The position of choice for the procedure was jack knife or left lateral position and the procedure is performed through an anoscope
as recommended by Sun et al in 2016, a position soothing and acceptable to patients8.
We routinely use a lighted bivalve anoscope
and over-suture the staple line with a 2-0 Vicryl suture.
With an open-sided anoscope
(CHEX CPH 34), a purse suture was inserted into the mucosa and submucosa of the rectum at level 2 of the open-sided anoscope
(approximately 3-4 cm above the hemorrhoidal piles).
Your doctor may also look closely at the rectum with an anoscope
(a lighted tube useful for viewing internal hemorrhoids), a proctoscope (which can be used to examine the entire rectum), or a sigmoidoscope (to look at the rectum and lower colon).
A purse-string anoscope
was inserted into the anus to inspect bleeding at the staple line.
First, hydrogen peroxide was injected into the external orifice, and the internal orifice was identified using an anoscope
. A probe was then inserted into the external orifice and out of the internal orifice.
In LUV procedure, submucosal tissue of the hemorrhoidal pile base was transfixed using absorbable sutures under direct vision through anoscope
in the Jackknife position.
Purse string anoscope
was then used to place the purse string sutures on rectal submucosal level using Prolene 2/0, placing 5-6 bites at 4 cm distance from the anal verge.
 and was performed by a single experienced surgeon as follows: TST consists of two rows of 33 mm diameter titanium staples; the obturator was inserted into the anus for full dilatation; the three-window anoscope
with the obturator was inserted into the anus again; the obturator was pulled out (Figure 1(a)); the mucosa was sutured using a 2/0 Vicryl suture (Ethicon, Cincinnati, OH, USA), at 3-4 cm above the dentate line; the TST was opened to the maximum; the 2/0 Vicryl suture was tied to the rod of the TST (Figure 1(b)); the stapler was strained and fired; and the TST was removed from the anal canal.
THD device consists of an anoscope
equipped on the superior surface with a Doppler sensor and a light source.
The researchers stressed that collecting an anal sample for cell study is easy, fast, and painless and can be done in the HIV clinic without a specialized tool called an anoscope
. The study showed that analyzing anal cells and testing women for high-risk HPV types, especially HPV-16, are a simple and reliable way to find HIV-positive women with anal lesions.