PPH Procedure

PPH stands for Procedure for Prolapse and Hemorrhoids. It is also known as a stapled hemorrhoidectomy and circumferential mucosectomy.

PPH was developed in the 90's to reduce the prolapse of hemorrhoidal tissue. It was developed to be a minimally invasive surgery. PPH is a welcome alternative to other forms of hemorrhoid surgery because of its simpleness.

The PPH procedure is done by excising a band of prolapsed anal mucosa membrane with a circular stapling device. The prolapsed tissue is pulled into an instrument that allows the excess tissue to be removed while stapling the remaining hemorrhoidal tissue. This helps to restore the tissue back to its normal position.

PPH Tools

The key to the simpleness of the PPH procedure is in the tools. The main tools used in the procedure are a circular anal dilator, a purse-string suture anoscope, and a hemorrhoidal circular stapler.

The circular anal dilator is inserted first, and reduces the prolapse of the anal skin and parts of the anal mucous membrane. The purse-string suture anoscope is inserted through the dilator and will push the prolapsed mucous back against the rectal wall 270 degrees around. By rotating the instrument it is possible to suture the entire anal circumference in a purse-string suture. The stapler is then inserted through the dilator and positioned proximal to the purse-string suture. The stapler is tightened, and then staples the prolapse. They will generally keep the instrument in the closed position for 30 seconds before firing, and 20 seconds after firing to act as a tamponade, which may help promote hemostasis. The stapler releases a double staggered row of titanium staples into the tissue. A circular knife removes the extra tissue. The staples are then examined through the anoscope to check for bleeding. If bleeding occurs, which is fairly common, additional sutures may be placed.

The PPH procedure is a great solution to hemorrhoids and a great choice for a minimally invasive treatment. For more info and animated pictures on the PPH procedure and hemorrhoid surgery in general visit these links.

PPH Procedure
Hemorrhoid Surgery
Hemaway Toilet Seat