Rectal prolapse

These are the 3 new techniques I offer to the patients with hemorrhoidal prolapse


  1. Haemorrhoidal Artery Ligation and Recto Anal Repair Systems (HAL-RAR)

A miniature Doppler ultrasound device is gently inserted into the anus. An audible signal allows the surgeon to pinpoint the exact location of the arteries supplying blood to the hemorrhoids. The surgeon then ties off each artery (ligation) by placing a stitch around it and knotting the ends, lifting up at the same time the hemorrhoids. This is one of the least invasive treatment methods practiced, with no cutting and virtually no pain. HAL-RAR takes as little as twenty minutes to complete and can be performed under various kinds of anesthesia, including local anesthesia with slight sedation. Most patients experience only minor discomfort and can return to work within one or two days of receiving treatment. The risk of subsequent bleeding is far lower than other methods, and any other complications that may arise post-surgery are both minor and quite rare.


  1. Procedure for Prolapse and Hemorrhoids (PPH) or Longo stapled anopexy

This technique has been invented by the Italian surgeon Antonio Longo. This is the only surgical procedure able to remove, with a circular stapler, the prolapsed tissue causing the diseases (hemorrhoids should be better considered as hemorrhoidal prolapse). In fact, since hemorrhoids are accounting of 8-10% of the continence, they shouldn’t be removed but only lifted up (thanks to the removal of the prolapsed tissue) and replaced in the correct anatomical position and de-vascularized. This technique is normally used for 4th degree hemorrhoids, so when is not possible to replace them in the anal canal.



  1. Stapled TransAnal Rectal ResectionSTARR

This technique is very similar to the PPH, but more tissue is excised in order to get the expected results. Therefore is used in advanced cases or in women patients with a descending perineum and the presence of rectocele.