This video demonstrate This operation is also known as stapled anopexy. A specially designed circular stapling instrument is inserted through the anus (back passage) into the rectum. . The operation pulls the swollen and prolapsing blood vessels of the hemorrhoids (piles) back into their normal position by removing a circumferential section (complete ring) of the internal rectal lining. The wound is inside the rectum causing little pain. Patients usually underwent a one-day surgical procedure, with a preoperative self-administered rectal enema on the evening before and the morning of the operation; no antibiotic prophylaxis was given.

Hemorrhoids, commonly known as piles, are swollen veins in the rectal and anal area that can cause discomfort, bleeding, and prolapse. In cases of advanced hemorrhoids with significant prolapse, the Procedure for Prolapse and Hemorrhoids (PPH), also called stapled hemorrhoidopexy, is a modern, minimally invasive surgical technique that offers effective relief with faster recovery.

What is PPH?

PPH is a surgical procedure designed to treat prolapsed hemorrhoids by repositioning the hemorrhoidal tissue back to its normal anatomical position rather than removing it entirely. This technique involves using a circular stapling device to excise a ring of mucosa above the hemorrhoids, which lifts the prolapsed tissue and restores normal blood flow.

Advantages of PPH

Less Pain: Since the procedure avoids sensitive anal tissue, patients experience less post-operative pain compared to traditional hemorrhoidectomy.

Faster Recovery: Most patients can resume normal activities within a few days.

Effective for Prolapse: Particularly useful for patients with significant prolapse of hemorrhoidal tissue.

Lower Complication Rates: Reduced risk of anal stenosis and incontinence compared to conventional surgery.

The Procedure

Anesthesia: PPH is usually performed under spinal or general anesthesia.

Preparation: The anal canal is cleaned, and a circular anal dilator is inserted to provide access.

Stapler Placement: A circular stapler is introduced above the hemorrhoids.

Tissue Excision and Stapling: A ring of excess mucosa is excised, and the stapler simultaneously staples the tissue, lifting and securing the hemorrhoids in place.

Completion: The device is removed, and hemostasis is checked. The procedure typically takes less than an hour.

Post-Operative Care

Patients are advised to avoid heavy lifting and maintain a high-fiber diet to prevent constipation.

Pain and discomfort are usually mild and managed with medications.

Follow-up visits are necessary to monitor healing and ensure the prolapse has been adequately corrected.

Conclusion

PPH is a safe, effective, and less painful alternative to traditional hemorrhoid surgery, especially for prolapsed hemorrhoids. By addressing both symptoms and tissue prolapse, it provides significant relief and allows for quicker return to daily activities. Patients with symptomatic prolapse and bleeding should consult a colorectal surgeon to determine if PPH is the appropriate treatment option.