Procedures for Benign Anorectal Disease

Published on 11/04/2015 by admin

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Last modified 11/04/2015

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CHAPTER 17 Procedures for Benign Anorectal Disease



Rubber band ligation can be performed in the office setting and is frequently used for the treatment of first-, second-, and some third-degree hemorrhoids. Traditional open and closed hemorrhoidectomy procedures are technically similar and lead to comparable outcomes. As its name implies, the closed technique involves closure of the defect created by hemorrhoid excision and is the approach most frequently used in the United States. Stapled hemorrhoidopexy is an increasingly popular alternative that may be associated with less postoperative pain than traditional hemorrhoidectomy.

III. Surgical Approach


Figure 17-2 Closed hemorrhoidectomy. A and B, The hemorrhoidal bundle is exposed and excised via an elliptical incision. Care is taken to preserve the underlying sphincter muscles. C, After excision, the defect is closed.

(From Townsend CM, Beauchamp RD, Evers BM, Mattox KL [eds]: Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice, 17th ed. Philadelphia, Saunders, 2004.)