ABSTRACT
Stapled hemorrhoidopexy was conceived by Dr Antonio Longo of Palermo in Italy in the early 1990s. Other surgeons had attempted using a circular stapling device for hemorrhoidectomy, however Longo’s operation was different in that he performed a ‘prolapsectomy’ with the distinct intention of preserving the hemorrhoids (anal cushions), but excising the concomitant prolapse of loosened rectal mucosa immediately cranial to the hemorrhoids. Initially, Longo also thought that the excision of a column of mucosa would also divide the arterial supply to the hemorrhoids which would result in shrinkage. The mature operation is an antiprolapse operation intended to reposition the hemorrhoidal cushions in their normal anatomical position at the top of the anal canal. The scar of the mucosal anastomosis binds the hemorrhoids to their normal anatomical position. The operation is correctly termed ‘hemorrhoidopexy’ or ‘anopexy’ to distinguish it from operations where the hemorrhoids are excised.
