The PPH Stapler In The Treatment of Hemorrhoids.
Hemorrhoids are nothing more than collections of nerves, arteries, veins and connective tissue. They are located in the anal canal and serve to cushion stool as it passes outward. Hemorrhoids are present from birth. When they enlarge and become symptomatic, a trip to the proctologist, also known as a colon and rectal surgeon, may be in your future.
Symptoms include bleeding, pain, itching discharge, mucus and prolapse. Prolapse is defined as a protrusion of the hemorrhoid from the anal canal. Sometimes the prolapse reduces by itself, spontaneously. Sometimes the patient must manually replace it. And sometimes, the prolapse cannot be reduced.
Treatments Before Surgery.
Surgical therapy is used when all other methods of treatment have been unsuccessful in stopping the symptoms. Therapies used in the doctor’s office include:
- Topical creams and stool softeners.
- Injections (sclerotherapy).
- Rubber band ligation.
- Infrared coagulation (IRC).
These therapies are successful in a majority of cases. But, what if they do not help? What if the symptoms increase? Time to call the colon and rectal surgeon.
PPH (Procedure For Prolapse And Hemorrhoids).
While there are several surgical options for treating intractable hemorrhoidal disease, one of the more popular methods of treatment is the PPH (stapled hemorrhoidectomy), invented by Anthony Longo in 1992. Rather than cutting out hemorrhoids as in a traditional hemorrhoidectomy, in a PPH, the hemorrhoids are partially excised (removed), with the remaining tissue being returned to its normal location. This is known as a “pexy”. The PPH is performed by a trained surgeon, in an outpatient center or hospital such as Cedars-SinaiMedicalCenter, under sedation. It proceeds as follows:
- The patient is positioned on the table and sedated.
- An anoscope is placed into the rectum.
- A stitch (a purse string suture) is place in the rectum around the circumference of the rectum.
- The stapler is opened and the tip (the anvil) is place across the suture. The suture is tied and the redundant tissue is drawn into the jaws of the stapler. The stapler is closed.
- The stapler is fired. The excess tissue excised, and the two ends of remaining mucosa (lining) are put back together using a double row if titanium staples.
- The patient is allowed to wake up and is later discharged home.
Los Angeles Colon and Rectal Surgical Associates.
The board certified surgeons of Los Angeles Colon and Rectal Surgical Associates were leaders in the development of PPH in Los Angeles. With many years of experience, the surgeons are well equipped to help you through the process of diagnosing and treating your hemorrhoids. Although this may be a daunting experience, the doctors and the staff will answer your questions and provide you with the information necessary to move forward.
By calling (310)273-2310, you will be able to schedule a confidential consultation with a physician. You may be able to see pictures of the procedure and have a chance to ask questions. Should you desire to proceed with a PPH, the staff will smooth the path for you.