Manual hemorrhoidopexy in the treatment of hemorrhoidal disease.

Over the last 10 years a number of mini-invasive procedures have been introduced which have revolutionized the surgical treatment of hemorrhoidal disease. I would like to present a very effective method of approaching this disease with reduced postoperative pain. I have been using this technique since the year 2000 with excellent results. From 1999 to 2006 we used a proctoscope, especially, designed and patented by me to perform Doppler-guided ligation of the branches of the superior hemorrhoidal artery in the treatment of prevalently grade III hemorrhoids (THD method). Since 2006, we have performed the hemorrhoidopexy procedure alone, without Doppler-guided ligation of the arteries, and achieved excellent results (67 cases), with greater simplicity (easy-learning curve) and reduced surgery times. We use the "beak" proctoscope to this end, as it provides good illumination of the surgical field and enables the excision of areas of grade IV prolapse which are irreducible with this conservative technique.