Severe Rectal Bleeding Following PPH-stapler Procedure for
Haemorroidal Disease
Surgical Stapler Introduction
Haemorrhoidal disease is the most frequent and ancient
proctological pathology. Haemorrhoidectomy is always feared for
intensive post-operative pain and complications.
Surgical techniques have advanced more and more with the aim of
reducing the post-surgical complications and to help a faster
recovery. “Open hemorrhoidectomy”, according to Milligan-Morgan
procedure, has been the most used method in Europe, also in the
“Ligasure” and “Ultracision” variants. “Closed hemorrhoidectomy”,
according to Ferguson procedure, has been the most used method in
the USA. Stapled hemorrhoidopexy (PPH-stapler) is an alternative
method to conventional surgical procedures. It has many advantages
such as less pain, faster recovery and a quicker return to normal
activities. PPH stapler procedure for treatment of haemorrhoidal
prolapse classified P4E4 is an important improvement, but may be
followed by severe postoperative complications of which haemorrhage
is one of the most serious early events.
Prevalence of Hemorrhoids
Although hemorrhoids occur in everyone, they become large and cause
problems in only 4% of the general population. Hemorrhoids that
cause problems are found equally in men and women, and their
prevalence peaks between 45 and 65 years of age.
What is stapled hemorrhoidectomy?
Stapled hemorrhoidectomy is surgical technique for treating
hemorrhoids, and is the treatment of choice for third-degree
hemorrhoids (hemorrhoids that protrude with straining and can be
seen on physical exam outside the anal verge. Persistent or
intermittent manual reduction is necessary). Stapled
hemorrhoidectomy is a misnomer since the surgery does not remove
the hemorrhoids but, rather, the abnormally lax and expanded
hemorrhoidal supporting tissue that has allowed the hemorrhoids to
prolapse downward.
For stapled hemorrhoidectomy, a circular, hollow tube is inserted
into the anal canal. Through this tube, a suture (a long thread) is
placed, actually woven, circumferentially within the anal canal
above the internal hemorrhoids. The ends of the suture are brought
out of the anus through the hollow tube. The stapler (a disposable
instrument with a circular stapling device at the end) is placed
through the first hollow tube and the ends of the suture are
pulled. Pulling the suture pulls the expanded hemorrhoidal
supporting tissue into the jaws of the stapler. The hemorrhoidal
cushions are pulled back up into their normal position within the
anal canal. The stapler then is fired. When it fires, the stapler
cuts off the circumferential ring of expanded hemorrhoidal tissue
trapped within the stapler and at the same time staples together
the upper and lower edges of the cut tissue.
Specification
| Specification | Staple Height (mm) | Staple Quantity (pcs) | Color |
| QYZ-32 | 3.8 | 32 | Black |
| QYZ-34 | 34 | White |
| QWZD-32 | 32 | Black |
| QWZD-34 | 34 | White |
Product Photoes
