MuRAL - Mucopexy and Recto Anal Lifting with HemorPex System® Plus (HPS Plus)

The highly functional and efficient HemorPex System® Plus (HPS Plus) is used to treat grade II-IV haemorrhoids, rectoceles and rectal mucosal prolapse disorders. The HemorPex System®Plus is a rotating surgical anoscope. Surgeons are able to perform minimally invasive operations such as mucopexy or recto-anal lifts that are comparatively painless for the patient with this unique and quick-to-learn procedure.

The procedure is performed above the anal canal (linea dentata) using slowly absorbable sutures. This involves reduction of the prolapsing anorectal mucosa/submucosa and simultaneous ligation of the haemorrhoidal vessels.
In addition to the reduction of complications and the significant minimisation of pain for the patients concerned, the total costs per procedure are also significantly reduced compared to other methods.


Thomas Bruesehaber:

„HemorPex System® Plus (HPS Plus) - the future reference in the treatment of typical anorectal diseases.“

The highly functional, quick-to-learn HemorPex System®Plus (HPS Plus) treats stage II-IV haemorrhoids, rectoceles and rectal mucosal prolapse while significantly minimising the pain burden on the affected patients.

Treatment of "haemorrhoids"

With the help of the HemorPex System® Plus (HPS Plus), haemorrhoids are treated in a minimally invasive way by first cutting off the blood supply to the haemorrhoids and then lifting the excess, prolapsed tissue.

Treatment of "rectoceles"

Rectoceles are removed using the HemorPex System® Plus (HPS Plus) in a simple, inexpensive and minimally invasive way that is painless for the patient.

Treatment of "rectal mucosal prolapse"

Incidents of rectal mucosa can also be treated efficiently with the help of the HemorPex System® Plus (HPS Plus). Ask your doctor.

Device description: HemorPex System®Plus


1: HPS Plus-Obturator:

The obturator facilitates smooth insertion of the HemorPex System Plus (HPS Plus) and allows gentle lifting and distribution of the prolapsed tissue as well as safe rotation of the working window.

2: Solid part (main body):

Three fastening holes on the fixed part of the HemorPex System® Plus (HPS Plus) allow perianal suturing of the main body for the duration of the intervention.

3: Moving part (rotating):

The rotating part of the system can be rotated and locked into 6 positions and causes the affected tissue to protrude into the anoscope to provide a direct view into the surgical field.

HemorPex System® Plus: Description of the method for operators

Preparation, anaesthesia and storage

Depending on the patient's wishes, this minimally invasive surgical procedure can be performed under local anaesthesia and light sedation. Depending on the patient's general condition, spinal or general anaesthesia may be required. The procedure is performed in the lithotomy position.

Treatment of haemorrhoids, rectal mucosa prolapse and rectoceles:

First, the main body (fixed part) of the HemorPex System® Plus is inserted into the patient's anus and sutured perianally to the 3 fastening holes provided for this purpose. Subsequently, the now opened op-window is rotated clockwise and counterclockwise in different directions and positions according to the prescribed scheme. A total of 6 sutures are performed. Start with a distal Z-suture; 1st stitch superficial, 2nd stitch deeper (mucosa and submucosa) above the dentate line. Now a continuous overhand suture is made proximally reaching the healthy mucosa including tying the suture and pulling up the tissue. Finally, blood dryness is checked and a dressing without tamponade is applied. Rectoceles are treated using a similar method.

Error correction:

By removing nodes that have already been placed, the procedure can be easily revised at any time.

The MuRAL procedure

Here you have the possibility to get to know the procedure (MuRAL with HemorPex System® Plus) in more detail. By pressing the following button you will be redirected to an external website.

Why HemorPex System® Plus (HPS Plus)?




Short training period, as the process is easy to learn.
Exceptional overview of the surgical field.
Low complication.




Minimal disruption of the patient's social and occupational interests.
Reduction / absence of postoperative pain or severe complications.




Significantly lower total cost per procedure compared to other methods.
Low complication.
Short length of stay.

Zentren für MuRAL mit HPS® Plus

Counselling and treatment:

Counselling Centre:

Czech Republic / Husova

thomas bruesehaber GmbH

OA MUDr. Petr Pachir
Tel.: +420 777 269061 und
Tel.: +420 777 207837

Husova 1735/48
412 01 Litomerice

Treatment Centre:

Germany / Riesa

Elblandklinikum Riesa

Clinic for General and Visceral Surgery

OA MUDr. Petr Pachir
Tel. +49 3525 75 5643

Weinbergstraße 8
01589 Riesa


Allow me to introduce myself.

My name is Thomas Brüsehaber. I am the Managing Director of "thomas bruesehaber GmbH". During the last 25 years I have been working in the sales of innovative and explanation-intensive medical products. During this period, I was able to witness how doctors, supported by medical technology, were able to successively improve the quality of treatment for patients. At the same time, however, in many cases the processes in the hospitals have become more complicated and expensive. thomas bruesehaer GmbH" has set itself the goal of making some of these processes simpler and more cost-efficient for the benefit of patients and the healthcare system. I would be happy to contact you and tell you more.

Ihr Thomas Brüsehaber.

Tel.: +49 3635 - 6029668

Arrange a personal consultation now, without obligation and free of charge for you.


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