Y.K. Lim • K.W. Eu () • K.S. Ho • B.S. Ooi • C.L. Tang Department of Colorectal Surgery Singapore General Hospital Singapore E-mail: gcsekw@sgh.com.sy plaints after surgery. Technically, the new PPH03 stapler device has a quick-close knob, which allows rapid open- ing and closing. The closed staple height of 0.75 mm increases staple line compression on tissue and key blood vessels, hence minimizing bleeding. Prior to this, stapled hemorrhoidectomy was done using the PPH01 device. Conclusions Stapled hemorrhoidectomy using the new PPH03 stapler is a safe, short and effective pro- cedure in the management of hemorrhoids. It can be done in the ambulatory setting and patients have few postoperative complications. Key words Stapled hemorrhoidectomy • PPH03 Introduction Hemorrhoidectomy is one of the most commonly per- formed anorectal operations. It is usually necessary when hemorrhoids are complicated by prolapse and persistent bleeding, or when internal hemorrhoids remain sympto- matic after ligation or sclerotherapy. Stapled rectal muco- sectomy was introduced in 1997 [1] and stapled hemor- rhoidectomy (SH) was reported one year later [2] as a less painful alternative to the open Milligan-Morgan pro- cedure. Generally, studies have found that patients who have had stapled hemorrhoidectomy have less pain and experience faster recovery compared to those treated with conventional hemorrhoidectomy [2–6]. The short-term benefits of SH are established and our center is very familiar with SH and have previously used the PPH01 (Ethicon Endosurgery, Cincinnati, USA) stapling device. Here we report our experience with the new Procedure for Prolapse and Hemorrhoids (PPH03) Proximate HCS hemorrhoidal circular stapler (Ethicon Endo-Surgery, Cincinnati, USA), which is a modified version of the PPH01 stapler and available for use since April 2004. Y.K. Lim • K.W. Eu • K.S. Ho • B.S. Ooi • C.L. Tang PPH03 stapled hemorrhoidectomy: our experience Received: 25 June 2005 / Accepted: 25 August 2005 / Published online: 15 March 2006 ORIGINAL ARTICLE Abstract Background Stapled hemorrhoidectomy is an established treatment for hemorrhoidal disease. We evaluated our experience with stapled hemorrhoidecto- my using the new Procedure for Prolapse and Hemorrhoids (PPH03) Proximate HCS hemorrhoidal circular stapler (Ethicon Endo-Surgery). Methods We retrospectively reviewed clinical data for 238 patients who had undergone stapled hemorrhoidectomy in our department over a 2-month period. Patients were fol- lowed-up for a median of 3.5 weeks (range, 1–11 weeks) and were analyzed for complications and resolution of symptoms. Results The hemorrhoids treated were third- and fourth-degree, as well as second degree (after fail- ure of other therapies). Mean duration of surgery was 12.7 minutes (range, 5–20 minutes) and the majority of patients was treated with an ambulatory procedure. Most patients were discharged within 6 hours after surgery. On follow-up, 3.7% of patiets had minor com- Tech Coloproctol (2006) 10:43–46 DOI 10.1007/s10151-006-0249-3