Summary
To avoid complication after the Whitehead radical circumferential hemorrhoidectomy, preservation of the anoderm assimple flaps has been recommended by others. This paper describes a new method ofsliding skin flap grafts for cases of insufficient anoderm. It provides for the use of this operation with greater frequency and safety. All internal and external hemorrhoids, crypts, and redundant rectal mucosa can be removed. There is remarkably little postoperative pain and there are few complications. Passage of large-caliber stools postoperatively, without pain, is explained by transient denervation of the flaps and protection of the sensitive sphincter muscle.
Complete relining of the anal canal with flaps, and providing a large lumen, prevents overstretching by a large constipated stool and decreases the incidence of hemorrhage, stricture, fissuring, painful scars and recurrence.
Similar content being viewed by others
References
Allingham, H. W.: A modified method of performing Whitehead’s operation for excision of piles. Med. Press & Circ. n.s.45: 657, 1888.
Anderson, H. G.: The after-results of the operative treatment of haemorrhoids: A study of three hundred cases. Brit. Med. J.2: 1276, 1909.
Andrews, E.: Some of the evils caused by Whitehead’s operation and by its modification, the American operation. Trans. Illinois Med. Soc., 1895, p. 433.
Andrews, E.: Disastrous results following Whitehead’s operation for piles and the so called American operation. Columbus Med. J.15: 97, 1895.
Bacon, H. E.: Anus, Rectum, Sigmoid Colon: Diagnosis and Treatment. Philadelphia, J. B. Lippincott Company, 1938, 855 pp.
Buie, L. A.: Practical Proctology, Ed. 1. Philadelphia, W. B. Saunders Company, 1937, 512 pp.
Carmel, A. G.: Modern surgical treatment of hemorrhoids and a new rectoplasty. Am. J. Surg.75: 320, 1948.
Davis, J. S., and E. A. Kitlowski: Regeneration of nerves in skin grafts and skin flaps. Am. J. Surg.24: 501, 1934.
Delorme: Traitment des hémorrhoïdes par le procédé de Whitehead. Assoc. franc. chir. Proc.-verb., Paris.10: 462, 1896.
Diamond, M.: Hemorrhoidectomy: An amputative and plastic procedure that lessens postoperative pain. Dis. Colon & Rectum.6: 374, 1963.
Eaton, C.: Amputative hemorrhoidectomy: Important surgical landmarks of anorectum. West. J. Surg.53: 386, 1945.
Fansler, W. A., and J. K. Anderson: A plastic operation for certain types of hemorrhoids. J.A.M.A.101: 1064, 1933.
Ferguson, J. A.: Repair of “Whitehead deformity” of the anus. Surg. Gynec. Obstet.108: 115, 1959.
Granet, E.: An anorectoplasty for extensive and complicated hemorrhoids. Surgery.34: 72, 1953.
Grunert, H. H.: Über funktionelle Störungen, die den Operationen von Whitehead und Rehn-Delorme folgen können. Zentralbl. Chir.79: 2071, 1954.
Hadda, S.: Die Excision der Hämorrhoiden nach Whitehead. Arch. klin. Chir.100: 1029, 1913.
Lewis, A. E.: Anorectoplasty for hemorrhoidal surgery. Am. J. Surg.90: 767, 1955.
Marten, R. H.: On Whitehead’s operation for piles. Australasian Med. Gaz.11: 413, 1891–92.
Mathews, J. M.: A critique of Whitehead’s operation. Med. Prog. (Louisville).5: 247, 1890.
McCarroll, H. R.: The regeneration of sensation in transplanted skin. Ann. Surg.108: 309, 1938.
O’Conor, J.: The radical cure of haemorrhoids: Modified Whitehead’s operation. Lancet.2: 946, 1910.
Parkinson, E. D.: The permanent cure of hemorrhoids. Am. J. Surg.88: 726, 1954.
Sarafoff, D.: Whitehead oder Langenbeck? Chirurg.24: 410, 1953.
Sarasola: Quoted by E. Büttner: Zur Technik der Hamorrhoidenoperation nach Whitehead. Zentralbl. Chir.62: 2090, 1935.
Schutte, A. G., and R. T. McCarty: Personal communication to the author.
Starr, K. W.: The heritage of Walter Whitehead. Surg. Gynec. Obstet.104: 751, 1957.
Villard, E.: Traitement des hémorrhoïdes par l’excision circulaire totale (procédé de Whitehead modifié); résultats éloignés. Lyon med.108: 1046, 1907.
Whitehead, W.: The surgical treatment of haemorrhoids. Brit. Med. J.1: 148, 1882.
Whitehead, W.: Three hundred consecutive cases of haemorrhoids cured by excision. Brit. Med. J.I: 449, 1887.
Whitehead, W.: The operative treatment of haemorrhoids. New York Med. J.49: 207, 1889.
Whitehead, W.: The excision of haemorrhoids. Lancet.1: 510, 1901.
Author information
Authors and Affiliations
Additional information
Read at the meeting of the American Proctologic Society, New Orleans, Louisiana, April 17 to 19, 1967.
About this article
Cite this article
Rand, A.A. The sliding skin-flap graft operation for hemorrhoids. Dis Colon Rectum 12, 265–276 (1969). https://doi.org/10.1007/BF02617283
Issue Date:
DOI: https://doi.org/10.1007/BF02617283