Hemorrhoid Surgery
The vast majority of patients with symptom-causing hemorrhoids can be managed with non-surgical methods. In practice of a surgeon skilled at dealing with piles of non-operatively, it is estimated that less than 10% of patients require hemorrhoid surgery on hemorrhoids treated early.
Hemorrhoidectomy: Non-operative treatment is preferred because it is associated with less pain and fewer complications than this hemorrhoid surgery. Surgical removal of hemorrhoids (hemorrhoidectomy) usually is reserved for patients with third or fourth degree hemorrhoids.
During hemorrhoidectomy (hemorrhoid surgery), the internal hemorrhoids and external hemorrhoids are cut out. The wounds that the remote can be sutured (stitched) together (closed technique hemorrhoid surgery) or left open (open technique hemorrhoid surgery). The results of both hemorrhoid surgery techniques are similar. Sometimes a proctoplasty is also made. A proctoplasty extends the removal of tissue higher in the anal canal so that redundant or prolapsing anal lining also is removed.
Post Surgical pain is a major problem with hemorrhoidectomy. Potent pain medicines (drugs) are usually required before hemorrhoid surgery. The addition of nonsteroidal anti-inflammatory drugs (NSAIDs) such as ketorolac (Toradol), celecoxib (Celebrex), valdecoxib (Bextra) increases the relief of pain, but patients are still not back to work for 2-4 weeks after hemorrhoid surgery.
Other complications may occur after a hemorrhoid surgery with hemorrhoidectomy. Urinary retention (difficulty urinating) occurs in approximately 5% of the patients after hemorrhoid surgery. Although the retention period is almost always transient, it may require catheterization (insertion of a tube) to empty the bladder. Delayed bleeding or bleeding 7 to 14 days after hemorrhoid surgery occurs in 1% -2% of patients. Narrowing of the anus due to scarring, the formation of cracks and infection (1% of patients) may also occur after hemorrhoid surgery. Incontinence of stool (inability to control the passage of stool) is unusual unless the anal sphincter has become damaged under hemorrhoid surgery. Finally, blood clots can form in external hemorrhoids after hemorrhoid surgery if they are not removed completly.
Dilation: excessive dilation of the anal sphincter is a hemorrhoid surgery which stretches the anal canal has been used to weaken the anal sphincter, the assumption is that the increased sphincter pressure is responsible for hemorrhoids. Unfortunately, the dilation often harms the sphincter more and many patients become incontinent or unable to control his stool after hemorrhoid surgery with dilation. Therefore, dilation is rarely used to treat hemorrhoids as a way of hemorrhoid surgery.
Doppler ligation: Recently, the use of a dedicated, illuminated anoscope with Doppler probe that measures the blood flow has enabled doctors to identify each artery that fills the hemorrhoidal vessels. The doctor can then tie off (ligate) artery as a way of hemorrhoid surgery. This causes hemorrhoid to shrink. The Doppler probe technology is expensive, and it seems maybe not so much advantage over the rubber ligation hemorrhoid surgery.
Sphincterotomy. Sometimes, the inner part of the anal sphincter are partially cut in an attempt to reduce the pressure of the sphincter within the anal canal. This hemorrhoid surgery procedure is rarely used by itself, and there is concern about incontinence (loss of control) of faeces as a possible complication after this hemorrhoid surgery.
Stapled hemorrhoidectomy: This is the latest hemorrhiod surgery techniques to treat hemorrhoids and has quickly become the real hemorrhoid surgery of choice for third-degree hemorrhoids. Stapled hemorrhoidectomy is a misnomer because the hemorrhoid surgery does not remove the hemorrhoids, but the abnormally lax and expanded hemorrhoidal supporting tissue that has made it possible for hemorrhoids to PROLAPSE down.
The procedure of hemorrhoid surgery when it comes to stapled hemorrhoidectomy, a round, hollow tube is inserted in the anal canal. This concerns a sutures (long wire) is located, it is actually woven, around the anal canal above the internal hemorrhoids. The ends of the suture removed from the anus through hollow tubes. The STAPLER (a disposable instrument with a Circular Stapling in the end) is placed by first hollow tube and the ends of the suture to be drawn. Pull the suture draws the expanded hemorrhoidal supporting tissue in the jaws, STAPLER. The hemorrhoidal cushions are withdrawn in their normal position within the anal canal. The STAPLER is then fired. When it goes of, the STAPLER cuts off the cross direction ring of expanded hemorrhoidal tissue trapped within STAPLER and staples together the upper and lower edges of tissue that has been cut.
The procedure of hemorrhoid surgery with stapled hemorrhoidectomy, although it can be used to treat second degree hemorrhoids, which is usually reserved for higher grades of hemorrhoids – the third and fourth degree.
If in addition to internal hemorrhoids there are small external hemorrhoids that cause a problem, external hemorrhoids may be less problematic after a hemorrhoid surgery with stapled hemorrhoidectomy. Another option is to make a stapled hemorrhoidectomy and a excision of the external hemorrhoids. If the external hemorrhoids are big, a conventional hemorrhoid surgery hemorrhoidectomy can be done to remove both internal and external hemorrhoids.
During stapled hemorrhoidectomy, the arterial blood vessels to travel within the enlarged hemorrhoidal tissue and feed the hemorrhoidal vessels are reduced, which reduces blood flow to the hemorrhoidal vessels and reduce the size of hemorrhoids. During the healing of the cut tissues around the staples, scar tissue forms, and this scar tissue anchors the hemorrhoidal cushions in their normal position higher in the anal canal. The braces are needed only until the tissue heals. Then falling off and passes unnoticed in the stools for several weeks. Stapled hemorrhoidectomy is designed primarily to treat internal hemorrhoids, but if external hemorrhoids are present, they can also be reduced.
Stapled hemorrhoidectomy is a faster hemorrhoid surgery than traditional hemorrhoidectomy, it takes only about 30 minutes. It is associated with much less pain than traditional hemorrhoidectomy, and patients usually return to work earlier after this hemorrhoid surgery, you don’t need to return to early. Patients often sense fullness or pressure in the rectum as if they need to go, but usually resolves within several days. The risks of hemorrhoid surgery with stapled hemorrhoidectomy include bleeding, infection, anal fissuring (tearing of the feed of the anal canal), narrowing of the anal or rectal wall due to scarring, persistence of internal or external hemorrhoids, and rarely, trauma to the rectal wall.
Hemorrhoid surgery with stapled hemorrhoidectomy can be used to treat patients who have both internal and external hemorrhoids, but it is also an opportunity to combine a stapled hemorrhoidectomy to treat internal hemorrhoids, and a simple resection of the external hemorrhoids.