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Related Experiment Videos

Stapled hemorrhoidectomy: surgical notes and results.

Domenico Mascagni1, Kenneth Paul Zeri, Filippo Maria Di Matteo

  • 1Department of Surgical, Sciences, La Sapienza University, Rome, Italy.

Hepato-Gastroenterology
|December 31, 2003
PubMed
Summary

Stapled hemorrhoidectomy using the Longo

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Area of Science:

  • Colorectal Surgery
  • Surgical Innovation
  • Gastroenterology

Background:

  • Hemorrhoid treatment has evolved, with stapled hemorrhoidectomy gaining traction.
  • The Longo's procedure offers a novel approach to prolapse reduction.
  • A dedicated instrument kit (PPH01) has facilitated the widespread adoption of this technique.

Purpose of the Study:

  • To evaluate the efficacy and safety of the Longo's procedure for treating severe hemorrhoids.
  • To compare stapled hemorrhoidectomy outcomes with traditional Milligan-Morgan diathermic hemorrhoidectomy.
  • To analyze pain, complications, recurrence, and hospital stay associated with stapled hemorrhoidectomy.

Main Methods:

  • 198 patients with III-IV degree hemorrhoids underwent stapled hemorrhoidectomy using the PPH01 kit.

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  • Minor modifications to the original Longo's technique were implemented, focusing on anal dilator handling, purse-string suture technique, and hemostasis.
  • Outcomes were compared to 40 patients who underwent Milligan-Morgan hemorrhoidectomy.

    • Main Results:

    • Stapled hemorrhoidectomy showed lower rates of moderate-to-severe pain (6%) and persistent pain (2.5%).
    • Postoperative bleeding rates were 4.5% (short-term) and 3.5% (long-term), with a 2.5% recurrence rate.
    • The mean postoperative hospital stay was 1.6 days, significantly shorter than the Milligan-Morgan group, with reduced bleeding and soiling.

    Conclusions:

    • Stapled hemorrhoidectomy (Longo's procedure) is a safe and effective treatment for severe hemorrhoids.
    • This technique offers significant advantages over Milligan-Morgan hemorrhoidectomy, including reduced pain, bleeding, and hospital stay.
    • The observed outcomes support the increasing approval and diffusion of stapled hemorrhoidectomy in surgical practice.