Modified stapled haemorrhoidopexy for the treatment of massive circumferentially prolapsing piles.

Stapled haemorrhoidopexy is becoming the procedure of choice for the treatment of symptomatic prolapsing piles. However, it can be technically difficult if the piles are massively enlarged and prolapsing circumferentially through the anal canal. We describe a novel method that combines both diathermy and stapled excision, producing complete haemorrhoidal eradication with anorectal mucosal fixation above the dentate line.