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Video ViewAttendees 1

Session: Ongoing Videos for CME

VM63 - Transanal Hemorrhoidal Dearterialization (THD) with Anal Lift

Saturday, June 1, 2024
10:00 AM – 1:30 PM ET, USA
Location: Baltimore Convention Center, Hall BCD

    Video Presentation(s)

  • Emily Rinebold, MD

    Colorectal Surgery Fellow
    Mount Sinai
    Mount Sinai Hospital
    New York, NY, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    • Author(s)

  • Katherine C. Lee, MD, MS (she/her/hers)

    Colorectal Surgery Fellow
    Mount Sinai Hospital
    Mount Sinai Hospital
    New York, NY, United States

    Disclosure information not submitted.

    • Senior Author(s)

  • SK

    Sanghyun A. Kim, MD

    Associate Professor of Surgery
    Mount Sinai
    Norwood, New Jersey, United States

    Disclosure information not submitted.

    • Author(s)

  • AB

    Alexander Bulanov, DO

    Assistant Professor
    Mount Sinai Colorectal Surgery
    New York, New York, United States

    Disclosure information not submitted.

  • AM

    Allison F. Markiewicz, PA-C

    Colorectal Surgery Physician Assistant
    Mount Sinai Hospital
    New York, New York, United States

    Disclosure information not submitted.

  • LL

    Lung Lau, MD

    Physician
    Nuvance Health Vassar Brothers Medical Center
    New York, New York, United States

    Disclosure information not submitted.

  • RC

    Rossana Cheng He, MD

    General Surgery Resident
    Icahn School of Medicine at Mount Sinai
    New York, New York, United States

    Disclosure information not submitted.

Purpose/Background: Transanal Hemorrhoidal Dearterialization (THD) is a surgical technique used to treat bleeding and prolapsing hemorrhoids with less pain compared to excisional hemorrhoidectomy. Selective mucopexy is better tolerated than traditional mucopexy. This video shows a modification of the selective mucopexy known as anal lift. In this technique we further decrease pain by using barbed suture. This eliminates the need to tie the proximal rectal tissue to hemorrhoidal tissue near the dentate line, while allowing a significant lift of the hemorrhoidal columns and restoration of anorectal anatomy.

Methods/Interventions: We describe the case of a 56 year old woman with a 10 year history of near circumferential prolapsing hemorrhoids causing pain and bleeding, with resultant anemia. Following failure of conservative management, she elected to proceed with THD with anal lift with significant improvement in symptoms.

Results/Outcomes: THD with anal lift is a safe and effective method of treating prolapsed hemorrhoids with restoration of anorectal anatomy. In our experience this procedure is associated with decreased pain, compared to selective mucopexy and a faster return to work. Our patient had resolution of pain and bleeding with restoration of anorectal anatomy.

Conclusion/Discussion: This video demonstrates a novel technique for the repair of prolapsing hemorrhoids using THD with anal lift. The use of barbed suture further reduces post operative pain and results is a faster return to work without compromising on the restoration of anorectal anatomy.