Friday, October 22, 2010



The pile is exposed and liberated to the vascular pedicle as in the clamp and cauterization method. The pedicle is then ligated or tied with catgut or silk.
The general operative procedure of the ligature operation for ordinary piles is as follows:

Step 1: The patient is placed in the lithotomy position, and the orifice of the anus is thoroughly dilated until it remains open and is easy of access. The rectum is washed out and packed with gauze.

Fig. 9: Operation for piles.

The clamp above grasps the pile in the long axis of the bowel. Interrupted sutures are shown placed in position, the sutures are tied after the pile is removed and the pile clamp released.

Step 2: The piles are seen easily; each one is grasped with forceps [Figure 9]. The mucous membrane of the pedicle of each pile is partly divided with scissors or scalpel; the pile is ligated or tied with stout catgut and then cut off. In the case of large pile, special large clamps are used.

Fig.10: Hemorrhoidectomy. After removing the pile, the crushed base is sutured, as shown in the illustration.

Step 3: When all piles have been removed, the gauze tampon is withdrawn from the rectum. The patient is kept constipated for a day or two.

The complication of operation:

The operation may be followed by hemorrhage, laceration; injury and perforation of the rectum, persistent stricture [narrowing of the rectum], or stenosis [stricture] of the anus

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