Dear Editor, In the last few years, many new surgical devices and instruments have emerged. These are being projected as innovation and revolutions in the field of medicine. Due to constant introduction and marketing of new surgical technologies, surgeons and doctors sometimes have difficulty deciding whether a new technology will be beneficial to their patients. In the last decade, we have seen many new inclusions in coloproctology which mainly include the staplers, Harmonic Scalpel, LigaSure, fistula plugs, Doppler-guided dearterialization, glues for fistula closure, Radiofrequency surgery and a number of pharmacological agents which have been proposed as non-surgical options for the treatment of anal fissure. However, it is seen that many of the new surgical devices are being marketed without sufficient evidence of effectiveness and safety [1]. There is growing evidence that manufacturers influence research findings and take all the steps to publish them! The intention behind this practice is to satisfy company owners and shareholders by seeking market share and financial success; but at times this may cost patient safety and satisfaction. There are many reasons which persuade physicians to adopt new technologies and instrumentations. The main aim is to improve patient care, as it is considered that the new surgical procedures will be more effective and/or safer for patients than the conventional techniques and ultimately more cost effective than the established procedures. At the same time, a desire to learn new techniques, to be pioneer in the field, or to lure and attract the patients by showing that they are doing something new and extraordinary for them are few other factors. New procedures requiring new instruments and advanced technical innovations are appealing because they are projected to be less invasive and are claimed to have shorter operative times. The apparent ease of use of such devices may lead to adoption of these techniques by surgeons who are not skilled enough to handle such instruments and techniques. The ongoing trend of introducing oneself as an expert in carrying out newer technique is to attend a 2–5 days training course conducted by the instrument manufacturer, perform several similar procedures in the animal laboratory, read all the recent pertinent literature, and then to start practicing the newly learned techniques on the patients. Patients too are to some extent responsible for driving the demand for new surgical techniques. This is due to the belief that new is better. But it is they who are at the risk, as they have to suffer the consequences of a new device used inappropriately or by an inadequately trained surgeon. This premature implementation of new devices into clinical practice with none or limited evidence of safety or effectiveness not only deprives the patients of expected standard of care, but also makes them vulnerable to some known and many unknown hazards of these new techniques. To quote few examples, stapled hemorrhoidopexy has been taken up with a great enthusiasm all throughout the world as being painless and most efficacious way of treating hemorrhoids. However, late results have come up with need of reoperations in about 10% of the patients [2]. Another significant finding was lasting perineal pain of unexplained etiology and persistent bleeding from hemorrhoidal disease distal to the staple line [3]. There are several reports of abuse of this technique in India, where patients of early grades of hemorrhoids (Grades 1 and 2) are being operated with staplers, which P. J. Gupta (&) Gupta Nursing Home, D/9, Laxminagar, Nagpur 440022, India e-mail: drpjg@yahoo.co.in; drpjg_ngp@sancharnet.in