V44 - Not Your Average Hemorrhoid Excision: A Case of a Giant Fibroepithelial Polyp

Saturday, May 9, 2026

On-Demand

Video Presentation(s)

Abdulmohsen Makhsaid

Assistant Registrar
Department of General Surgery, Mubarak Al-kabeer Hospital
Sabah Alsalem, Mubarak al Kabir, Kuwait

All disclosed relationships have been reviewed and managed prior to the start of this activity. Any relevant relationships will be listed below. This individual has no financial relationships to disclose

Author(s)

MA

Michael Robil Ramzy Aziz, M.B.B.Ch, M.S. (Surgery)

General surgeon
Mubarak Al-Kabeer hosptial, ministry of health of Kuwait
Jabriya, Hawalli, Kuwait

Disclosure information not submitted.
AA

Abdullatif A. Ashkanani, B.Med.Sc M.D.KBGS

Board-Certified General Surgeon
Mubarak Al-Kabeer Hospital, Kuwait
Kuwait, Hawalli, Kuwait

Disclosure information not submitted.
FA

Fawaz Alnaqi, MD MPH FRCSC FACS

Assistant Professor
College of Medicine, Kuwait University
Kuwait city, Al Asimah, Kuwait

Disclosure information not submitted.

Senior Author(s)

JA

Jasim Alabbad, MD FRCSC FACS FASCRS

Associate Professor
Kuwait University
Jabriya, Hawalli, Kuwait

Disclosure information not submitted.

CME Eligible

Purpose/Background: Giant fibroepithelial polyps arising adjacent to hemorrhoidal tissue are uncommon and may cause bleeding, pain, and hygiene difficulties. This operative video demonstrates the technique and perioperative considerations for excision of a hemorrhoid with concomitant large fibroepithelial polyp, with emphasis on preserving anorectal anatomy, and minimizing sphincteric trauma.

Methods/Interventions: A 50-year-old female presents with a five year history of a proturding anal mass and anemia.

Physical examination demonstrated a prolapsed 7 cm posterior lesion on hemorrhoidal tissue. Further workup was unremarkable and a decision was made to excise the symptamtic lesion.

Results/Outcomes: This video demonstrates the management of a large fibroepithelial polyp. The procedure was performed under general anaesthesia with the patient in the prone jack-knife position. Key steps are shown in the video include: complete rectal examination, dilation of the anus and placement of an anoscope, retraction of the anal lesion, excision of the skin and mucosa with elliptical incision, dissection of the hemorrhoidal tissue with the associated lesion free of the surrounding structures taking care not to injure the sphincter muscles, clamping and ligation of the pedicle at the base, secure hemostasis with absorbable sutures, closure of the incision. Pathology demonstrated a large fibroepithelial polyp.

Conclusion/Discussion: This video demonstrates the management of a giant fibroepithelial polyp noted on a hemorrhoidal tissue using principles of a standard hemorrhoidectomy.