The treatment of mixed hemorrhoids with external stripping and internal ligation is considered to be the most classic operation in traditional surgery. The operation is to cut the external hemorrhoids from the anal opening, and then separate upwards until the internal hemorrhoids above the dentate line. Finally, the base of the internal hemorrhoids is ligated and removed. The operation spans the entire anal canal from the anal edge to the end of the rectum, so the surgical wound Because the painful and elastic skin of the anal canal is removed by the operation, the pain is obvious after the operation. Excessive skin removal will lead to a decrease in anal bowel control. If there is a scar contracture, it will also cause anal stenosis. The PPH operation is to circularly remove the lower part of the rectum, submucosa tissue, and the upper part of the internal hemorrhoids. At the same time, the distal and proximal ends are nailed and fixed, so that the retained anal cushion after nailing does not prolapse downward, thereby solving The problem of internal hemorrhoids prolapsed, and there is no pain nerve above the dentate line, it is a "painless" area, so it can better solve the postoperative pain problem. At the same time, because PPH surgery retains part of the anal cushion tissue and the anal canal skin tissue intact, it can minimize postoperative anal stenosis, sensory incontinence, and fine stool control dysfunction. Of course, if you are in PPH surgery The posterior external hemorrhoids are still obvious, we need to remove them at the same time to ensure long-term results.
Since this operation completes the nailing while cutting, there is only an anastomosis and almost no wound, so the wound is greatly reduced compared with traditional resection, so the postoperative hospital stay and the time to return to work are also greatly shortened, which is tight for the rhythm of modern life For urbanites, it is a better choice.
In short, compared with traditional hemorrhoidectomy, PPH has the advantages of less pain, faster wound healing, faster recovery, and less impact on anal function. Of course, these advantages must be based on the correct choice of surgical indications and proficiency in operating skills. .
The treatment of prolapsed hemorrhoids with a stapler is not only a reform of the treatment tool, but also a change in the treatment concept, which is more in line with the concept of minimally invasive and painless treatment in the future, and in line with the development of modern surgery! When one day, biodegradable biomaterials can replace the currently used titanium nails and make the nails stronger and more reliable. This operation will surely bring greater benefits to patients with severe prolapsed hemorrhoids!
--------Excerpt from "The Secret of Hemorrhoids" edited by Li Shenglong and Yin Tingbao, published in October 2005