Prolapsed Hemorrhoids Procedure

• Insertion of the anal dilator/obdurator.

         A circular anal dilator/obdurator is inserted into the anal canal to push the prolapse back and lift the hemorrhoidal, tissue into place.

• Preparation of the purse-string suture.

        The internal hemorrhoids are held back white a purse string is prepared in the rectal mucosa/submucosa approximately 4-6 cm from the dentate line.

• Initiate placement of the circular stapler.

        A fully opened hemorrhoidal circular stapler is inserted beyond the purse-string suture. The purse string is tied around the anvil to secure the excess mucosal tissue. With the suture threader, each limb of the suture is brought through the charmer of the instrument.

• Insertion of the stapler into the anal canal.

       After the ends of the retraction suture are knotted, the stapler is tightened and gentry pushed into the anal. canal Moderate traction on the purse-string must be maintained so that the prolapse is drawn into the stapler casing.

• Closure, firing, and withdrawal of the stapler.

       The stapler is then dosed completely, fired in one fluid motion, and withdrawn gently. The anal-canal, wall is reconnected and restored, and the hemorrhoidal, artery's terminal branches, which feed internal hemorrhoids, are interrupted.

• Repositioned mucosae and hemorrhoids.

      Successful completion of the procedure for prolapse and hemorrhoids corrects the prolapse, restores internal hemorrhoids to their normal anatomic position, and alleviates the patient's symptoms.