPH03) Proximate HCS hemorrhoidal circular stapler (Ethicon Endo-Surgery). METHODS: We retrospectively reviewed clinical data for 238 patients who had undergone stapled hemorrhoidopexy in our department over a 2-month period. Patients were followed-up for a median of 3.5 weeks (range, 1-11 weeks) and were analyzed for complications and resolution of symptoms. RESULTS: The hemorrhoids treated were third- and fourth-degree, as well as second degree (after failure of other therapies). Mean duration of surgery was 12.7 minutes (range, 5-20 minutes) and the majority of patients was treated with an ambulatory procedure. Most patients were discharged within 6 hours after surgery. On follow-up, 3.7% of patiets had minor complaints after surgery. Technically, the new PPH03 stapler device has a quickclose knob, which allows rapid opening and closing. The closed staple height of 0.75 mm increases staple line compression on tissue and key blood vessels, hence minimizing bleeding. Prior to this, stapled hemorrhoidopexy was done using the PPH01 device. CONCLUSIONS: Stapled hemorrhoidopexy using the new PPH03 stapler is a safe, short and effective procedure in the management of hemorrhoids. It can be done in the ambulatory setting and patients have few postoperative complications.