Outcome of Chivates trans anal suture mucoanopexy procedure for haemorrhoids: primary findings in South Indian population


  • Scott Arokia Singh M. Department of General Surgery, Laparoscopic Surgery, Colorectal Surgery, Dr. Scott’s Laser Piles, Fistula center, Nager coil, Tamil Nadu, India




Grade III, Grade IV haemorrhoids, Constipation, Bleeding per anus, Mass per anus


Background: This procedure is used by surgeons all across India and we offer our preliminary findings from Southern India. To the best of our knowledge, this is the first publication from the rural part of Tamil Nadu to be disclosed.

Methods: One of the novel methods for treating grade III and IV haemorrhoids is the Chivate's procedure (CP). Restoring lowered anal cushions to their original positions and ligation of blood flow to the anal canal are the two main components of the Chivates surgery. Hemorrhoids' engorgement, prolapse, recurrence, and discomfort are the main factors influencing how haemorrhoids are treated.

Results: This procedure is the effective method with successful outcome in grade III and grade IV haemorrhoids. No complications like pain, soiling and leakage were noted.

Conclusions: CP of trans anal suture rectopexy for haemorrhoid is a very promising procedure with a short learning curve. In our experience with 58 patients, we conclude that the procedure successfully controlled mass, prolapse and recurrence of haemorrhoids.



Loder PB, Kamm MA, Nicholls RJ, Phillips RK. Haemorrhoids: pathology, pathophysiology and aetiology. Br J Surg. 1994;81:946-54.

Parks AG. De haemorrhois; a study in surgical history. Guys Hosp Rep. 1955;104:135-56.

Tewari M, Shukla HS. Sushrusha the father of Indian surgery. Indian J Surg. 2005;67:229-30.

Milligan ETC, Morgan CN, Officer R. Surgical anatomy of the anal canal, and the operative treatment of haemorrhoids. Lancet. 1937;230:1119-24.

Thomson WH. The nature of haemorrhoids. Br J Surg. 1975;62:542-52.

Haas PA, Fox TA, Jr, Haas GP. The pathogenesis of hemorrhoids. Dis Colon Rectum. 1984;27:442-50.

Lohsiriwat V. Hemorrhoids: from basic pathophysiology to clinical management. World J Gastroenterol. 2012;18:2009-17.

Khubchandani IT. A randomized comparison of single and multiple rubber band ligations. Dis Colon Rectum. 1983;26:705-8.

Chivate SD, Ladukar L, Ayyar M, Mahajan V, Kavathe S. Transanal Suture Rectopexy for Haemorrhoids: Chivate's Painless Cure for Piles. Indian J Surg. 2012;74(5):412-7.

Sutherland LM, Burchard AK, Matsuda J, Sweeney L, El B, Childs PA, Roberts AK, Waxman BP, Maddern GJ. A systematic review of stapled hemorrhoidectomy. Arch Surg. 2002;137:1395-406.

Morinaga K, Hasuda K, Ikeda Y. A noveI therapy for internal haemorrhoids: ligation of the haemorrhoidal artery with a newly devised instrument (Moricorn) in conjunction with a Doppler flowmeter. Am J Gastroenterol. 1995;90:610-13.

Herzog S, Sager H, Khmelevski E, Devlig A, Wulf D. Collateral arteries grow from preexestinganastososis in the rat hind limb. Am J Physiol Heart Circ Physiol. 2002;283:H2012-20.

Gibbons CP, Trowbridge EA, Bannister JJ, Read NW. Role of anal cushions in continence. Lancet. 1986;1:886-8.

Loder PB, Kamm MA, Nicholls RJ, Phillips RKS. Haemorrhoids: pathology, pathophysiology and aetiology. Br J Surg. 1994;81:946-54.

Bruch HP, Roblick UJ. Pathophysiologic des haemorrhoidolencidens. Chirurg. 2001;72:656-9.






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