Doppler-guided hemorrhoidal artery ligation

Scheyer, M.; Antonietti, Elisabeth; Rollinger, Gerd; Mall, Helene; Arnold, Steffen

doi:10.1016/j.amjsurg.2005.10.007

Cited by 132 publications

(111 citation statements)

References 11 publications

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“…The ligament of Parks is consisted by muscular fibroplastic tissue that is located around the glands of the anus [8] and supports the hemorrhoidal plexus of the anal canal [2]. When the hemorrhoid cushions get enlarged and prolapsed, this mucosal ligament stretches and becomes irreversibly separated into pieces.…”

Section: Discussionmentioning

confidence: 99%

“…The armamentarium for hemorrhoidal disease includes several treatments such as Doppler-guided hemorrhoidal artery ligation [2,6] plication and stapled hemorrhoidopexy [4]. Nevertheless, for patients with grades III and IV hemorrhoids, surgery is considered as the gold standard among procedures.…”

Section: Discussionmentioning

confidence: 99%

“…Hemorrhoidal disease is a common anal disorder that affects both male and female patients of all ages [1][2][3]. Hemorrhoids are defined as the enlargement and displacement of the anal cushions [4] that lead to a variety of symptoms that subsequently determine the appropriate therapeutical approach.…”

Section: Introductionmentioning

confidence: 99%

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The direct relation between safe hemorrhoidectomy and anal canal anatomy

Mariolis‐Sapsakos¹,

Skarpas²,

Xifara³

et al. 2017

Clin Case Rep Rev

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Hemorrhoids are a common anal disorder that affects both men and women of all ages. One out of ten patients with hemorrhoidal disease, requires surgical treatment. However, hemorrhoidectomy is related to complications that can be present early or late postoperatively. In the present manuscript, the safe surgical technique which emphasizes to the identification of the ligament of Parks (Trietz's muscle) is described. A total of 145 patients with grades III and IV hemorrhoids, underwent Milligan-Morgan or Ferguson's hemorrhoidectomy. The mucosal ligament of Parks was located to all patients and was used as a key anatomical structure through the excision of the hemorrhoids. Its detection guides surgeons during hemorrhoidectomy. Finally, since the ligament of Parks represents a constantly identifiable landmark, it leads to simple and reliable identification of the internal sphincter and minimizes the potentiality of postoperative complications. Hereby, surgeons' thorough knowledge of the anatomy of the anal canal is a cornerstone of safe hemorrhoidectomy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

The direct relation between safe hemorrhoidectomy and anal canal anatomy

Mariolis‐Sapsakos¹,

Skarpas²,

Xifara³

et al. 2017

Clin Case Rep Rev

View full text Add to dashboard Cite

show abstract

“…This condition occurs due to abnormal blood flow that leads to tissue protrusion from the anal canal (1,2). Patients mostly complain of pain, discomfort, bleeding and itching.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Doppler Guided Hemorrhoid Artery Ligation and Milligan Morgan Hemorrhoidectomy in Management of Hemorrhoidal Disease

Shabahang

Maddah

Fattahi

et al. 2013

Iran Red Crescent Med J

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“…(1) As most studies report that the DG-HAL results in minimal post operative pain with less than 10% recurrence rate and over 90% patient satisfaction, it is being widely used in Europe and Japan as an alternative procedure to conventional hemorrhoidectomy. (1)(2)(3) However, most of studies have been based on Grade II and III internal hemorrhoids that show the symptoms of bleeding and discomfort. (4) As for symptomatic Grade IV hemorrhoids with prolapse, the DG-HAL has its limitations.…”

Section: Introductionmentioning

confidence: 99%

Early Experience of Doppler-Guided Hemorrhoidal Artery Ligation and Rectoanal Repair (DG-HAL & RAR) for the Treatment of Symptomatic Hemorrhoids

et al. 2010

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Purpose: This study is to introduce our preliminary experience of the Doppler-guided hemorrhoidal artery ligation and Rectoanal repair (DG-HAL & RAR) as a new treatment for symptomatic or prolapsed hemorrhoids. Methods: A Doppler probe incorporated proctoscope was inserted under the lithotomy position and the location of the hemorrhoidal artery was identified. The identified artery was ligated as a 'figure of eight' method with an absorbable suture into the submucosa. Then the prolapsed hemorrhoidal pile was lifted at the rectal mucosa by continuous suture to 5 mm above the dentate line and tied. The procedure was repeated at the 1, 3, 5, 7, 9, and 11 o'clock positions. We evaluated post-operative hospital stay, degree of pain, time to return to work, and recurrence. Results: The patient's mean age was 50.2±15 years old and the mean follow-up time was 415±75 days. The constitution of the type of internal hemorrhoids was as follows: Grade II: 13, Grade III: 16, and Grade IV: 5. The mean operation time was 35 minutes and post-operative hospital stay was 1.4 days. The mean time it took to return to work was 1.8 days. There were no severe pains requiring injection of analgesics or other severe complications. So far, 2 patients have had recurrence of symptoms.

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Doppler-guided hemorrhoidal artery ligation

Cited by 132 publications

References 11 publications

The direct relation between safe hemorrhoidectomy and anal canal anatomy

The direct relation between safe hemorrhoidectomy and anal canal anatomy

Comparison of Doppler Guided Hemorrhoid Artery Ligation and Milligan Morgan Hemorrhoidectomy in Management of Hemorrhoidal Disease

Early Experience of Doppler-Guided Hemorrhoidal Artery Ligation and Rectoanal Repair (DG-HAL & RAR) for the Treatment of Symptomatic Hemorrhoids

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