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Background: Rectocele is defined as an erniation of the anterior rectal and vaginal wall in the vaginal lumen due to the loss of recto-vaginal septum. Rectal mucosal prolapse was characterized by the protrusion of the mucosa alone in the rectal lumen. The Authors, herein, reported the results of a new surgical technique defined Sequential Transfixed Stitch Technique (STST) using a new anoscope. MATERIALS AND METHODS; A total of 30 consecutive patients symptomatic III or IV stage rectocele assessed with clinical and instrumental criteria were submitted to STST using the new anoscope. The new anoscope, consisting of non-toxic metallic material, designed and realized according to surgery needs and tested by the authors, increases the vision of the anal canal can be fixed according to the operator's needs., Results: STST was correctly performed in all the cases without early and late complications. The mean value was of 17 according to the Agachan-Wexner for patients with rectocele, significantly improved score in comparison to pre-operatory condition (p<0.05). Surgical procedure of rectocele repair was judged satisfactory in 80% of the cases., Conclusions: The new operative anoscope was useful in III and IV stage rectocele repair with STST, ensuring ease of implementation of the binding repair in the absence of side effects for the patient.

In this paper the authors present the technical characteristics and clinical results of a new anal retractor designed and produced by them. This new instrument, made of disposable material, allows the proctologist to operate completely alone thanks to a system of rotating rings which are fixed directly to the patient's legs by means of Velcro bands. Twenty consecutive patients with proctological diseases have been operated on to date with the new device. No complications were registered in our series. The rotation movement and overall stability of the retractor were judged sufficient in 6 cases and good in 14. Opening of the device proved asymmetrical in 20% of the cases without this affecting the surgical technique. Our surgical team considered the prototype ideal, and the operative space available to the surgeon much greater than with previous retractor models. No limitations have been observed in treating any of the proctological diseases. The possibility of performing sutures in the anal canal was judged to be good. In conclusion, our new anal retractor would appear to guarantee greater autonomy in proctological surgery with much better clinical and therapeutic results and lower costs.