✦ HAEMORRHOIDS · STAPLED

Stapled Haemorrhoidopexy (PPH)

Q: Can haemorrhoids recur after stapled haemorrhoidopexy?

Recurrence occurs in approximately 5–10% in 5 years. Maintaining a high-fibre diet and adequate hydration significantly reduces recurrence risk.

Q: Is PPH the same as MIPH?

PPH (Procedure for Prolapse and Haemorrhoids) and MIPH (Minimally Invasive Procedure for Haemorrhoids) refer to the same stapled haemorrhoidopexy technique.

Q: Does stapled haemorrhoidopexy treat external haemorrhoids?

PPH addresses internal prolapsing haemorrhoids above the dentate line. Prominent external skin tags may require additional excision if symptomatic.

Procedure for prolapse and haemorrhoids — stapled repositioning of prolapsed haemorrhoids above the dentate line.

30–45 Min TREATMENT DURATION

Day Care / 1 Day CARE SETTING

Stapler-Based APPROACH

3–5 Days RECOVERY TIMELINE

What is Stapled Haemorrhoidopexy (PPH)?

Stapled Haemorrhoidopexy (PPH — Procedure for Prolapse and Haemorrhoids) uses a circular stapling device to excise a ring of prolapsed rectal mucosa above the haemorrhoidal cushions, repositioning prolapsed haemorrhoids and interrupting their blood supply. Operating above the dentate line causes significantly less pain. Dr. Tagore Mohan Grandhi performs PPH as a day surgery procedure. Same-day discharge with return to normal activities within 3–5 days. PPH is preferred for Grade III–IV prolapsing haemorrhoids.

Suitable for patients with Grade III–IV prolapsing internal haemorrhoids, particularly those preferring minimally painful surgery with faster recovery than conventional haemorrhoidectomy.

How the Procedure Works

Anaesthesia

General or spinal anaesthesia. Circular anal dilator inserted and secured.

Purse-String Suture

2/0 polypropylene suture placed in rectal mucosa 3–4 cm above dentate line using purse-string anoscope.

Stapler Firing

Circular stapler introduced above purse-string and fired — excising ring of prolapsed mucosa and creating anastomosis.

Haemostasis

Staple line inspected. Additional sutures added if any bleeding points are identified.

Discharge

Same-day or 23-hour discharge. Pain score assessed. High-fibre diet and stool softeners commenced.

Outcomes

30–45 MinTREATMENT DURATION

Day Care / 1 DayCARE SETTING

Stapler-BasedAPPROACH

3–5 DaysRECOVERY TIMELINE

Who Needs This Treatment?

→Above-dentate line operation — significantly less post-operative pain
→Same-day discharge or 23-hour admission
→Effective for Grade III–IV prolapsing haemorrhoids
→Return to normal activities in 3–5 days versus 1–2 weeks open surgery

Stapled haemorrhoidopexy gives patients with Grade III–IV haemorrhoids a definitive surgical result with a fraction of conventional surgery pain. Same-day discharge and back to routine in days, not weeks.

— Dr. Tagore Mohan Grandhi, Senior Consultant Gastrointestinal Surgeon, Lux Hospitals, Hyderabad

Common Questions

Frequently Asked Questions

Can haemorrhoids recur after stapled haemorrhoidopexy?+

Is PPH the same as MIPH?+

Does stapled haemorrhoidopexy treat external haemorrhoids?+

Not sure which treatment is right for you?

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