Proctology
Treatments
Rubber Band Ligation (RBL / Banding)
An outpatient procedure in which a tight rubber band is applied to the base of an internal haemorrhoid, leading to ischemic necrosis and eventual sloughing of the tissue.
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Laser Hemorrhoidoplasty
A minimally invasive technique where laser energy is delivered into the hemorrhoidal tissue, causing controlled coagulation, fibrosis, and shrinkage without excision.
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Hemorrhoidectomy (Milligan-Morgan / Ferguson)
A definitive surgical procedure involving excision of hemorrhoidal cushions; performed as open (Milligan-Morgan) or closed (Ferguson) techniques, depending on wound closure.
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Stapled Hemorrhoidopexy (PPH / MIPH)
A circular stapling device is used to excise a ring of rectal mucosa above haemorrhoids, repositioning prolapsed tissue and interrupting the blood supply.
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HAL / THD with Mucopexy
Doppler-guided identification and ligation of hemorrhoidal arteries combined with mucosal lifting (mucopexy) to reduce prolapse and vascularity.
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Infrared Coagulation (IRC)
A non-excisional technique using infrared radiation to induce coagulation and fibrosis of hemorrhoidal tissue, leading to fixation and symptom relief.
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Fistulotomy
A surgical procedure where the fistula tract is laid open along its length, allowing healing by secondary intention while minimising recurrence.
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Seton Placement
Insertion of a surgical thread or material through the fistula tract to maintain drainage, promote fibrosis, and gradually divide or preserve the sphincter muscle.
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LIFT Procedure
Ligation of the intersphincteric fistula tract via an intersphincteric approach, aiming to close the internal opening while preserving sphincter integrity.
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Fistulectomy
Complete excision of the fistulous tract, often resulting in a larger wound, with healing occurring by secondary intention.
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Endorectal / Endoanal Advancement Flap
Mobilisation of a rectal mucosal or anodermal flap to cover the internal fistula opening after tract clearance, preserving sphincter function.
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VAAFT
Video-assisted technique using a fistuloscope to directly visualise the tract, allowing internal closure and destruction under endoscopic guidance.
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FiLaC
A sphincter-preserving procedure where a radial-emitting laser probe is used to obliterate the fistula tract via controlled thermal energy.
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Fistula Plug / Fibrin Glue
Biologic or synthetic materials are inserted into the tract to occlude it and promote healing without surgical division of the sphincter muscle.
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Lateral Internal Sphincterotomy (LIS)
Partial division of the internal anal sphincter to reduce resting pressure, improve blood flow, and facilitate healing of chronic fissures.
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Fissurectomy
Excision of fibrotic fissure edges and associated sentinel tags to convert a chronic fissure into an acute wound for better healing.
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Advancement Flap / Anoplasty
Reconstruction using adjacent healthy tissue to cover the fissure defect, particularly in chronic or recurrent cases with poor healing.
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Incision and Drainage (I&D)
A surgical procedure involving incision of an abscess cavity to evacuate pus, relieve pressure, and control infection.
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EUA + Drainage
Examination under anaesthesia allows a thorough assessment of the extent and associated fistula, followed by adequate drainage.
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Polypectomy
Endoscopic removal of polyps using snares or other instruments is typically performed during colonoscopy.
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Transanal Excision / TAMIS / TEM
Minimally invasive transanal approaches using specialised platforms to excise rectal lesions with precision under direct visualisation.
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Endoscopic Mucosal Resection (EMR)
Resection of superficial mucosal lesions after submucosal lifting is suitable for smaller, non-invasive growths.
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Endoscopic Submucosal Dissection (ESD)
Advanced technique involving precise dissection in the submucosal plane to remove larger lesions en bloc with clear margins.
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Bascom Cleft Lift
A reconstructive procedure that flattens the natal cleft and lateralizes the incision to reduce hair accumulation and recurrence.
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Karydakis Flap
An off-midline flap technique that excises the sinus and shifts the closure away from the midline to minimise recurrence.
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Limberg Flap (Rhomboid flap)
Excision of the sinus followed by reconstruction using a rhomboid-shaped transposition flap.
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Excision with Open Healing
Complete removal of sinus tracts, leaving the wound open to heal by secondary intention.
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Excision with Primary Closure
Excision followed by immediate suturing of the wound for faster healing, though with a higher recurrence risk in some cases.
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Pit Picking
Minimally invasive removal of sinus pits and tracts through small incisions.
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EPSiT
Endoscopic visualisation and ablation of the sinus tract using specialised instruments.
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Rectopexy
A surgical procedure in which the rectum is mobilised and fixed to the sacrum to restore normal anatomical position and prevent prolapse or abnormal descent.
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Ventral Mesh Rectopexy
A nerve-sparing anterior approach where a mesh is used to support and fix the rectum to the sacrum, commonly performed for rectal prolapse or obstructive defecation.
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Delorme Procedure
Perineal mucosal stripping with plication of the muscular layer for short-segment prolapse.
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Altemeier Procedure
Perineal rectosigmoidectomy involving full-thickness resection of the prolapsed rectum.
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Resection Rectopexy
A combination of sigmoid resection with rectal fixation to address redundancy and prolapse.
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Thiersch Procedure
Placement of a circumferential encircling material around the anus to provide mechanical support.
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Sacral Neuromodulation (SNM)
Implantation of a neurostimulator to modulate sacral nerve activity and improve continence.
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Overlapping Sphincteroplasty
Reconstruction of disrupted sphincter muscles by overlapping and suturing them to restore function.
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Artificial Bowel Sphincter
An implantable device that mimics sphincter function by controlled inflation and deflation.
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Stoma (Colostomy/Ileostomy)
Diversion of the faecal stream through an abdominal opening when continence cannot be restored.
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Pelvic Floor Therapy / Biofeedback
Behavioural therapy using feedback mechanisms to retrain the coordination of pelvic muscles during defecation.
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Rectocele Repair
A surgical procedure to correct the herniation of the rectal wall into the vaginal wall by reinforcing or reconstructing the rectovaginal septum.
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STARR Procedure
Stapled Transanal Rectal Resection is a procedure that removes redundant rectal tissue using a circular stapling device to improve obstructed defecation.
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Subtotal Colectomy
A surgical procedure involving the removal of a major portion of the colon, typically performed for severe disease not responding to medical management.
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Total Proctocolectomy with IPAA (J-Pouch)
Complete removal of colon and rectum with construction of an ileal pouch anastomosed to the anus.
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Total Proctocolectomy with End Ileostomy
Complete removal of the colon and rectum. The small intestine is brought out as a permanent ileostomy for stool diversion.
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Ileocecal Resection
Surgical removal of the terminal ileum, cecum, and ileocecal junction. Commonly performed for localised disease such as Crohn's.
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Stricturoplasty
A bowel-preserving procedure where a narrowed intestinal segment is widened without removing it. Helps maintain intestinal length.
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Segmental Bowel Resection
Removal of a diseased segment of the intestine with reconnection of healthy ends. Performed for localised pathology.
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