Stapled hemorrhoidectomy is a surgical technique for treating hemorrhoids. It is the treatment of choice for third-degree hemorrhoids (hemorrhoids that protrude with straining and can be seen on physical exam outside the anal verge. Persistent or intermittent manual reduction is necessary). Stapled hemorrhoidectomy is a misnomer since it does not remove the hemorrhoids but, instead, the abnormally lax and expanded hemorrhoidal supporting tissue that has allowed the hemorrhoids to prolapse downward.
For stapled hemorrhoidectomy, a circular, hollow tube is inserted into the anal canal. Through this tube, a suture (a long thread) is placed, actually woven, circumferentially within the anal canal above the internal hemorrhoids. The ends of the suture are brought out of the anus through the hollow tube. The stapler (a disposable instrument with a circular stapling device at the end) is placed through the first hollow tube, and the terms of the suture are pulled. Pulling the suture pulls the expanded hemorrhoidal supporting tissue into the jaws of the stapler.
The hemorrhoidal cushions are pulled back up into their normal position within the anal canal. The stapler then is fired. When it fires, the stapler cuts off the circumferential ring of expanded hemorrhoidal tissue trapped within the stapler and, at the same time, staples together the upper and lower edges of the cut tissue.
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