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Procedure for Prolapse & Hemorrhoids
A surgeon begins the PPH stapled hemorrhoidectomy by inserting a circular anal dilator and obturator into the anal canal and then securing the dilator in place with four sutures. The surgeon then inserts a PPH anoscope into the obturator. Next, he places a circumferential purse-string suture of 2-0 Monocryl on a UR-6 needle 4 cm proximal to the dentate line. The surgeon opens a PPH stapler and places its anvil across the purse string. The stapler is then closed and fired; it is held closed for two minutes to improve hemostasis. Prior to firing the stapler in a female patient, the surgeon places a gloved finger in the vagina to ensure the vaginal mucosa and rectal-vaginal septum are not trapped within the jaws of the closed stapler. The surgeon then opens and removes the stapler.
This video in 30 seconds
This video shows a PPH stapled hemorrhoidectomy for prolapse and hemorrhoids. It follows the placement of a circular anal dilator and the purse-string suture, then the closing and firing of the PPH stapler.
Key points
- Shows insertion of a circular anal dilator and obturator into the anal canal, secured with four sutures
- Shows placement of a circumferential purse-string suture proximal to the dentate line
- Shows the PPH anvil placed across the purse string and the stapler closed and fired
- Notes the stapler is held closed for two minutes to improve hemostasis
- Notes a vaginal check in female patients before firing to ensure vaginal mucosa is not trapped
Video Overview
This video presents “Procedure for Prolapse & Hemorrhoids” — A surgeon begins the PPH stapled hemorrhoidectomy by inserting a circular anal dilator and obturator into the anal canal and then securing the dilator in place with four sutures. The surgeon then inserts a PPH anoscope into the obturator. Whether you are preparing for a procedure, studying the technique, or learning how a condition is assessed, the recording shows the process as it is performed in practice.
From our Surgery Videos collection: Surgery videos: watch real operations step by step — general, laparoscopic and specialist surgery performed in the OR, explained for students and surgeons. Browse all Surgery Videos videos →
Educational content only — not a substitute for professional medical advice.
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