A PLASTIC OPERATION FOR CERTAIN TYPES OF HEMORRHOIDS

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Abstract
If hemorrhoidectomies are to be done with uniformly good results, the method of procedure must be varied to suit the condition that presents itself. No one operation is equally satisfactory for all cases. This procedure is suggested for a certain type of case; namely, that in which there is a complete prolapse and thrombosis of the entire ring of internal, anal and external hemorrhoidal vessels (fig. 1). This condition presents itself as a bluish doughnut-like ring surrounding the anal opening, the doughnut being covered by the prolapsed anal mucosa and perianal skin, which, of course, is squamous in character. Inside this "doughnut" are several prolapsed and thrombotic internal hemorrhoids covered with a moist columnar type of rectal mucosa. A definite constriction or sulcus separates these two protuberances. This sulcus is the pectinate line and represents the upper limit of the anal canal when the anal mucosa is in its normal

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