Transanal suture mucopexy – A nonexcisional cost effective procedure for advanced haemorrhoids: A video vignette

Abstract

Transanal suture mucopexy (TSM) is a simple, nonexcisional cost effective procedure to treat advanced haemorrhoids (late grade II, III and IV). No costly gadgets are required.The procedure is done under saddle (spinal) anesthesia and has the following steps:1. The haemorrhoids are manually reduced inside the anus. The repositioned mucosa is fixed to internal anal sphincter (IAS)muscle in two circumferential rows of sutures with 2-0 polyglycolic acid, on a tapered, 30 mm. half circle needle.3. The first circumferential row is taken 2 cm above the dentate line.4. The second circumferential row is taken 2 cm above the first