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MIPH ( Minimally Invasive Procedure for Haemorrhoids )

It is a procedure that was originally conceived in 1994 by Dr Antonio Longo, and has since gained popularity as the treatment of choice for Grade 3 and Grade 4 prolapsed Piles.<br>The procedure is usually done under short general anaesthesia and takes around 25-30 minutes. Using the circular stapler, the mucosa which is responsible for the the prolapse of Haemorrhoids is circumferentially excised and the prolapsed Haemorrhoids are pulled up back to their normal position.

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MIPH ( Minimally Invasive Procedure for Haemorrhoids )

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  1. MIPH ( Minimally Invasive Procedure for Haemorrhoids)  www.healinghandsclinic.co.in

  2.  MIPH procedure In 1995, Longo described a new and innovative operative technique for hemorrhoid. This novel procedure to treat piles is not a hemorrhoidectomy. In this technique neither the anal mucosa and nor the hemorrhoidal tissue is excised. The procedure of MIPH is performed in the patient with piles on distal rectal mucosa and submucosa, proximally to the dentate line. MIPH hemorrhoidectomy includes excision of a band of excessive or loose prolapse mucosa and submucosa within the rectum, proximally to the hemorrhoidal tissue and fixation of the mucosa by stapled end to end mucosa anastomosis. This minimally invasive maneuver occlude the blood supply of the superior hemorrhoidal artery above the hemorrhoidal tissue and thus piles is cured as well as prolapsed mucosa is retracted up. www.healinghandsclinic.co.in

  3. Advantages • The Stapler procedure has definite advantages over other treatments available for Piles. • No external cuts or stitches • Minimal blood loss • Minimal pain can be easily managed by painkillers • Sphincter function is not hampered hence voluntary control over motion is preserved • Faster recovery - Patient can resume work from 5th day • Lowest recurrence rate ( 8% ) - This is further brought down to <1% by Mucopexy technique introduced by Dr Porwal at HHC • Safe in diabetics, heart patients and senior citizens www.healinghandsclinic.co.in

  4. Drawbacks • Inflammation or Infection – it Can be prevented with anti-inflammatory agents and antibiotics. • Urgency ( i.e. need to rush to the toilet )- May last for 4-8 weeks. This can be kept under control with Kegels exercises • Bleeding following the procedure ( 6-8% ) • Staple line stricture ( ~5% ) - In experienced hands it can be prevented with proper positioning of staple line • Recurrence ( 8% ) - With the addition of Mucopexy, this can be brought down to <1% www.healinghandsclinic.co.in

  5. MEET Dr Ashwin Porwal “Founder surgeon healing hand clinic” Consultant Colorectal Surgeon,M.B.B.S, D.N.B. ( Surgery ),Dip. Proctology ( Italy ),Dip. Laparoscopy ( EITS- IRCAD, France ). www.healinghandsclinic.co.in

  6. www.healinghandsclinic.co.in

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