MILLIGAN AND MORGANDownload in PDF

It's a surgical procedure known as open predicl.


I) Advantages :

  • Technical aese,
  • Reproducibility,
  • Safety,
  • This procedure treats both external and internai hemorrhoids.

II) Disadvantages :

  • These disadvantages are associated with open procedure :
  • 3 incisions are left open leading to considerable oozing thus often a longer healing time,
  • This procedure requires rigorous topical tare,
  • Risk of bleeding when scabs fall off,
  • We leave in place 3 ligated pedicles leading to oozing causing painful inflammation,
  • The pedicles will necrose and attach themselves to the walls of the anal causing the rectal mucous membrane to retract with a significant risk of stenosis espacially if the pedicle ligature has been made too high in the rectal mucous membrane,
  • Extensive intraductal cuts exist despite the presence of persistent mucocutaneeous bridges,
  • This procedure has the disadvantage of not treating mucosal prolapse in the lower rectum and neglecting a previous rectocele, which cannot be fully treated during the same surgical procedure.