Supradentate Transmucosal Hemorrhoidopexy (Original Technical Variant)

Abstract

Symptomatic hemorhoidal disease is a serious issue affecting the quality of life. The multiplicity of current interventional procedures reflects the failure of covering all pathological aspects, thus justifying the quest for other operative solutions. Any new operative procedure is challenged by the need for broad applicability and less invasive attributes and should fit inside the frame of reasonable costs, fair efficacy, low morbidity and recurrence rate based on a procedural technique that is simple enough, reproducible and easy-tolearn. Aiming to achieve these goals we conceived a procedural variant of hemohrhoidopexy fit for outpatient surgery, a technique that does not require sophisticated/costly medical equipment or disposables and is less invasive. The operative indication concerned 2nd, 3rd and 4th grade hemorrhoids. The surgical indication was represented by 2nd, 3rd and 4th grade hemorrhoids. The needed anesthesia is regional (caudal spinal anesthesia), which qualifies this procedure for private medical services. Prolapse reduction is followed by transmucosal suturing using two rows of slowly absorbable half-step staggered en-X stitches placed just above the dentate line. Preliminary results are encouraging both as therapeutic success rate and legerity of postoperative consequences. This hemorrhoidopexy is a simple and broadly applicable technique, causing mild pain, low morbidity and good efficacy, preferable to other techniques used to treat 3rd grade and selected 4th grade hemorrhoids.

Haemorrhoidal artery ligation with and without Doppler guidance in the treatment of haemorrhoidal disease: a single-centre randomized study

“…По нашему мнению, в большинстве наблюдений пульсация ГА отчетливо определяется пальцем хирурга в тех же точках, в которых они выявляются ультразвуковым датчиком. Хотя исследования, посвященные выполнению изолированной мукопексии, косвенно свидетельствуют об отсутствии необходимости прецизионного лигирования ГА [14,19,20], в случае выявления пульсации ГА при пальцевом исследовании, по нашему мнению, их все-таки следует перевязывать перед выполнением мукопексии.…”