Milligan-Morgan hemorrhoidectomy - general and visceral surgery
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Inspection and confirmation of indication
Dissecting the pile
Grasp the pile with a Kocher forceps and retract it outward. With diathermy (e.g. electric needle cautery) start the dissection of the pile from the outside in clearly lateral to the anocutaneous line. Then extend radial incision proximally to just inside the dentate line. At the same time dissect the hemorrhoidal tissue off the internal anal sphincter muscle underneath. The muscle is completely spared.
Suture ligation at the base and excision of the pile
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for the modul: vascular surgery