Longo's Technique:-

■ PPH is an innovative surgical technique that uses a specific circular stapling device to reduce the hemorrhoidal  prolapse and excise a band of anorectal mucosa above the dentate line.


■ Excessive  prolapsing tissue is excised and residual hemorrhoidal tissue is fixed to the underlying muscle.

■ PPH addresses the problem of hemorrhoidal prolapse form both an anatomical and physiological perspective, combining excision of the prolapse with resuspension (-pexy) and avoiding the painful anodermal wounds associated with other excisional procedures.

■ This technique involves simultaneous excision and stapling of the circumferential column of the mucosa and submucosa, in the insensitive area above the dentate line, using a circular stapling device.

■ The procedure involves interruption of terminal branches of the superior hemorrhoidal arteries thus reducing the vascular congestion. This results, in lifting the mucosa up in the anal canal, thus correcting the prolapse and reducing the arterial inflow.


As the procedure takes place above the dentate line, so there is no perianal wound, thus it is less painful, with a quicker recovery, whereas conventional surgical hemorrhoidectomy involves excision of hemorrhoidal tissue, anoderm and perianal skin, all below the dentate line.

Stapled Hemorrhoidopexy does not damages the sensitive mucosa of the anus, thus results, in controlling the post operative pain.

Stapled haemorrhoidectomy is a safe and effective method of closed haemorrhoidectomy.



Benefits of MIPH over Open Surgical procedures?

  • Patients experience virtually no pain as compared to conventional techniques.
  • Quicker return to normal activities
  • Mean hospital stay is much lower
  • Reduced blood loss
  • First bowel movements appear early.
  • Leaves the richly innervated anal canal tissue and perianal skin intact.
  • Infection (local sepsis) abscess or fistula formation,
  • Less stricture/ stenosis,
  • Less urinary retention