Thursday, September 23, 2010



Generally speaking, external and internal hemorrhoids can be treated by:
• Stapled hemorrhoidectomy treatment
• Clamp and cauterization,
• Ligature operations of hemorrhoids.


Dr Longo is an Italian surgery who introduced his technique to the world in June 1998 in Rome. He reason that since piles are due to prolapse or displacement of enlarged, engorged anal cushions from the upper anus and lower rectum, why not pull them up to their normal positions from the inside instead of cutting them out from the outside.

Fig. 5: Longo hemorrhoidectomy stapling device.

If at the same time, you could cut down the flow of the very rich blood supply, you would reduce the congestion and cause the piles to regress and shrink. The beauty of this approach is that the cutting is on tissues, which carry no sensory nerve endings, so it is totally painless.

Fig. 6: Stapling of hemorrhoids in progress.

Source: Ibid

The Longo hemorrhoidectomy uses a purpose designed staple device to cut a 2 cm circumferential sleeve of lining of the rectum which will pull up the displaced piles to their normal positions, and will also interrupt their blood supply. Over a few days or weeks, the piles will regress to normal. Because of the circumferential cut, all piles are treated, unlike conventional surgery when smaller piles are often left behind to grow giving them a chance to recur.
The bonus of this procedure is once the external piles are fully pulled inside and regress to normal, the anal skin becomes smooth again.

With the conventional operation, skin tags are often formed even though the piles have been completely removed. Patients, especial women, do not like skin tags.

Fig. 7: Final result normal anatomy restored.

Source: op.cit

The other advantage of this procedure is that that patients can be discharged the same day later and return to normal activity much quicker, average 4 days to one week instead of two to three weeks for the conventional operation.
Possible complications. [continued]

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