Hemorrhoidal prolapse & PPH procedure
Published by Jon Mikel Iñarritu August 12th, 2007 in Medical Images Tags: .This is a case of a 67 years old male with history of chronic constipation (20 years) and chronic hemorrhoidal disease came to the office with rectal bleeding and a non-redicible anal mass.
On physical examination we found Grade IV hemorrhoidal disease.
We decide to perform a PPH procedure with an hemorrhoidal circular stapler (33 mm) kit.
Note the tissue removed.
This donut confirms the circular and complete resection of the defect.
On the postoperatory period the patient was in excellent condition without pain and without bleeding.
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hi.
i think this might have been mentioned before, but i just wonder how do u take these pictures? obviously you would have been involved in the procedure? no? or were u just watching and had a great camera phone?
i mention camera phone because wouldn’t u want to be rather discreet or “secretive” to take patient pictures?
yes they are deidentified but do they know? (just wondering, not pointing fingers here or anything like that)
next, i have no idea what is PPH. maybe someone could enlighten me? (i saw haemarrhoids being removed, they were much more severe than that above, and the surgical trainee was using the cautherizer to cut them away bit by bit….
is PPH some novel method of doing things?
Dr. Jeff,
I take all this pictures with the agreement of the patient.
There are four objectives of this pictures:
1. It’s a way to explain my patients the datails of the procedure.
2. I’m able to show them to the students for teaching purposes.
3. I upload them to this site with educational purposes.
4. I usually show the pictures taken to my patients in the PO period so they can figure how was the procedure.
When I can’t take them because I’m too busy during surgery I ask the anesthesiologist or the nurse to take them for me; sometimes with a regular digital camera and sometimes with a cameraphone.
Regarding the PPH, or procedure for prolapsing hemorrhoids with stapler is a “novel” approach to the management of enlarged, prolapsing hemorrhoids. Rather than rely on excision of the complexes, the primary goal is to reduce the hemorrhoidal tissue and anoderm to the correct anatomical location within the anal canal. We use an hemorroidal circular stapler kit which includes: clear plastic anoscope, half-slit anoscope, suture threader, and the 33 mm stapler.
More information about PPH in This Post (Worst hemorrhoidal prolapse ever).
Excellent information which includes the facts just as I needed. I will undergo a PPH in 2 weeks.
If the surgeon desires to take photos I would be fine with that as well.
It´s important to say that the Ferguson hemorroidectomy stills as the gold standard for treatment of hemorroids.
sir,
my elder sister suffering from pph,
she is suffering high swelling on her both legs and stomatch
is any treatment for this
with thanks
yusef