For advanced hemorrhoids is called the Procedure for Prolapse and Hemorrhoids (PPH). This minimally invasive surgery technique was developed in the early 1990s to reduce the prolapse of hemorrhoidal tissue to allow a patient to experience less pain and recover faster than patients who undergo the conventional hemorrhoidectomy procedure.
Conventional hemorrhoidectomy procedures are painful because hemorrhoidal tissue is surgically removed, affecting many nerve endings. In comparison, PPH reduces the prolapse of hemorrhoidal tissue by utilizing a circular stapler to trim out a band of tissue above the dentate line, or "pain" line, within the anal canal. The PPH surgical procedure essentially "lifts up" or repositions the anal canal tissue and restores the hemorrhoidal tissue to its original anatomical position, without cutting sensitive nerve endings. The internal hemorrhoids then shrink within four to six weeks after the procedure.