Hemorpex Mural Thailand: an innovative care for hemorrhoids
Hemorpex is distributed by Kha Group Thailand
Mural Hemorpex System (HPS) is a single use device for the surgical treatment of the hemorrhoidal disease through dearterializing hemorrhoidopexy.
The advantages of the procedure are easiness, quickness, reduction or absence of post-operative pain. The procedure is exempt from serious complications. This technique can be performed without anaesthesia or with local anaesthesia, and allows the patient to return immediately to his activities.
The procedure performed with the use of HemorPex System (HPS) is indicated for all types of hemorrhoids, especially of 2nd and 3rd stage. The proposed procedure consists in the re-positioning of the hemorrhoidal cushions in their anatomical place by means of sutures which determine a plication of the mucosa and, at the same time, the ligature of the branches of the superior hemorrhoidal artery.
HemorPex System (HPS) is a device made by a fixed part which remains in contact with the anoderma and the sensible mucosa of the anal canal (fig. A), and by a rotating operative part which includes the window through which the suture stitches are posed (fig. B).
HEMORPEX – MURAL SURGICAL TECNIQUE
The patient is put in the JACK-KNIFE position or in the surgeon’s preferred position.Any type of anaesthesia is suitable, but in the majority of cases it is possible to perform the procedure without anaesthesia, only intravenous sedation (Midazolam 2,5 mg) is advisable.The instrument is introduced and positioned with the handle turned towards the intergluteal furrow: in this way the preset positions of the operative window will coincide with the hours 1 – 3 – 5 – 7 – 9 – 11.
In these positions there are the 6 terminal branches of the superior hemorrhoidal artery. The hemorrhoidal nodules will be highlighted at the hours 3 (left lateral), 7 (right posterior) and 11 (right anterior). The suture stitches posed in these positions will therefore safely close the arteries and, at the same time, will treat the hemorrhoidal pedicles.It is advisable to start the procedure by positioning the operative window at the level of the most voluminous hemorrhoidal pedicle (fig. 1 and 2).On the mucosa protruding inside the window a suture stitch is posed.
Distally from this stitch one or more passages of the needle are applied, depending on the entity of the prolapse, in order to obtain a plication (fig. 3 and 4).Keeping the instrument still, the external ring nut is rotated until the next position, and a similar suture is posed; the same for the following positions (fig. 5).The result will be immediately appreciable at the end of the procedure.