THD with Targeted Mucopexy for prolapsing haemorrhoids

THD TM for prolapsing haemorrhoids

THD procedure with Targeted Mucopexy for advanced haemorrhoidal disease

The video demonstrates a technical modification that separates the dearterialisation from the mucopexy and optimise the management of the prolapsing component. Once identified, the haemorrhoidal artery was transfixed and ligated using a “figure of 8” stitch with 2/0 Vicryl™ mounted on a 5/8 needle. The level of the transfixion depended upon where the strongest signal was obtained. Mucopexy was performed targeting the areas of largest prolapse introducing the THD slide as far in as possible and the mucopexy is achieved plicating the rectal mucosa using a 2/0 PDS™ stitch mounted on a 4/8 needle, starting proximally at the level of the window of the proctoscope and proceeding distally towards the dentate line, taking the mucosa and submucosa.