Hemorrhoids are a common anorectal disease that almost everyone may encounter once or multiple times in their lifetime. Traditional hemorrhoid surgeries, such as external excision and internal ligation, are effective but often cause significant post-operative pain and lengthy recovery periods, deterring many patients. In recent years, with the development of minimally invasive surgical techniques, a new treatment method—PPH operation (Procedure for Prolapsing Hemorrhoids)—has gradually become one of the mainstream options for hemorrhoid treatment. This article will explain the principles, advantages, indications, and precautions of PPH operation to help everyone better understand this advanced treatment method.
The full name of PPH operation is "Procedure for Prolapse and Hemorrhoids," first proposed by Italian surgeon Longo in 1993. It is a minimally invasive surgical technique. Unlike traditional surgery that directly excises hemorrhoid nuclei, PPH uses a specialized circular stapler to remove a ring of rectal mucosa above the dentate line. The prolapsed hemorrhoidal tissue is then pulled up and fixed in place, causing the hemorrhoidal tissue to lose its blood supply and gradually shrink and absorb, thereby treating hemorrhoids.
The main feature of this surgical method is "lifting" rather than "removing." In other words, it mainly corrects the prolapsed state of the hemorrhoids rather than directly removing the hemorrhoidal tissue, causing less damage to normal tissues.
Since its introduction, PPH operation has been widely used among patients with moderate to severe hemorrhoids due to its significant advantages. The main benefits include:
Mild Post-operative Pain
Traditional hemorrhoid surgery is performed close to the sensitive nerve area near the anus, causing noticeable pain after surgery. PPH operation is performed above the dentate line, where nerve distribution is less, significantly reducing post-operative pain.
Short Recovery Time
The surgery is minimally invasive, causing little tissue damage and minimal bleeding, leading to a quick recovery. Most patients can resume normal activities 1-2 days after the surgery and return to work within 5-7 days.
Short Hospital Stay
Due to minimal post-operative reactions, patients usually only need to stay in the hospital for 1-3 days before being discharged.
Preservation of Anal Function
Traditional surgery may lead to complications such as anal stenosis or incontinence. PPH avoids direct damage to the anal canal and sphincter, better protecting normal anal function.
Low Recurrence Rate
PPH restores the anatomical structure of hemorrhoidal tissue, reducing the likelihood of recurrent prolapse of the hemorrhoidal nuclei, ensuring stable long-term efficacy.
Despite its many advantages, not all hemorrhoid patients are suitable for PPH. The main indications include:
Grade III and IV internal hemorrhoids (i.e., hemorrhoids that prolapse and need manual reduction or cannot be reduced);
Mixed hemorrhoids with prolapsed internal hemorrhoids;
Chronic internal hemorrhoidal bleeding that is unresponsive to conservative treatment.
Patients unsuitable for PPH include:
External hemorrhoids or mixed hemorrhoids primarily involving external hemorrhoids;
Acute perianal infection, anal fistula, etc.;
Other tumorous lesions in the lower rectum;
Pregnant patients, etc.
Although PPH is a minimally invasive procedure, it is not completely without risk. Some patients may experience post-operative bleeding, infection, difficulty in defecation, or anastomotic stricture. However, with standardized operation and reasonable care, the vast majority of patients can recover smoothly.
Post-operative care points include:
Avoid vigorous exercise and maintain smooth bowel movements;
Take stool softeners as prescribed;
Keep the anal area clean to prevent infection;
Adopt a reasonable diet and avoid spicy and irritating foods;
Regular follow-ups to promptly address post-operative issues.
The Victor Medical provides strong support for PPH operation with its excellent design and performance. Its main features include:
24.1ml Ultra-large Capacity Chamber: Can accommodate more tissue, ensuring adequate specimen removal and providing more operating space for the surgery.
53mm Integrated Central Rod Design: Ensures concentricity and verticality, making sure the staples form consistently, providing a clearer surgical view, and helping doctors operate more precisely.
Monolithic Central Rod Design: Ensures the stapler's concentricity and verticality, guaranteeing consistency during the surgical process.
Variable speed tail:Protects the anastomosis when opened, and evenly squeezes the tissue when closed, reducing postoperative complications.
Higher stitch density: provides better hemostasis and reduces postoperative bleeding.
Single-edged round blade: ensures sharper cuts and improves surgical efficiency.
Visible Shot Feedback: High-quality gaskets provide visible audible and tactile feedback to ensure the safety of surgical procedures.
Indicator Window Design and Tissue Compression Scale: Make sure the indicator is in the green zone during firing for secure stitching.
As a modern minimally invasive method for the treatment of moderate to severe hemorrhoids, PPH operation has brought new hope to many patients with hemorrhoids with its advantages of "light pain, fast recovery and stable effect". It is not a simple "hemorrhoid" surgery, but a fundamental solution to the problem of hemorrhoidal prolapse by restoring the structural function of the anorectum. Of course, whether PPH operation is suitable or not needs to be comprehensively judged by professional doctors based on the specific condition of the patient. For patients with recurrent hemorrhoids and affecting their quality of life, timely medical treatment and scientific treatment are the key.
Hemorrhoids are small and should not be overlooked. Scientific prevention and treatment and regular life are the fundamental ways to maintain "worry-free anus".
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