Lord's procedure for haemorrhoids
From Peter Lord’s description: The treatment: The patient with third-degree haemorrhoids is seen in the clinic, a history is taken and the usual examinations carried out to make sure no other disease is present. The patient is then admitted, usually on the same day, to the hostel ward where he is prepared for theatre. In the anesthetic room he is given an injection of propanidid and the moment he is asleep a forcible digital dilatation of the anal canal and lower third of the rectum is performed.
It is difficult to prescribe the degree of stretch but the aim is to dilate sufficiently to allow the four fingers of both hands to be inserted well into the lower rectum. In a favourable case a band or bands are felt to give way. These bands are situated superficially at the anal orifice, around the anal canal itself or around the lower third of the rectum. Many patients have more than one band. After the dilatation a moistened sponge is inserted into the anal canal. This exerts gentle pressure on the walls and prevents haematoma formation. The patient goes back to the hostel ward and an hour later the nurse removes the sponge. After recovery from the anaesthetic the patient is allowed home and is expected to return to normal activities within two days.
He takes with him a dilator, a packet of Normacol and a card printed with the following instructions: The dilatation treatment for piles is based on the knowledge that most troubles in that region are due to the back passage being too tight. This may, or may not be associated with the passage of hard difficult motions.
The aim of the treatment is to stretch the back passage and to keep it stretched and to try to regulate the motions so that they are soft and bulky. The first part of the treatment is carried out in the operating theatre under general aneesthetic. The second part of the treatment is carried out by the patient and consists of using a special anal dilator and Normacol.
We thank Patrick Jucker-Kupper, Switzerland, for information submitted.
- Peter H. Lord:
A New Regime for the Treatment of Hæmorrhoids.
Proceedings of the Royal Society of Medicine, 1968, 61 (9): 935-936.