Also known as "circumcision of hemorrhoids", this is a new technique based on the new understanding of the pathogenesis of hemorrhoids caused by anal pad disease. PPH surgery uses a special instrument called a "PPH stapler" to make a circular resection of the prolapsed rectal mucosa above the hemorrhoids. During the operation, first open the anus and suture the rectal mucosa about 4 cm above the dentate line (the junction between the rectum and anal canal), and then insert the PPH stapler into the anus. The stapler can tape the prolapsed mucosa It only takes about half an hour to remove it. Because the rectal mucosa above the dentate line is innervated by splanchnic nerves, the patient has almost no pain after the operation; and because the operation not only removes the rectal mucosal prolapse zone, but also blocks the terminal anastomotic branches of the arteries and veins of the rectum, eliminating The root cause of hemorrhoids has a very ideal therapeutic effect on internal hemorrhoids, external hemorrhoids, mixed hemorrhoids, ring hemorrhoids, severe hemorrhoid prolapse, prolapse and so on. It has the characteristics of quick effect, quick recovery and no pain after operation.
Scope of application
It has a very ideal therapeutic effect on internal hemorrhoids, mixed hemorrhoids, ring hemorrhoids, severe hemorrhoid prolapse, prolapse and so on. Prolapsed hemorrhoids, namely hemorrhoids in stage Ⅱ, Ⅲ, and Ⅳ or mixed hemorrhoids with internal hemorrhoids, especially the hemorrhoids with a circle, are especially suitable for middle-aged and elderly people, white-collar workers who pay attention to efficiency, and those who have relapsed in traditional treatment, accompanied by light Patients with severe rectal prolapse and rectal mucosal prolapse.
Principle of operation
Use a special circular stapler to insert into the rectum through the anus, circularly excise the mucosa and submucosal tissues of the intestinal wall at the lower end of the rectum, and perform an anastomosis at the same time as the excision, so that the prolapsed anal cushion is lifted and the normal anatomical position of the anal cushion is restored. The "suspension" function cuts off the arterial blood branch supplying hemorrhoids at the same time, and plays a "cut-off" function, so as to achieve the goal of radical cure.
1. Safety: There is no need to remove the anal cushion, and the normal function of the anus is preserved to the greatest extent to avoid complications such as anal stenosis and anal incontinence.
2. Painless: Pull the hemorrhoids protruding from the anus back to the original position, and cut off the blood vessels that provide blood to the hemorrhoids, without damaging the perianal skin, so there is almost no pain after the operation.
3. Small trauma and quick recovery: the circular stapling of the mucosa is a non-open wound, with less bleeding, eliminating the trouble of dressing change after surgery, and returning to normal life quickly.
4. Scope of diagnosis and treatment: ring hemorrhoids, multivalve hemorrhoids, huge isolated hemorrhoids, internal hemorrhoids, external hemorrhoids, mixed hemorrhoids, ring hemorrhoids, incarcerated hemorrhoids, rectal mucosal prolapse, prolapse, etc.
5. Suitable target: Because of less damage, it is especially suitable for middle-aged and elderly people, white-collar workers who pay attention to efficiency, and those who have relapsed in traditional treatment, and patients with mild prolapse and rectal mucosal prolapse.
It is not recommended for pregnant women, children, intractable constipation, pelvic tumors, portal hypertension, Bu-Ca syndrome or those who cannot tolerate surgery.
Contraindications for PPH surgery include:
● Anal stenosis
● Full-thickness rectal prolapse
In the presence of gangrene or infection, stapled hemorrhoidectomy is an absolute contraindication, because the operation cannot remove the source of infection, and cutting other tissue levels will cause pelvic abscess and fournier’s gangrene (necrotizing fasciitis). Since an anal expander (cad) cannot be inserted, anal stenosis is also a contraindication. Full-thickness rectal prolapse is not suitable for pph surgery.