Transanal Stapling Techniques for Anorectal Prolapse
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1 Transanal Stapling Techniques for Anorectal Prolapse
2 Transanal Stapling Techniques for Anorectal Prolapse Edited by David Jayne Department of Colorectal Surgery, Leeds General Hospital, Great George Street, Leeds, LS1 3EX, UK Angelo Stuto 2 nd Surgical Unit, Ospedale S: maria degli Angeli, Pordenone, Italy
3 Editors David Jayne Department of Colorectal Surgery Leeds General Hospital Great George Street Leeds, LS1 3EX UK Angelo Stuto 2 nd Surgical Unit Ospedale S: Maria degli Angeli Pordenone Italy ISBN: e-isbn: DOI: / British Library Cataloguing in Publication Data Library of Congress Control Number: Springer-Verlag London Limited 2009 Apart from any fair dealing for the purposes of research or private study, or criticism or review, as permitted under the Copyright, Designs and Patents Act 1988, this publication may only be reproduced, stored or transmitted, in any form or by any means, with the prior permission in writing of the publishers, or in the case of reprographic reproduction in accordance with the terms of licences issued by the Copyright Licensing Agency. Enquiries concerning reproduction outside those terms should be sent to the publishers. The use of registered names, trademarks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant laws and regulations and therefore free for general use. Product liability: The publisher can give no guarantee for information about drug dosage and application thereof contained in this book. In every individual case the respective user must check its accuracy by consulting other pharmaceutical literature. Printed on acid-free paper Springer Science+Business Media springer.com
4 Foreword It has never been easy to introduce new concepts and therapeutic in-terventions into surgical practice. When attempting to do so, one is faced with the interagency of traditional dogma, which still in this era of evidence-based medicine tends to dominate the surgical thought process. This is particularly so in the area of coloproctology, where prejudice and personal opinion often influence objective analysis whenever tradition is challenged. A large body of literature on anorectal prolapse has accumulated over the years; although much is based on personal viewpoint rather than scientific evidence, it has nevertheless been passed down through the generations as ac-cepted wisdom and practice. As a consequence, it is a challenge to change the mindset of a generation of surgeons and to introduce new concepts and novel techniques which at first might appear to be a radical departure from conventional teaching. It is obviously not possible to present the basis for the develop-ment of transanal stapling techniques for anorectal prolapse in this Foreword; this is dealt with in detail elsewhere in this book. The in-terested reader will have the opportunity to share in the new and emerging concepts surrounding anorectal prolapse and to deepen their understanding of the pathophysiology and basis for surgical correction. Although hemorrhoidal disease and external rectal prolapse have been known about for centuries, the understanding of internal rectal prolapse (intussusception) and rectocele has only really advanced with the emergence of radiological imaging tech-niques, such as defecography. With a heightened awareness of the condition, it has become apparent that the prevalence of sympto-matic anorectal prolapse is far more common than originally por-trayed, and that its impact on quality of life has been underestimated and undervalued. Perhaps for the first time, modern surgical tech-niques can now offer symptomatic improvement and enhanced qual-ity of life for those unfortunate enough to suffer with this chronic condition. Historically, hemorrhoidal prolapse, internal and external rectal prolapse, and rectocele have been considered as separate clinical en-tities, with distinct etiologies. Modern thinking and clinical observa-tion, however, would suggest that the different manifestations of anorectal prolapse in fact share a common pathophysiological basis. There is thus emerging a unified theory for anorectal prolapse. Transanal Stapling for Anorectal Prolapse provides the reader with a clear overview of the pathophysiological basis of the disease and the evolution of transanal stapling techniques. Chapters have been contributed by an international panel of expert colorectal surgeons to give a broad and comprehensive coverage of the subject. As well as covering the history and pathophysiology of anorectal prolapse, this book provides a structured approach to anorectal sta-pling techniques along with tips and tricks for success. This book will be an essential reference for all specialists with an interest in coloproctology. Wien, Austria Antonio Longo v
5 Contents Foreword... Contributors... v ix Introduction... 1 David Jayne and Angelo Stuto 1 Historical Background: Treatments for Hemorrhoids and ODS Prior to Transanal Stapling Techniques... 3 Longo L. Lenisa and V. Landolfi 2 Anatomy and Physiology of Anorectal Prolapse S.R. Brown and A.J. Shorthouse 3 Diagnosis of Hemorrhoids and ODS D. Jayne and K.P. Nugent 4 Evaluation of Patients with Symptomatic Hemorrhoids and Obstructed Defecation F. Pigot, F. Hetzer, and J.-J. Tuech 5 Patient Selection for Stapled Hemorrhoidopexy and STARR Oliver Schwandner and Roland Scherer 6 Stapled Hemorrhoidopexy: The Technique E. Espin and F. Corbisier 7 Stapled Transanal Rectal Resection Procedure D.G. Jayne and A. Stuto 8 The Evidence for Stapled Hemorrhoidopexy and STARR F.H. Hetzer and A. Senagore 9 Areas of Controversy and Future Research D.G. Jayne and A. Stuto Index vii
6 Contributors Steven Brown Northern General Hospital, Sheffield, UK Fabrice Corbisier CH Notre-Dame et Reine, Fabiola, Belgium Eloy Espin Hospital Univeritari Vall, Barcelona, Spain Franc Hetzer Kantonsspital St. Gallen, St. Gallen, Switzerland David Jayne Academic Surgical Unit, St. James's University Hospital, Leeds, UK V. Landolfi General Surgery, Landolfi ; Hospital, Solofra (AV), Italy Leonardo Lenisa Casa di Cura San Pio X, Milan, Italy Antonio Longo St. Elizabeth Hospital, Wien, Austria Karen Nugent Southampton General Hospital, Southampton, UK Francois Pigot Bagatelle-Maison de Sante, Talence Cedex, France Roland Scherer Krankenhaus Waldfriede, Berlin, Germany Oliver Schwandner Caritas Krankenhaus Str. Josef, Regensburg, Germany Anthony Senagore Department of Surgery, Medical University of Ohio, Toledo, OH, USA ix
7 x Contributors Andrew Shorthouse Northern General Hospital, Sheffield, UK Angelo Stuto 2nd Surgical Unit, Ospedale S. Maria degli Angeli, Pordenone, Italy Jean-Jacques Tuech CHU Hopitaux de Rouen, Rouen, France
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