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Advance Haemorrhoids: Last Line – Personalized, Purposeful, Predictable and Precise Fibrosis (4PF)

Parshottambhai B Patel, Dr1, Kush Patel, MS Molecular Science and Nanotechnology2, Lav Parshottambhai Patel3. 1Shiv Shraddha Nursing Home, 2SnapFinance LLC, 3University of Kansas Medical Center

Statement of the Problem: Grade III and IV highly vascular haemorrhoids with Secondary haemorrhoids – (between the anal cushions) and Circumferential and Circumferentially Protruding Haemorrhoids with external haemorrhoids is a challenging problem for both surgeon and patient. Surgery is the only option

Open haemorrhoidectomy (Milligan Morgan) remains the gold standard for surgical intervention for haemorrhoids and is the still most popular technique. Other popular options are Closed hemorrhoidectomy (Ferguson), Submucosal technique of Parks and many other

However, haemorrhoidectomy is recognised as a painful procedure with a risk of significant complications and remains unpopular.  

Primary and secondary haemorrhage, retention of urine, wound infection, incontinence, and anal stenosis are common.

The purpose: To describe a unique method called Personalized, Purposeful, Predictable and Precise Fibrosis (4PF) focusing on decreasing haemorrhoid vascularity, reducing redundant tissue, and promoting haemorrhoid fixation to the rectal wall.  The method is reproducible, has a short learning curve and consistently predictable result and useful in any and all type of grade III and IV highly vascular haemorrhoids with Secondary haemorrhoids – (between the anal cushions) and Circumferential and Circumferentially Protruding Haemorrhoids with external haemorrhoids. Presenting 156 patients over the period of 30 years with a maximum follow up of 30 years and minimum follow up of 5 years    

Conclusion & Significance: Almost all patients are discharged after 24 hours with no need to follow up except have a problem

No case of postoperative bleeding or reexploration or wound complications was reported. Even on the long-term study of 5 to 30 years incontinence, anal fissure, external haemorrhoids, mucosal prolapse, recurrence of haemorrhoids, anal stenosis /stricture were not reported

This new method has the potential to replace all surgical methods available now. It has an excellent short term and long term results.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 98731

Program Number: ETP773

Presentation Session: Emerging Technology Poster Session (Non CME)

Presentation Type: Poster

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