A “modified whitehead” hemorrhoidectomy

Abstract

Is there a place for the “modified White-head” hemorrhoidectomy? Some factors have been found to mitigate against the procedure: 1) inadequate extent of hemorrhoidal disease; 2) excess scar from previous disease or operation; 3) concurrent abscess or fistula: 4) unusually thin, tight anoderm (or conversely, moderately healthy anoderm with some tissue resiliency is an important factor in healing); 5) irritable-bowel disease. However, there is no greater discomfort or disability with this technique than with lesser procedures. We have found acceptable incidences of postoperative wound complications and have created no “wet anus.” We are aware that definitive measures directed toward alleviating postoperative urinary retention are indicated. Attention is being directed to this. We have not had “recurrent” hemorrhoids with this circumferential procedure, which removes all hemorrhoid-bearing tissue and leaves a smooth, unbunched anal canal. Therefore, we feel that this is the surgical procedure of choice for the patient who has advanced hemorrhoidal disease.