The Treatment of Haemorrhoids by Submucosal Haemorrhoidectomy (Parks Method)

Alan Parks conceived and described this operation in 1952 in order to avoid excessive sacrifice of anal mucosa during haemorrhoidectomy. He identified the cause of postoperative pain, stenosis and faecal continence disturbances as anal deformity due to three factors: excessive scarring of the anal canal, the positioning of endoanal tubes, and the inclusion of fibres from the internal anal sphincter in the ligature of the pedicle. This operation didn’t become popular because of its duration, the quite complicated technique, and the possible occurrence of bleeding during and after the operation. But in our opinion, this procedure still remains a great therapeutic option for the treatment of prolapsed haemorrhoids (third or fourth degree) or recurrences. The principles of a correct technique are accurate preparation and the high ligature of each single pedicle, minimal excision of the anodermal and anal mucosae, and accurate reconstruction of the anal mucosal layer.