Conditions Treated

• Haemorrhoids (Piles) — Grade 1–4; Stapled Haemorrhoidopexy (MIPH), conventional haemorrhoidectomy, rubber band ligation
• Anal Fissure — Lateral Internal Sphincterotomy (LIS) for chronic fissure; botulinum toxin injection; topical therapy for acute fissure
• Anal Fistula — Lay-open fistulotomy, LIFT (Ligation of Intersphincteric Fistula Tract), fibrin glue, advancement flap for complex fistula
• Perianal Abscess — Incision and drainage; intersphincteric, ischioanal and suprasphincteric abscesses
• Pilonidal Sinus — Excision with primary closure, Karydakis flap, Limberg flap for recurrent disease
• Anal Cancer — Biopsy, staging, chemoradiation (non-surgical primary treatment); salvage APR for residual/recurrent disease
• Perianal and Retrorectal Tumours — Wide local excision, posterior approach (Kraske)

Stapled Haemorrhoidopexy (MIPH / PPH)

Stapled haemorrhoidopexy (also called MIPH — Minimally Invasive Procedure for Haemorrhoids or PPH — Procedure for Prolapse and Haemorrhoids) is a minimally invasive technique for Grade 3–4 haemorrhoids. The prolapsed haemorrhoidal tissue is resected and the remaining tissue is stapled back into its normal position. Advantages: no external wound, minimal pain, rapid return to activity (usually 1–3 days), day-care procedure.