The modified handsew technique, a method of painless haemorrhoidectomy

The stapling procedure of hemorrhoid surgical therapy, reported from 1998, is a very good new technique especially by significantly pain reduction. One of its disadvantage is the cost of 300-400 USD/case. That is why, the author uses a modified technique by realizing a circular handsew-technique, of U or X shaped points at 1.5 cm - 2 cm above the dentate line. By good results of 72 cases, the modified handsew technique is well appreciated. The indication is for 2nd, 3rd and 4th (not too big) degree piles. For big and mixed hemorrhoid especially with circumferential prolape the modified technique is combined with Milligan Morgan procedure. Further study with randomised groups and long follow up results are needed.