Use of a dinner fork as a retractor during transanal excision of large rectal villous adenomas

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Abstract
Because of inadequate exposure by standard retractors during transanal excision of rectal adenomas, a dinner fork may provide sufficient retraction to obtain a sample for histopathological biopsy of a 4 cm polyp. This technique is reported to be successful in 10 patients. Surgical and anesthetic procedures are described in detail including use of a Pratt speculum, epinephrine administration to reduce bleeding and excisional sequence.

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