SLIDING SKIN-FLAP GRAFT OPERATION FOR HEMORRHOIDS - A MODIFICATION OF WHITEHEAD PROCEDURE

To avoid complication after the Whitehead radical circumferential hemorrhoidectomy, preservation of the anoderm as simple flaps has been recommended by others. This paper describes a new method of sliding skin flap grafts for cases of insufficient anoderm. It provides for the use of this operation with greater frequency and safety. All internal and external hemorrhoids, crypts, and redundant rectal mucosa can be removed. There is remarkably little postoperative pain and there are few complications. Passage of large-caliber stools postoperatively, without pain, is explained by transient denervation of the flaps and protection of the sensitive sphincter muscle. Complete relining of the anal canal with flaps, and providing a large lumen, prevents overstretching by a large constipated stool and decreases the incidence of hemorrhage, stricture, fissuring, painful scars and recurrence. © 1969 American Proctologic Society.