Srapled haemorridectomy

2.  Hemorrhoids are when the veins or
blood vessels in and around anus and
lower rectum become swollen and
irritated. This happens when there is
extra pressure on these veins

3.  It is located on 3,7,11 hours of a
clock dial and accompanied from the
inflamed and thrombosed venous
boluses

4. Stapler haemorrhoidectomy(Longo technique)
The operation is based on the principle of a
mucosectomy atleast 3-4cm above the dentate line
where a purse string suture placed at that level and
tied around the stapler shaft then resection and
stapling of the mucosa are carried out
simultaneously
This procedure effectively reduces mucosa
Blocks the end of branches of the upper rectal artery
thus stopping venous and arterial blood flow of
hemorrhoidal plexus

5. (A) Pursestring suture anoscope;
(B) circular anal dilator;
(C) suture threader (crochet hook);
(D) 33mm hemorrhoidal circular stapler.

6.  The patient lies in lithotomy position
 For stapled hemorrhoidectomy, a circular, hollow tube is inserted into the anal canal.
 Through this tube, a suture (a long thread) is placed, actually woven, circumferentially within
the anal canal above the internal hemorrhoids.
 The ends of the suture are brought out of the anus through the hollow tube.
 The stapler (a disposable instrument with a circular stapling device at the end) is placed through
the first hollow tube and the ends of the suture are pulled.
 Pulling the suture pulls the expanded hemorrhoidal supporting tissue into the jaws of the
stapler.
 The hemorrhoidal cushions are pulled back up into their normal position within the anal canal.
 The stapler then is fired.
 When it fires, the stapler cuts off the circumferential ring of expanded hemorrhoidal tissue
trapped within the stapler and at the same time staples together the upper and lower edges of
the cut tissue.

8.  Hollow Tube Inserted into the Anal
Canal and Pushing up the
Hemorrhoids
 Suturing the Anal Canal through the
Hollow Tube
 Bringing Expanded Hemorrhoidal
Supporting Tissue into the Hollow
Tube by pulling On Suture
 Hemorrhoids Pulled Back Above
Anal Canal after Stapling and
Removal of Hemorrhoidal
Supporting Tissue