Alternative Approach to Hemorrhoid Surgery Performed at St. Mary
For people with severe internal hemorrhoids, there is a
new surgical procedure being done at St. Mary Medical Center that is proving
dramatically less painful than traditional hemorrhoid surgery.
Dr. Richard Goldstein and his partner, Dr. Anne-Marie Marcoux,
are among a handful of colorectal surgeons on the East Coast to perform PPH
(Procedure for Prolapse and Hemorrhoids). PPH utilizes a Hemorrhoidal Circular
Stapler, manufactured by Ethicon Endo-Surgery, a division of Johnson &
Johnson, as an alternative approach to the surgical treatment of hemorrhoids.
Dr. Goldstein has performed more than a dozen procedures using
PPH, and calls himself a ‘true believer’ in the merits of the new procedure. "As
someone who personally has undergone traditional hemorrhoid surgery, I wished
this procedure had been available for me," said Dr. Goldstein. "And as a
colorectal surgeon with more than 20 years experience, I am very excited to be
able to provide people with relief from a distressing problem without them
having to suffer the great discomfort of traditional surgical methods."
In the PPH procedure, the prolapsed tissue is drawn into the device that
removes a donut-shaped amount of excess tissue. The remaining hemorrhoidal
tissue is then secured back to its original position within the rectum lining
using titanium staples applied in a circular pattern by the stapling device.
Internal stapling has been used in surgical procedures for more than 20 years.
The staples do not need to be removed and the process restores the normal
anatomy of the anal canal.
Because the tissue removed is internal, in an area above the anus, the nerve
endings are less sensitive than external tissue and the patient does not feel
the sharp pain of a traditional hemorrhoidectomy.
The PPH procedure is completed in about 20 minutes, using a short-acting
spinal anesthesia. Most patients go home the same day and return to work and
normal activities in 2 to 4 days, and require significantly less pain
medication, said Dr. Goldstein. In a traditional hemorrhoidectomy, normal
recovery time is estimated to be about 10 days.
Prolaspse, often referred to as piles, is a common condition,
especially in people over age 50, in which the hemorrhoid tissue enlarges and
descends in the anal canal.
The most common symptoms of hemorrhoidal prolaspe are pain,
bleeding and discharge.
Dr. Goldstein strongly cautions patients to never assume that rectal bleeding
is from hemorrhoids until they have been evaluated by a physician, because
bleeding is also a warning sign of colorectal cancer.
Colorectal Cancer Awareness. Colorectal cancer
is the second leading cause of cancer deaths. Although highly preventable and
curable if detected and treated early, many people do not get the recommended
screenings. A digital rectal exam and fecal occult blood test are recommended
annually beginning at age 40, and a sigmoidoscopy or colonoscopy are recommended
every 5 to 10 years, beginning at age 50. People at increased risk include those
with a personal or family history of colorectal polyps or cancer, as well as a
history of breast, uterine or ovarian cancers, chronic ulcerative colitis or
Colorectal cancer often has no symptoms when first developing and can only be
detected through regular screenings.
Tips for lowering risk of colon cancer
- Avoid foods high in fat
- Eat plenty of vegetables, fruits and high-fiber foods
- Stop smoking
- Use alcohol only in moderation