Procedure for Prolapse And Hemorrhoids – PPH

Long time hemorrhoid sufferers will go to great lengths to get the pain, aggravation, and embarrassment. One of the easier surgical procedures is the PPH or procedure for prolapse and hemorrhoids. It is also referred to as stapled hemorrhoidectomy, stapled hemorrhoidopexy, and circumferential mucosectomy.

What Is PPH?

The main surgical tool that is used is the hemorrhoidal stapler device. The main advantage of this approach is that the stapler does not involve as much tissue cutting so that there is less pain due to fewer nerve endings being cut.

As an overview, the kind of hemorrhoids that are best suited for this surgical approach are external, hemorrhoids where there is a mucous prolapse of the anal tissue. What happened after bulging veins stretch the membranes of the anus, the supporting muscular and connective tissue are weakened and stretched so that the veins and the skin around them bulge out of the anus.

Prolapsed tissue means that the internal hemorrhoidal cushions push the hemorrhoidal sacs out. The upper vessels stretch and the middle and lower hemorrhoid vessels can become kinked. If the hemorrhoids continued to grow, they might keep on swelling to the point that they develop thrombosis or the blood flow is completely cut off from the external hemorrhoids and they atrophy.

PPH Procedure

PPH has been in fairly common use since the early 1990s and how it works is that the device is inserted into the anus and the loose anal mucosa membrane that has been stretched by the bulging veins is pulled into the device where it is removed and the remaining tissue is stapled together.

In a little more detail, it works like this: A circular anal dilator reduces the size of the prolapsed tissue that is hanging outside of the anus by pulling it inside. The doctor inserts a purse-string suture anoscope through the dilator into the anus and thus the prolapse is pushed back against the rectal wall and the mucous membrane is captured between the dilator and the anoscope is then ready for the stapler.

The stapler is then placed in the anal canal. The prolapsed mucous membrane is pulled into the casing of the circular stapler. The stapler is tightened and fired in a slow motion – this helps prevent bleeding. When the stapler is fired, a double row of titanium staples attaches the tissue smoothly and the excess mucosa is then sheered off.

Benefits

There are some benefits of PPH. Among the primary benefits are:

• It is not as painful as standard surgery.

• You recover more quickly than from traditional surgery.

• You spend less time in the hospital recovering.

Risk

There are also risks involved with PPH, including the possibility that more than mucosa tissue will be pulled in and cut.

For instance, if muscle tissue is cut, it can damage the anal wall, that the sphincter will be damaged, or that pelvic sepsis can result. PPH is less intrusive than straight surgery but may not work if the person has large hemorrhoids that run together because there might be too much tissue to fit into the stapling device. There is also the possibility that hemorrhoids will recur.

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