Check, whether the hemorrhoids can be reduced, and if so, intraoperatively verify the indication for stapled hemorrhoidopexy. Carefully dilate the anal sphincter.
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Verifying the indication and dilating the anal sphincter
![Verifying the indication and dilating the anal sphincter]()
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Purse string suture
![Purse string suture]()
With the PPH set (Procedure for Prolapse and Hemorrhoids), place a circular, submucous purse string suture just superior to the hemorrhoidal base, markedly proximal to the dentate line and sparing the muscles.
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Inserting the stapler
![Inserting the stapler]()
With the stapler fully opened, close and tie the purse string suture below the anvil. Digitally examine the anal canal and stapler position.
Resecting the hemorrhoidal tissue
When the stapler is being closed, it is pulled 3-4 cm into the anal canal, thereby ensuring that th
When the stapler is being closed, it is pulled 3-4 cm into the anal canal, thereby ensuring that th
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