Longo Operation |
A modern operation for piles without any trauma
Prof Dr A K M Fazlul Haque
Whenever there is any bleeding and pain in the anus or rectum, people feels that they are suffering from something like hemorrhoid or piles. There are many symptoms like occasional bleeding, itching, discharge, pain, protrusion of lump (mass of hard tissue which rises on the surface or under the surface of the skin) from the anus etc. With the same symptoms, there can be varieties of diseases like piles, anal fissure, fistula, cancer, and polyp, ulcerative colitis tuberculosis etc. A doctor needs to do some test to decide about what the patient is suffering from. This tests are proctoscopy, sigmoidoscopy and colonoscopy. Through the instrument we can see the diseases inside anus, rectum and colon.
There are various treatment options for hemorrhoid (piles) like medication, diet, injection ring ligation, conventional piles operation and the latest operation called Longo operation. Injection treatment started first in USA in 1869. Ring ligation started in UK in 1954.
About 20 percent hemorrhoid patients require surgical operation, which involves excision of three masses around anal canal causing three big wounds, which needs two months for healing. After conventional hemorrhoid operation there are pain, bleeding, itching, discharge, chances of anal narrowing, absence from working places for 3-6 weeks makes this operation unpopular.
In the backdrop of this situation, Dr Antonio Longo, Professor of surgery, University of Palermo, Italy, devised a circular stapling instrument by which piles operation can be done without any injury or trauma to the anal canal. This instrument works in the rectum and excises a circular band of mucus membrane and stitches by itself. This cures the piles and the protruding mass also gets back into anus. Pain after operation is very short lasting.
Because there is no wound around anus after this operation, there is no need to heal the wound. The anus remains completely intact. Patients need only few days to abstain from normal work. Pain medication is hardly required for the procedure. Chance of recurrence after this operation is 2-3 percent. Patients need to stay in hospital for 2-3 days.
I did this operation for the first time in our country on June 8, 2003. Since then I have done 310 such operation successfully. Patients are very happy. We have treated about 40,000 Patients having problem of piles, anal fissure, fistula cancer, polyp etc. in last ten years.
Prof Dr A K M Fazlul Haque MBBS, FCPS, FICS is the Head of Colorectal Surgery in Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka.