A new type of open-loop anoscope was used in tissue selective rectal mucosal resection and anastomosis (TST), and the clinical efficacy and safety of this method were evaluated.

Forty-eight patients with grade Ⅲ and Ⅳ prolapsed hemorrhoids were selected as subjects, and an anal anastomat was performed using an open-loop anoscope. Observe the operation and completion, the amount of tissue removed, the time spent on surgery, the length of postoperative hospital stay, the postoperative pain score, the feeling of anal bulge, and the presence or absence of complications.

All 48 patients successfully completed the operation without interruption or midway change of the surgical plan. Intraoperative operation is smooth, no abnormalities in the instrument, nail removal, and failure to fire. There was less bleeding during the operation and no uncontrollable bleeding occurred. The average operation time was (21.3±5.5) minutes, the average tissue resection amount was (11.6±1.9) mL, and the average postoperative hospital stay was (4.8±1.7) days. After 6 months of follow-up, there was no clinical stenosis and potential subclinical relative stenosis in the entire group.

The application of open-loop anal mirror in TST can selectively remove enough prolapsed mucosa while preserving part of the normal rectal wall, avoiding serious complications such as rectal stenosis and rectal vaginal fistula from the technical source. Postoperative pain, anal bulge, and defecation dysfunction are also relatively mild, which can be regarded as a simple, safe and effective surgical procedure.