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Discription
The “Chivate procedure,” also referred to as Chivate’s Mucopexy or transanal suture rectopexy, is a surgical technique primarily used for treating hemorrhoids. It is particularly indicated for Grade II and III hemorrhoids with prolapse, as well as Grade III and IV hemorrhoids.Â
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Here’s how it generally works
- Repositioning and fixation:Â The procedure involves repositioning and fixing prolapsed hemorrhoidal mucosa and submucosa to the underlying rectal muscles using sutures.
- Minimally invasive:Â Chivate’s Mucopexy is considered a minimally invasive technique, preserving anal sphincter function and minimizing tissue removal, potentially leading to less postoperative pain and faster recovery compared to traditional hemorrhoidectomy.
- Suture placement:Â Sutures are typically placed at two different levels, approximately 2 cm and 4 cm proximal to the dentate line (an anatomical landmark in the anal canal).
- Double-locking sutures:Â A specific interlocking suture pattern, including double-locking passes, is often used to ensure stability and reduce the risk of suture slippage.
- Preserving blood supply:Â The technique aims to ligate hemorrhoidal vessels and fix the lax mucosa, potentially reducing the chances of recurrence due to collateral formations.Â
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Advantages
- Minimally invasive approach.
- Reduced postoperative pain compared to traditional procedures.
- Faster recovery time and shorter hospital stays.
- Low recurrence rate.Â
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Disadvantages
- Potential for minor bleeding episodes.
- Possible postoperative pain if sutures are placed below the dentate line.
- May be difficult to perform in patients with very narrow anal canals or those with thrombosed hemorrhoids.
- Some patients might experience constipation in the postoperative period, requiring laxatives for longer durations.Â
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Overall
The Chivate procedure offers a promising approach for managing hemorrhoids, particularly for patients seeking a minimally invasive option with reduced pain and a quicker recovery. However, a thorough evaluation and understanding of its indications, limitations, and potential complications are crucial for both surgeons and patients considering this treatment option.Â