Transanal Suture Rectopexy for Haemorrhoids: Chivate's Painless Cure for Piles

The aim of the study was to evaluate Chivate's new procedure of transanal suture rectopexy for haemorroids for pain, bleeding, hospital stay, recurrence and complications. During the period between January 2006 and December 2008, the procedure was used for 166 cases symptomatic of grade II, III and IV haemorrhoids, at six different institutes by five different colorectal surgeons. In the series, 92 cases were males and 74 cases were females; average age was 49.5 years; youngest patient was 23 years of age and eldest was of 82 years of age. According to the gradation, II-52 cases, III-86 cases and IV-28 cases were enrolled for the procedure. The piles mass was reduced by head low and manually. The mucosa and submucosa were transfixed to muscle of the rectum by 0.5-1.0 cm long stitches. Similar stitching was continued all along the complete circumference of the rectum, 2 and 4 cm distal to the dentate line. In all cases, antibiotics and anti-inflammatory medicines were prescribed for 5 days. No pain was noticed in 162 cases; in 4 cases a pain dull in nature was described by the patients. All the 166 cases were discharged after 24 h. Intraoperative bleeding from the suture line was observed in 15 cases, which required temporary compression. On proctoscopy, in 3 cases intra-anal grade I, protrusion of piles cushion without bleeding was noticed. No incontinence, no recurrent bleeding, no frequency of stool, or no tenusmus was observed. In 2 cases, 6 months after operation, residual external piles were observed, which required excision. The procedure requires no special costly instruments or any disposables. Patients require short stay for 24 h. The procedure is a painless cure for haemorrhoids.