Stapled Hemorhoidctomy -
(The worst surgery for piles)
(References / videos at the bottom of the article for public awareness)
Hemorrhoid (Piles) (Bawasiri) patients should never do Stapled Hemorhoidctomy surgery and it should be Banned worldwide:
During Stapled Hemorrhoidctomy the Anal Hemorhoidal Vascular Cushion is cut leading to disability of fecal urgency up to 2 years till it grows back damaging the quality of life.
The function of the Anal Hemorrhoidal Vascular Cushion is to help to seal stools, create air tight seal and continence.
*Warning : Its a Criminal offence by surgeon and hospital staff if patient is not told about the function of Anal Hemorrhoidal Vascular Cushion prior to surgery and should be arrested. *
Stapled Hemorrhoidctomy surgery is for Internal Hemorrhoids only and not for External Hemorrhoids, Fissures or Fistula. The external Hemorrhoids are pulled in due to internal tight stapling and looks like they are gone but they are pulled and tucked inside sphincter muscle. It fools the eye.
During Stapled Hemorrhoidctomy a circular piece of flesh known as anal cushion / anal hemorrhoidal vascular cushion / seal cushion is cut. It is referred to as Donut ring after it is cut. The function of the Hemorhoidal Vascular Cushion is to seal stools and create air tight seal.
Stapled Hemorrhoidctomy can cause Death and MAY give you side effect as follows:
1) Extreme anal sphincter tightening /stenosis / stricture due to anal canal connected muscle damage causing discomfort and pain which will give you narrow stools (pencil size).
2) Fecal urgency (unable to hold stools for long) due to cutting of anal hemorrhoidal vascular seal cushion and the cushion takes long time to grow back. May take 2 years.
3) Anal fissures and spasms due to tight anal sphincter causing tears and cracks.
4) Rectal stricture (tightening and narrowing of rectal cushion after rectum in the anal canal) due to trauma to anal canal and connected muscle damage.
5) Narrow stools (pencil size) due to tightness and narrowing of anal sphicter muscle.
6) May cause Gangrene (reduction in blood supply to anal sphincter muscle)
7) Unhappiness due to discomfort of stenosis (extreme tightness).
8 ) Failing to eat and move freely during working hours due to worrying about fecal urgency.
9) May also cause death due to trauma.
10) Displaced muscle - Anal sphincter muscle is pulled to wrong position from its original position due to cutting and stapling and if scar tissue heals before staples fall it can remain in wrong position causing stenosis and has to be corrected by agraffectomy surgery.
11) Severe back pain and bleeding for 4 months.
12) Physical and psychological trauma.
13) proctitis - rectal inflamation
14) Nerve damage and reduction of blood circulation and sensation in the sphincter muscle
15) Narrowing and Stricture due to over growth of Hemorrhoidal Vascular Anal cushion after it is cut forcing to recut the anal cushion to create space.
16) Staple line fibrosis.
17) Overgrowth of anal cushion after stapled hemorrhoidctomy causing blockage
18) Stools becoming dry and hard due to no secretion of mucosa lubricant by mucos membrane. Later it may secrete mucosa.
You might have to do multiple surgeries due to side effect of stenosis caused by Stapled Hemorrhoidctomy such as:
1) Dilatation - stretching of anal sphincter muscle to remove narrowing.
2) Fissurectomy - removing skin on anal verge so new tissue can grow and heal the fissures.
3) Sphincterectomy - cutting of sphincter muscle to remove tightness.
4) Agraffectomy - removal of pph staples.
5) Strictureoplasty - cutting and elongating the anal sphincter muscle.
6) Anoplasty - mending surgery damage by plastic surgery.
7) Stapled trans anal rectal resection (starr) - cutting of cushion after rectum (rectal cushion) due to narrowing and tightness.
Most patients loose bowel control completely due to multiple surgeries.
Most animation videos on youtube by manufacterers of Stapled Hemorhoidctomy Machines fool patients and inexperienced surgeons that Excess Rectal Mucosa (excess anus skin) is being cut but instead they are cutting the anal seal hemorhoidal vascular cushion used to seal stools.
It may be a money making scheme by some surgeons to make money from multiple surgeries so be careful. Manufacters are doing strong marketing online and are making money big time from this procedure as it's expensive and are fooling patients that its a painless procedure. Refer videos on references.
Manufacters have purposely hidden information on the function of anal cushions on the internet and you will not find proper information on the internet till you go into surgery books. It's a money making scheme. The info is hidden purposely so patients don't get knowledge and manufacters make money. Even in usa it's falsely marketed and patients are being fooled and misguided.
Hemorrhoids (Piles) is a common problem among office workers and driver's who sit for too long, pregnant women, bodybuilders, heavy labourers, those who eat too much chilies & spicies and those who get trauma due to hard stools with constipation.
After Stapled Hemorhoidctomy patients get side effect of fecal urgency. A lot of patients say that they can't travel long distance or eat in peace due to worrying about fecal urgency. Some cut down on eating food volume and others skip lunch during working hours so they don't have to worry about fecal urgency.
When you are not next to the loo and have to hold for long. The anal sphincter muscles, muscles of the anal canal and cushions pull the stools up and the circular anal cushion fills with blood, expands and seals the stools. Anal cushion is an involuntary muscle / cushion in the anal canal between anal sphincter muscle and rectum.
Patients should not be forced by family members, relatives, friends or doctors to do Stapled Hemorrhoidctomy surgery as it's against the law to force or misguide patients and can be considered criminal offense. Surgeons, hospital staff and family members can be arrested if patient is forced.
Surgeons and hospitals can be sued in court by patients if surgeons dont explain to the patient prior to surgery about the function of the Anal Hemorhoidal Vascular Seal Cushion. Unfortunately most surgeons don't tell the truth to the patient about the function of Hemorhoidal Vascular Cushion and are later sued in court for damages.
Stapled Hemorrhoidctomy is for internal hemorrhoids only and not for external hemorhoids. Internal Hemorrhoids and External Hemorrhoids have no connection and have to cut separately. Some surgeons think that Stapled Hemorhoidctomy is also for External Hemorrhoids and have done this surgery for external hemorrhoids due to no knowledge or false information on the internet.
Location of Hemorhoidal Cushion is just above sphincter muscle. Luckily there are 3 cushions between the rectum and anal sphincter muscle in the anal canal namely - Hemorrhoidal cushion, Rectal Cushion and Middle Cushion.
Procedure
During stapled hemorrhoidctomy the sphincter muscle and external hemorrhoids are pulled in during cutting, pulling and stapling. The anal sphincter is pulled in by around 3cm and it looks like the external hemorhoids are gone if present but they are tucked in and hidden inside the anal sphincter muscle. After the staples fall the sphincter muscle comes to it's normal position and the hidden external hemorhoids reappear outside again after 4 months.
When the circular flesh (hemorhoidal cushion) is cut with the machine immediately 56 titanium staples of 33mm in length are placed to stop the bleeding with the machine. The staples should all fall off with feaces gradually overtime. The pulled tight stapling cause extreme tightness and discomfort to anal sphincter muscle. The flexibility, bending and moving space is not there in the anal canal due to the tightness caused by staples.
After stapled hemorrhoidctomy if the scar tissue (cut area) heals before all staples have not fallen, the sphincter muscle can remain up and in wrong position and a small difference of 1 cm from its original position can cause major tightness, discomfort and unhappiness. The stenosis may narrow the sphincter opening and can cause you to have very narrow stools.
If some staples remain and don't fall they have to be checked with endoanal ultrasound with volume probe to spot any staples if left and then they can be removed agragfectomy procedure.
Stapled hemorhoidoctomy is 20 times more painful than normal excision conventional hemorhoidoctomy as a very big piece of flesh is cut compared to excision hemorrhoidctomy. Bleeeding and extreme pain stays for four months after Stapled Hemorhoidctomy surgery.
Conclusion
The internal hemorrhoids grow on the lower part of the anal cushion. Normal cutting of hemorrhoids by normal excision or laser is safer procedure and is the Gold Standard for internal hemorrhoids with no long term lifelong side effects.
Stool size may remain narrow for life after stapled hemorrhoidctomy and may improve with dilatation or self dilatation with petroleum jelly or sesame seed oil.
Holding power and sealing power may remain to some extent but not like before. Exercise may help improve the strength but it is advised not to do Stapled Hemorhoidctomy.
Although the anal cushion grows back after it is cut but sealing strength may not remain like before so stapled hemorrhoidctomy is not advised unless it's a severe internal hemorrhoid case of grade 4 and beyond circular hemorrhoid.
References:
View: https://youtu.be/LfcwBzzo5DY
Dr Sam Webster at 19th minute explains the
Function of Anal cushion (hemorhoidal cushion) is to Seal stools (continence)
lacolon.com
How does PPH work ?
PPH cannot be used to treat external hemorrhoids, which are heavily endowed with pain fibers.
View: https://youtu.be/zRJRvQ1073k
Watch at 27 min
Case 1 - Rubber band ligation killed,
Case 2 - stapled hemorhoidctomy caused extreme tightness (stenosis) and complications ,
Case 3 - USA case wins 10 million dollars
View: https://youtu.be/rNjxG1RehQE
Dr explains side effects of Stapled Hemorhoidctomy of stricture and bleeding.
View: https://youtu.be/zl51U4LiQEM
Dr Venkatesh says excision Hemorhoidoctomy is the best surgery and is the Gold Standard with no long term side effects. Anal hemorhoidal vascular cushions give air tight seal and should not be cut by stapled hemorhoidctomy unless there is no choice.
View: https://youtu.be/lyN2JbS_O1E
This animated video by Ethicon -Johnson & Johnson is fooling patients that Excess Mucosa Skin is being cut but instead they are cutting the Anal Seal Hemorrhoidal vascular Cushion whose function is to seal stools and create air tight seal and continence.
View: https://youtu.be/QHTQLDzNOkQ
Laser agraphectomy - staples removal
This article identified four cases of death following stapled hemorrhoidopexy and all were associated with rectal perforation and sepsis, as seen in Table 3.
pssjournal.biomedcentral.com
Post-pph proctitis was managed medically with malasazine suppositories and NSAIDs. Other forms of suppositories [25, 26] and orally administered calcium dobesilate have been reported to be effective for similar conditions [27, 28].
View: https://youtu.be/DPT6zzqzQuM
Dr Anne Y Lin of UCLA discussing Hemorhoids & Fissures. Stapled Hemorrhoidctomy causes deaths.
Watch at - 16 min 30 sec.
View: https://youtu.be/V4NWQPm8jng
Endoanal ultrasound with volume probe to spot stuck staples after pph surgery
en.m.wikipedia.org
Severe complications leading to death have been described but are rare. Irreversible urge incontinence due to lesions of the sphincter muscle or a diminished rectal capacity due to resection of too much mucosa, are quite common complications if the procedure is not performed properly.
Google Books- Refer page 15 function of anal cushion is to Seal stools
View: https://youtu.be/PPJAyUEz-hk
In Last minute of the video Dr R K Mishra says - Stapled Hemorhoidctomy is not a good surgery and there are lot of complains but fda has not banned it. Also video explains earlier that external hemorhoids are pulled in and not visible from outside and fools the eye that they are gone. Stapled Hemorhoidctomy is for internal hemorrhoids only.
PPH: To Staple or Not to Staple: That is the Question Simultaneously, a mucosal anastomosis is performed with a 33 mm circular surgical stapler, applying a staggered double row of 28 titanium staples.
View: https://youtu.be/4RKS0aeR7B0
Agraffectomy (removing stuck staples) after Stapled hemorrhoidctomy by Dr Kushal Mital - watch at 21 minutes till 25th minute
View: https://youtu.be/xfK33CLffeM
United States Medical Council
View: https://youtu.be/TZThMIIr080
Anal fissure - (usmle)
View: https://youtu.be/BUY6qbJZnuI
How to analyse anal fissure
Hemorrhoid - Wikipedia
When a person bears down, the intra-abdominal pressure grows, and hemorrhoid cushions increase in size, helping maintain anal closure.
View: https://youtu.be/XSGTNHXmgcY
Dr Anurag Mishra - Comparison all hemorhoid surgery options and selected choice
View: https://youtu.be/LOaRMWJMb9c (in hindi)
Anal cushions used to seal stools so never do staple hemorrhoidctomy which cut anal vascular cushion
Patients should be informed of these risks when being offered the stapled hemorrhoidopexy as surgical therapy. If hemorrhoid recurrence and prolapse are the most important clinical outcomes, then conventional excisional surgery remains the "gold standard" in the surgical treatment of internal hemorrhoids.
- YouTube (hindi)
Anal cushions used to seal stools so never do staple hemorrhoidctomy which cut anal vascular cushion
Minimally Invasive Proctology - Trick of the Trade on 14 July 2020 with Bangladesh Surgeons
Dr Mittal also very good Dr in Mumbai . He ish also a teacher and teaches.
- YouTube
Dr Kamal Gupta explaining about anal vascular cushions
Anal fissure - Dr Daniel Popowich
Dr daniel popwich
- YouTube
Fissurectomy
- YouTube
Good lecture in hindi on piles - he is saying laser hemorhoidctomy is best for piles patients. Stapled hemorrhoidctomy has been discontinued by them due to side effect of nerve damage and reduction of senses in the sphincter muscle.
- YouTube
fibrosed anterior fissure with papillae inside at the end on anterior side and sentinel pile (skin tag) outside.
Complex Fissure Surgery Simplified
Big papilla surgery
(The worst surgery for piles)
(References / videos at the bottom of the article for public awareness)
Hemorrhoid (Piles) (Bawasiri) patients should never do Stapled Hemorhoidctomy surgery and it should be Banned worldwide:
During Stapled Hemorrhoidctomy the Anal Hemorhoidal Vascular Cushion is cut leading to disability of fecal urgency up to 2 years till it grows back damaging the quality of life.
The function of the Anal Hemorrhoidal Vascular Cushion is to help to seal stools, create air tight seal and continence.
*Warning : Its a Criminal offence by surgeon and hospital staff if patient is not told about the function of Anal Hemorrhoidal Vascular Cushion prior to surgery and should be arrested. *
Stapled Hemorrhoidctomy surgery is for Internal Hemorrhoids only and not for External Hemorrhoids, Fissures or Fistula. The external Hemorrhoids are pulled in due to internal tight stapling and looks like they are gone but they are pulled and tucked inside sphincter muscle. It fools the eye.
During Stapled Hemorrhoidctomy a circular piece of flesh known as anal cushion / anal hemorrhoidal vascular cushion / seal cushion is cut. It is referred to as Donut ring after it is cut. The function of the Hemorhoidal Vascular Cushion is to seal stools and create air tight seal.
Stapled Hemorrhoidctomy can cause Death and MAY give you side effect as follows:
1) Extreme anal sphincter tightening /stenosis / stricture due to anal canal connected muscle damage causing discomfort and pain which will give you narrow stools (pencil size).
2) Fecal urgency (unable to hold stools for long) due to cutting of anal hemorrhoidal vascular seal cushion and the cushion takes long time to grow back. May take 2 years.
3) Anal fissures and spasms due to tight anal sphincter causing tears and cracks.
4) Rectal stricture (tightening and narrowing of rectal cushion after rectum in the anal canal) due to trauma to anal canal and connected muscle damage.
5) Narrow stools (pencil size) due to tightness and narrowing of anal sphicter muscle.
6) May cause Gangrene (reduction in blood supply to anal sphincter muscle)
7) Unhappiness due to discomfort of stenosis (extreme tightness).
8 ) Failing to eat and move freely during working hours due to worrying about fecal urgency.
9) May also cause death due to trauma.
10) Displaced muscle - Anal sphincter muscle is pulled to wrong position from its original position due to cutting and stapling and if scar tissue heals before staples fall it can remain in wrong position causing stenosis and has to be corrected by agraffectomy surgery.
11) Severe back pain and bleeding for 4 months.
12) Physical and psychological trauma.
13) proctitis - rectal inflamation
14) Nerve damage and reduction of blood circulation and sensation in the sphincter muscle
15) Narrowing and Stricture due to over growth of Hemorrhoidal Vascular Anal cushion after it is cut forcing to recut the anal cushion to create space.
16) Staple line fibrosis.
17) Overgrowth of anal cushion after stapled hemorrhoidctomy causing blockage
18) Stools becoming dry and hard due to no secretion of mucosa lubricant by mucos membrane. Later it may secrete mucosa.
You might have to do multiple surgeries due to side effect of stenosis caused by Stapled Hemorrhoidctomy such as:
1) Dilatation - stretching of anal sphincter muscle to remove narrowing.
2) Fissurectomy - removing skin on anal verge so new tissue can grow and heal the fissures.
3) Sphincterectomy - cutting of sphincter muscle to remove tightness.
4) Agraffectomy - removal of pph staples.
5) Strictureoplasty - cutting and elongating the anal sphincter muscle.
6) Anoplasty - mending surgery damage by plastic surgery.
7) Stapled trans anal rectal resection (starr) - cutting of cushion after rectum (rectal cushion) due to narrowing and tightness.
Most patients loose bowel control completely due to multiple surgeries.
Most animation videos on youtube by manufacterers of Stapled Hemorhoidctomy Machines fool patients and inexperienced surgeons that Excess Rectal Mucosa (excess anus skin) is being cut but instead they are cutting the anal seal hemorhoidal vascular cushion used to seal stools.
It may be a money making scheme by some surgeons to make money from multiple surgeries so be careful. Manufacters are doing strong marketing online and are making money big time from this procedure as it's expensive and are fooling patients that its a painless procedure. Refer videos on references.
Manufacters have purposely hidden information on the function of anal cushions on the internet and you will not find proper information on the internet till you go into surgery books. It's a money making scheme. The info is hidden purposely so patients don't get knowledge and manufacters make money. Even in usa it's falsely marketed and patients are being fooled and misguided.
Hemorrhoids (Piles) is a common problem among office workers and driver's who sit for too long, pregnant women, bodybuilders, heavy labourers, those who eat too much chilies & spicies and those who get trauma due to hard stools with constipation.
After Stapled Hemorhoidctomy patients get side effect of fecal urgency. A lot of patients say that they can't travel long distance or eat in peace due to worrying about fecal urgency. Some cut down on eating food volume and others skip lunch during working hours so they don't have to worry about fecal urgency.
When you are not next to the loo and have to hold for long. The anal sphincter muscles, muscles of the anal canal and cushions pull the stools up and the circular anal cushion fills with blood, expands and seals the stools. Anal cushion is an involuntary muscle / cushion in the anal canal between anal sphincter muscle and rectum.
Patients should not be forced by family members, relatives, friends or doctors to do Stapled Hemorrhoidctomy surgery as it's against the law to force or misguide patients and can be considered criminal offense. Surgeons, hospital staff and family members can be arrested if patient is forced.
Surgeons and hospitals can be sued in court by patients if surgeons dont explain to the patient prior to surgery about the function of the Anal Hemorhoidal Vascular Seal Cushion. Unfortunately most surgeons don't tell the truth to the patient about the function of Hemorhoidal Vascular Cushion and are later sued in court for damages.
Stapled Hemorrhoidctomy is for internal hemorrhoids only and not for external hemorhoids. Internal Hemorrhoids and External Hemorrhoids have no connection and have to cut separately. Some surgeons think that Stapled Hemorhoidctomy is also for External Hemorrhoids and have done this surgery for external hemorrhoids due to no knowledge or false information on the internet.
Location of Hemorhoidal Cushion is just above sphincter muscle. Luckily there are 3 cushions between the rectum and anal sphincter muscle in the anal canal namely - Hemorrhoidal cushion, Rectal Cushion and Middle Cushion.
Procedure
During stapled hemorrhoidctomy the sphincter muscle and external hemorrhoids are pulled in during cutting, pulling and stapling. The anal sphincter is pulled in by around 3cm and it looks like the external hemorhoids are gone if present but they are tucked in and hidden inside the anal sphincter muscle. After the staples fall the sphincter muscle comes to it's normal position and the hidden external hemorhoids reappear outside again after 4 months.
When the circular flesh (hemorhoidal cushion) is cut with the machine immediately 56 titanium staples of 33mm in length are placed to stop the bleeding with the machine. The staples should all fall off with feaces gradually overtime. The pulled tight stapling cause extreme tightness and discomfort to anal sphincter muscle. The flexibility, bending and moving space is not there in the anal canal due to the tightness caused by staples.
After stapled hemorrhoidctomy if the scar tissue (cut area) heals before all staples have not fallen, the sphincter muscle can remain up and in wrong position and a small difference of 1 cm from its original position can cause major tightness, discomfort and unhappiness. The stenosis may narrow the sphincter opening and can cause you to have very narrow stools.
If some staples remain and don't fall they have to be checked with endoanal ultrasound with volume probe to spot any staples if left and then they can be removed agragfectomy procedure.
Stapled hemorhoidoctomy is 20 times more painful than normal excision conventional hemorhoidoctomy as a very big piece of flesh is cut compared to excision hemorrhoidctomy. Bleeeding and extreme pain stays for four months after Stapled Hemorhoidctomy surgery.
Conclusion
The internal hemorrhoids grow on the lower part of the anal cushion. Normal cutting of hemorrhoids by normal excision or laser is safer procedure and is the Gold Standard for internal hemorrhoids with no long term lifelong side effects.
Stool size may remain narrow for life after stapled hemorrhoidctomy and may improve with dilatation or self dilatation with petroleum jelly or sesame seed oil.
Holding power and sealing power may remain to some extent but not like before. Exercise may help improve the strength but it is advised not to do Stapled Hemorhoidctomy.
Although the anal cushion grows back after it is cut but sealing strength may not remain like before so stapled hemorrhoidctomy is not advised unless it's a severe internal hemorrhoid case of grade 4 and beyond circular hemorrhoid.
References:
View: https://youtu.be/LfcwBzzo5DY
Dr Sam Webster at 19th minute explains the
Function of Anal cushion (hemorhoidal cushion) is to Seal stools (continence)
PPH (Procedure for Prolapse and Hemorrhoids). The Proctologist.
Briefly, PPH is performed as an outpatient procedure using a “twilight sleep”. It can be performed in an outpatient setting at a surgical center.
lacolon.com
PPH cannot be used to treat external hemorrhoids, which are heavily endowed with pain fibers.
View: https://youtu.be/zRJRvQ1073k
Watch at 27 min
Case 1 - Rubber band ligation killed,
Case 2 - stapled hemorhoidctomy caused extreme tightness (stenosis) and complications ,
Case 3 - USA case wins 10 million dollars
View: https://youtu.be/rNjxG1RehQE
Dr explains side effects of Stapled Hemorhoidctomy of stricture and bleeding.
View: https://youtu.be/zl51U4LiQEM
Dr Venkatesh says excision Hemorhoidoctomy is the best surgery and is the Gold Standard with no long term side effects. Anal hemorhoidal vascular cushions give air tight seal and should not be cut by stapled hemorhoidctomy unless there is no choice.
View: https://youtu.be/lyN2JbS_O1E
This animated video by Ethicon -Johnson & Johnson is fooling patients that Excess Mucosa Skin is being cut but instead they are cutting the Anal Seal Hemorrhoidal vascular Cushion whose function is to seal stools and create air tight seal and continence.
View: https://youtu.be/QHTQLDzNOkQ
Laser agraphectomy - staples removal
NCBI - WWW Error Blocked Diagnostic
www.ncbi.nlm.nih.gov
Proctitis after stapled hemorrhoidopexy is an underestimated complication of a widely used surgical procedure: a retrospective observational cohort study in 129 patients - Patient Safety in Surgery
Background Hemorrhoidal disease is highly prevalent in the western world. Stapled hemorrhoidopexy also known as the procedure for prolapsed hemorrhoids (pph) has been shown to be superior to conventional hemorrhoidectomy with regard to postoperative pain, length of hospital stay and early return...
pssjournal.biomedcentral.com
View: https://youtu.be/DPT6zzqzQuM
Dr Anne Y Lin of UCLA discussing Hemorhoids & Fissures. Stapled Hemorrhoidctomy causes deaths.
Watch at - 16 min 30 sec.
View: https://youtu.be/V4NWQPm8jng
Endoanal ultrasound with volume probe to spot stuck staples after pph surgery
Stapled hemorrhoidopexy - Wikipedia
Hemorrhoids
This book provides up-to-date knowledge on hemorrhoids for proctologists. It covers all aspects, including the history of hemorrhoids, the anatomy of the anal canal, pathophysiology, diagnosis, and treatment. Both conservative treatment approaches and surgical methods are explained with the aid...
books.google.com
View: https://youtu.be/PPJAyUEz-hk
In Last minute of the video Dr R K Mishra says - Stapled Hemorhoidctomy is not a good surgery and there are lot of complains but fda has not banned it. Also video explains earlier that external hemorhoids are pulled in and not visible from outside and fools the eye that they are gone. Stapled Hemorhoidctomy is for internal hemorrhoids only.
PPH: To Staple or Not to Staple: That is the Question Simultaneously, a mucosal anastomosis is performed with a 33 mm circular surgical stapler, applying a staggered double row of 28 titanium staples.
View: https://youtu.be/4RKS0aeR7B0
Agraffectomy (removing stuck staples) after Stapled hemorrhoidctomy by Dr Kushal Mital - watch at 21 minutes till 25th minute
View: https://youtu.be/xfK33CLffeM
United States Medical Council
View: https://youtu.be/TZThMIIr080
Anal fissure - (usmle)
View: https://youtu.be/BUY6qbJZnuI
How to analyse anal fissure
Hemorrhoid - Wikipedia
When a person bears down, the intra-abdominal pressure grows, and hemorrhoid cushions increase in size, helping maintain anal closure.
View: https://youtu.be/XSGTNHXmgcY
Dr Anurag Mishra - Comparison all hemorhoid surgery options and selected choice
View: https://youtu.be/LOaRMWJMb9c (in hindi)
Anal cushions used to seal stools so never do staple hemorrhoidctomy which cut anal vascular cushion
- YouTube (hindi)
Anal cushions used to seal stools so never do staple hemorrhoidctomy which cut anal vascular cushion
Minimally Invasive Proctology - Trick of the Trade on 14 July 2020 with Bangladesh Surgeons
Dr Mittal also very good Dr in Mumbai . He ish also a teacher and teaches.
- YouTube
Dr Kamal Gupta explaining about anal vascular cushions
Anal fissure - Dr Daniel Popowich
Dr daniel popwich
- YouTube
Fissurectomy
- YouTube
Good lecture in hindi on piles - he is saying laser hemorhoidctomy is best for piles patients. Stapled hemorrhoidctomy has been discontinued by them due to side effect of nerve damage and reduction of senses in the sphincter muscle.
- YouTube
fibrosed anterior fissure with papillae inside at the end on anterior side and sentinel pile (skin tag) outside.
Complex Fissure Surgery Simplified
Big papilla surgery
