Hemorrhoidectomy according to Milligan-Morgan: ligature and excision technique

The author notes of the fundamental principles and particularly the techniques of hemorrhoidectomy according to Milligan-Morgan, adopted with full satisfaction in more than 1,000 cases of third and fourth degree hemorrhoids. Correct indication and a precise, accurate technique based upon the high ligature of the vascular peduncle and on the preservation of the muco-skin bridges, are the essential conditions for the radicality of the intervention in 97% of the cases and for a minimum incidence of morbility. The modifications by Arnous based upon a posterior sphincterectomy with anoplasty in those cases with sphincteric hypertone, and upon the revision of the muco-skin bridges make this technique feasible even in the most complicated cases.