Description

The management of anorectal disorders like prolapse and hemorrhoids has undergone a remarkable transformation with the advent of minimally invasive techniques. In his insightful lecture on “Procedure for Prolapse and Hemorrhoid (PPH)”, Dr. R. K. Mishra, a globally recognized laparoscopic and robotic surgeon, explained the principles, techniques, and outcomes of this advanced surgical procedure. Understanding the Problem Hemorrhoids and rectal prolapse are common anorectal conditions that cause significant discomfort, bleeding, pain, and disruption of daily life. Traditional hemorrhoidectomy often leads to prolonged recovery and considerable post-operative pain. To overcome these limitations, the Procedure for Prolapse and Hemorrhoid (PPH), also known as stapled hemorrhoidopexy, was developed. Lecture Highlights In his lecture, Dr. Mishra emphasized the following key aspects: Concept of PPH PPH is a minimally invasive procedure performed using a circular stapling device. Instead of excising hemorrhoidal tissue, it repositions and secures the prolapsed hemorrhoids back into their normal anatomical position. This reduces blood supply to the hemorrhoids, leading to their shrinkage over time. Step-by-Step Surgical Technique Patient positioning and preparation for optimal exposure. Purse-string suture placement in the rectal mucosa above the hemorrhoids. Introduction of the circular stapler, which excises a circumferential strip of rectal mucosa and submucosa. Stapling and anastomosis, which restore normal anatomy and reduce prolapse. Advantages of PPH Less postoperative pain compared to conventional hemorrhoidectomy. Shorter hospital stay and faster recovery. Early return to daily activities. Preservation of anal cushions, maintaining continence. Limitations and Considerations Not suitable for external hemorrhoids or advanced prolapse. Requires precise surgical expertise to avoid complications like bleeding or strictures. Careful patient selection is essential. Role in Modern Surgical Practice Dr. Mishra highlighted how PPH has become a preferred option in many cases due to its patient-friendly outcomes. He also stressed the importance of surgeon training in minimally invasive techniques to achieve consistent success. Educational Value Dr. Mishra’s lecture combined theoretical knowledge with real clinical case demonstrations, making the complex concept of stapled hemorrhoidopexy easy to understand. His teaching reflected the balance between innovation, patient safety, and surgical precision—qualities that define modern colorectal surgery. Conclusion The Procedure for Prolapse and Hemorrhoid (PPH) represents a milestone in the treatment of anorectal disorders. Dr. R. K. Mishra’s lecture provided an in-depth understanding of this advanced technique, equipping surgeons and trainees with the knowledge to perform the procedure effectively. By focusing on minimally invasive solutions, he continues to inspire surgical excellence and better patient care worldwide.