How I do it: Submucosal hemorrhoidectomy with advanced bipolar technology-modified Parks' method.

Area of Science:

• Colorectal Surgery
• Minimally Invasive Procedures
• Hemorrhoidal Disease Treatment

Background:

• Park's submucosal hemorrhoidectomy is minimally invasive but underutilized.
• Hemorrhoidal disease affects a significant portion of the population.
• Current treatments vary in efficacy and invasiveness.

Purpose of the Study:

• To evaluate a modified submucosal hemorrhoidectomy technique.
• To assess the combination of Park's method with LigaSure™ bipolar technology.
• To determine the safety and efficacy of this combined approach for stage III hemorrhoidal disease.

Main Methods:

• A patient with stage III hemorrhoidal disease underwent surgery using subarachnoid anesthesia and the Lloyd Davis position.
• External hemorrhoids were lifted to expose internal hemorrhoids.
• LigaSure™ bipolar technology was used for submucosal dissection and hemorrhoidal artery ligation, preserving mucosa.

Main Results:

• The modified technique resulted in three small anoderm incisions with complete preservation of the anal canal mucosa.
• Hemorrhoidal tissue was excised and arteries ligated without sutures.
• The procedure was performed on a patient with stage III hemorrhoidal disease.

Conclusions:

• This modified submucosal hemorrhoidectomy with LigaSure™ is a promising approach for hemorrhoidal disease.
• The technique preserves anal canal mucosa, potentially leading to less postoperative pain.
• Shorter hospital stays and rapid recovery are potential benefits of this sutureless, minimally invasive method.