In stapled haemorrhoidectomy, a circular anal dilator is inserted and the purse-string suture anoscope then used to reduce three-quarters of the circumference of prolapsing mucosa whilst the suture is inserted. Maintaining the position of the purse-string suture anoscope whilst inserting the suture can be difficult, often requiring an unsighted assistant in a difficult position. We have found use of a Rampley's sponge holding forceps to hold the purse-string suture anoscope on the circular anal dilator (Fig. 1) frees the surgeon's hand or obviates the need for an assistant. In addition, it can be torqued and angulated to facilitated suture insertion.
Figure 1.
Rampley's sponge holding forceps holding the purse-string suture anoscope on the circular anal dilator.