Page 44 - NEWSLETTER_15

E.O.E Newsletter | www.huanet.gr
blood loss, better cosmetic results and surgeons’ more convenient experience are all advantages which foster the use of circular stapler. The only disadvantage of the circular stapler remains its cost, which is inevitably higher than the conventional methods. However, this drawback can be easily overshadowed by the many advantages associated with its use. Similar results were reported by Jin et al., who performed a prospective randomised clinical trial, comparing adult male circumcision with a circular stapler versus conventional circumcision. In their study, 879 consecutive adult male patients were randomly divided into 2 groups: a stapler circumcision group and a conventional circumcision group. The authors reported significantly shorter operative time and lower blood loss volume in the stapler group, with the intraoperative and postoperative pain scores being also remarkably lower in the stapler group compared with the conventional group. Moreover, the stapler group was associated with notably fewer complications than the conventional group. Nevertheless, the treatment costs in the stapler group were much higher than those in the conventional group and most patients undergoing stapler circumcision required removal of residual staple nails. They concluded that stapler circumcision is a time- efficient and safe circumcision technique, needing further improvement [1]. Pozza et al. also presented their results, using a new mechanical stapling tool (the “langhe disposable circumcision suture device”, LDCDS). They used the LDCSD in 20 patients aged from 14 to 80 years-old with congenital phimosis, redundant prepuce or balanopostitic outcome, reporting simple and easier manipulation, shorter operation time, fewer complications and better cosmetic results. They, thus, concluded that the LDCSD is a useful tool to perform a quick, aesthetic, effective and safe circumcision [4]. Similarly, Yuan et al. investigated the performance of a circular cutter with stapled anastomosis for circumcision in a total of 62 men, reporting that it is a 1-step device capable of achieving excellent postoperative results with minimal operative time [3]. Finally, Jiang et al. investigated the safety and efficacy of circumcision stapler in paediatric patients, concluding that it is superior to conventional circumcision for the advantages of shorter operation time and fewer blood loss [5]. Our results along with results from other studies demonstrate that the stapler is a very promising device. Further development and technical improvements can make its future even more promising.
REFERENCES
Intraoperative photo of a circumcision with the circular stapler.
The postoperative cosmetic result of the procedure in two (2) of our cases.
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