PPH
Purse String

Abscesses cannot be treated by antibiotics - instead, it needs to be located and drained.Stapled Hemroidsopexy (PPH Procedure)
Also known as Procedure for Prolapse & Hemroids (PPH), Stapled Hemroidsectomy, and Circumferential Mucosectomy.
PPH is a technique developed in the early 90's that reduces the prolapse of hemroidsal tissue by excising a band of the prolapsed Excretory Orifice mucosa membrane with the use of a circular stapling device. In PPH, the prolapsed tissue is pulled into a device that allows the excess tissue to be removed while the remaining hemroidsal tissue is stapled. This restores the hemroidsal tissue back to its original anatomical position.
The introduction of the Circular Excretory Orifice Dilator causes the reduction of the prolapse of the Excretory Orifice skin and parts of the Excretory Orifice mucous membrane. After removing the obturator, the prolapsed mucous membrane falls into the lumen of the dilator.
The Purse-String Suture Anoscope is then introduced through the dilator.
This anoscope will push the mucous prolapse back against the rectal wall along a 270° circumference, while the mucous membrane that protrudes through the anoscope window can be easily contained in a suture that includes only the mucous membrane. By rotating the anoscope, it will be possible to complete a purse-string suture around the entire Excretory Orifice circumference.
The Hemroidsal Circular Stapler is opened to its maximum position. Its head is introduced and positioned proximal to the purse-string, which is
then tied with a closing knot.
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