Transanal Stapling Techniques for Anorectal Prolapse

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 pr- ess. 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 pat- physiology 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.

From the reviews: "This is an excellent description of the historical background and a comparison of two similar techniques for two different diagnoses, internal hemorrhoids and obstructive defecation … . the audience is … colorectal surgeons and surgeons who do a larger amount of anorectal or pelvic floor work. … It is very clear and concise and the diagrams/photos are particularly good. … a great addition to the subspecialist’s library and will probably become a classic since it covers the material so precisely and completely." (Shauna Lorenzo-Rivero, Doody’s Review Service, April, 2009)

David G Jayne MB BCh FRCS MD, Academic Surgical Unit, St James’ University Hospital, Leeds, UK.Clinical Editor of International Journal of Medical Robotics & Computer Assisted Surgery, John Wiley & Sons (2004-)