TND's Vertical Ligation-Mucopexy: A Minimally Invasive Approach for Circumerential Hemorrhoids

Introduction: Hemorrhoids are the most common benign anorectal condition, significantly impairing patients' quality of life.When medical treatment fails, surgery becomes necessary.In recent years, minimally invasive techniques have gained attention and been increasingly applied in clinical practice.Objective: This study aimed to evaluate the outcomes of TND's Vertical Ligation-Mucopexy (TVLM) in the treatment of circumferential hemorrhoids at Hanoi Medical University Hospital.Methods: A retrospective study was conducted on 308 patients undergoing TVLM from April 2022 to March 2025.Results: The mean age was 45.28 14.05 years, with a male-to-female ratio of 0.9:1.According to the BPRST classification, the distribution was B1 (6.8%), P2 (100%), R1 (89.3%),S1 (32.8%), and T1 (14.9%).Rectal mucosal prolapse coexisted in 45.1% of cases.The average operative time was 32.69 8.99 minutes; for TVLM alone, it was 15.2 3.6 minutes.Additional procedures included skin tag excision (22.37%), hemorrhoidectomy (23.70%), thrombectomy (8.77%), and papilloma removal (13.31%).The mean VAS pain score was 3.23 1.03 on postoperative day one and decreased to 1.96 1.18 at discharge.The average hospital stay was 1.48 0.74 days, and the mean duration of postoperative pain was 15.04 6.56 days.Postoperative complications included urinary retention (11.4%) and bleeding (5.2%), with no cases of anal stricture.Only one patient (0.3%) required reoperation.Recurrence after a 14.41-month follow-up was 3.6%.Conclusion: TVLM is a simple, low-cost, minimally invasive technique with low complication and recurrence rates, suitable for widespread adoption, especially in resource-limited settings.