Colorectal

Haemorrhoidectomy (Open) (Milligan-Morgan)

HAEMORRHOIDECTOMY (OPEN) (MILLIGAN-MORGAN)

Indication: Fourth-degree haemorrhoids, mixed third-degree haemorrhoids with significant external component, failure of non-operative treatments. May be performed as emergency for acutely strangulated or gangrenous haemorrhoids.

Patient Position: Lithotomy.

Anaesthesia: General or spinal.

Procedure:
1. Examination under anaesthesia performed. Degree and extent of haemorrhoidal disease confirmed. Digital rectal examination and proctoscopy.
2. Three primary haemorrhoidal cushions identified: left lateral (3 o'clock), right anterior (11 o'clock), and right posterior (7 o'clock).