The New Minimally Invasive Surgical Procedure

What is HSC (Hemorrhoid Submucous Closure)?

The Hemorrhoid Submucous Closure is a surgical method involving the ligation of the hemorrhoid vessels under the mucous membrane. We have developed it in 2004 and applied successfully to over 500 patients. At the surgery the base of the hemorrhoid vein is tied with a thread; the difference to known procedures is that the thread is not applied to the entire hemorrhoid, but only to the venous vessel under the mucous membrane. (fig. 2)

The covering mucous membrane is thus not cut off from the blood supply because it stays outside of the loop of thread. (fig. 3) A small part of the mucosa can be removed and the residual mucosa used for closure purposes. The thin thread dissolves within a few weeks.

fig. 1 fig. 2 fig. 3

What are the benefits of the Hemorrhoid Submucous Closure?

  • The method can be applied even to very large, for example, grade IV hemorrhoids.
  • Up to 8 piles can be removed in one operating session.
  • There is no or only light pains after the operation, even during the first post-op bowel movement, because there are no open wounds.
  • Patients can move normally a few hours after treatment.
  • Complications such as after-bleeding, urinary retention or injuries of the anal sphincter do not occur.
  • Follow-up treatment is not necessary.
  • Treatment involves only a short period of disability.
  • The recidivism rate is under 3%.

Pictures listed below are showing the treatment with HSC (click to enlarge)

before   after before   after before   after

When should hemorrhoids be surgically treated?

Hemorrhoids that prolapse and do not return into the rectum, or do so only very slowly, are a detriment to life quality. Here, surgical treatment is required. Regardless of a prolapse, bleeding hemorrhoids must be operated on as soon as possible.

When should anal skin tags be removed?

Small skin tags do not cause any complaints and do not have to be removed. Larger tags are problematic regarding hygiene and can impair quality of life. In those cases surgical treatment is advisable.

before   after

The surgical technique we developed allows primary closing of the wound after skin tag removal. Healing takes place after a week. Special treatment of the wound (such as hip baths) is not necessary. The threads dissolve without the patient noticing.

What kind of anesthesia is applied?

Operation is performed under general anesthesia, typically under laryngeal mask.

How long is the hospital stay?

You are discharged from the hospital usually on the second day after surgery. Patients who are not from Berlin can travel home by any means of transportation without problems.

Do patients stay in contact with his doctor after the surgery?

All patients are asked to contact us on the day of their discharge as soon as they are at home, and then every two or three days until full recovery. Thus the healing process is constantly checked by the surgeon.