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Hemorrhoidectomy surgery
A hemorrhoidectomy surgery is designed to remove haemorrhoids. Haemorrhoids are swollen veins in the lowest part of your rectum and anus. It can be internal haemorrhoids, inside the rectum, or external, on the skin around the anus.
Haemorrhoids symptoms include:
• pain or itchy sensation around your anus
• lumps around your anus
• swelling around the affected area
• blood after you poo or on the tissue
• painful bowel movements
Haemorrhoid is fairly common condition and in most cases, people can manage symptoms by controlling their diet and lifestyle. Hemorrhoidectomy surgery is only recommended for people with severe symptoms and when other non-invasive treatments have failed.
Who is it suitable for
✔ Patients diagnosed with hemorrhoids
✔ Patients experiencing extreme itching, irritation and pain around anus
✔ Patients experiencing painful lump or swelling near your anus
✔ People who tried non-invasive treatments and it did not help
✔ Patients who are suffering from severe hemorrhoids that is causing a lot of discomfort
Treatment duration
✔ Hemorrhoidectomy surgery normally takes less than 1 hour but might take longer
✔ Depending on the complexity and selected procedure, it can be performed either as outpatient or inpatient (requiring you to stay for a night at the hospital)
Recovery
✔ Most patients can resume normal daily activities after 1 or 2 weeks
✔ It is common to experience some pain and aching for about 2 to 4 weeks
✔ You should avoid heavy lifting and strenuous activities for about 4 to 6 weeks
✔ For a few days after surgery, you should drink liquids and eat a bland diet (plain rice, bananas, dry toast or crackers, applesauce)
✔ Gentle exercise, such as walking, can help the healing process
Types of hemorrhoidectomy surgery
Hemorrhoidectomy is a surgical procedure to remove internal haemorrhoids. It is the most effective treatment for haemorrhoids that is causing severe symptoms and when other non-invasive treatment have failed. The goal of hemorrhoidectomy surgery is to:
• remove the haemorrhoids
• or make the haemorrhoids shrink by reducing blood supply to it
There are several different types of hemorrhoidectomy surgery:
Hemorrhoidectomy (Miligran morgan)
Hemorrhoidectomy is a classical surgical procedure to remove haemorrhoids. It involves opening the anus, clamping and cutting the hemorrhoidal tissue off. Once the haemorrhoids is removed, sutures are applied to close the wound. This type of surgery is generally safe and effective but may require longer recovery than other surgery types, and it can result in more post surgery symptoms such as pain, bleeding, urinary retention and other possible complications.
Hemorrhoid stapling (Longo)
​Haemorrhoid stapling or Longo, is a surgical procedure used to treat large or prolapsed haemorrhoid. This procedure involves the use of a circular stapling device to remove the excess of hemorrhoidal tissue, and then lifting and 'stapling' it back into place in the anal canal. By doing this, it restricts the blood supply and as a result makes the hemorrhoids to shrink in size. People who have stapled surgery may have less pain after surgery and quicker recovery than people who have the traditional hemorrhoid surgery. However, with this surgery there is a chance that the condition occur again.
Ligasure
Ligaasure is a popular treatment which uses an electric device to cut the hemorroidal piles and to seal affected tissues and vessels. It's a closed surgery technique and less invasive than the traditional hemorrhoidectomy. Ligaasure is a safe and effective procedure, and quick recovery compared to more invasive treatment types.
THD Doppler surgery
THD Doppler surgery is an advanced and minimally invasive procedure for hemorrhoid treatment. It is suitable for treating all grades of hemorrhoids and prolapsed hemorrhoids. The benefit of this procedure is that it does not require the removal of hemorrhoids, and as a result recovery is usually quicker. This procedure involves the use of proctoscope and a doppler probe to locate the position of hemorrhoidal arteries, ligate the arteries and then cutoff the blood supply to the hemorrhoids.
Before The Treatment
Before scheduling the treatment, you will need to meet with a doctor to discuss your treatment plan and perform an examination:
• Goals and expectations - Prepare to discuss you goals and your expectations. Your doctor should explain you different types of methods, potential risks, recovery and expected outcomes.
• Medical history - You should provide a complete medical history including your past and current medical conditions, and medications that you are taking.
• Examination - Your doctor is going to perform physical examination to determine the best treatment approach for you. As part of the physical examination, your doctor will look at your anus and rectum, check for lumps, swelling, irritation and other symptoms. Your doctor may also do a digital rectal exam, which includes inserting a gloved, lubricated finger into the rectum for further assessment.
• Diagnostics, tests and additional examination - Your doctor may ask you to do additional diagnostics such as sigmoidoscopy or colonoscopy.
You will be advised by your doctor how to prepare for the procedure which may include dietary and medication requirements.
What does it involve?
There are different types of hemorrhoid surgery and the process will vary depending on a chosen procedure. The type of surgery depends on your symptoms, hemorrhoid grade and other health conditions. You should discuss and agree your treatment approach with your doctor prior to surgery
While there are different types of treatment, generally the following is involved:
• Before hemorrhoid surgery you are generally advised to follow a prescribed diet and then you should normally stop eating the day before your surgery.
• This procedure is generally performed under local or general anaesthesia. In most cases, general anaesthesia is used.
• Depending on the chosen procedure, a surgeon will be either removing hemorrhoid or performing surgical manipulations to make haemorrhoids shrink by reducing its blood supply.
Hemorrhoid operation usually takes 30 minutes to an hour. Depending on the type and complexity of your operation, you may go home the same day or stay for a night.
After the treatment
Your recovery and how quickly you can return to work largely depends on your treatment type and complexity of the operation. Most patients can resume normal daily activities after 1 or 2 weeks. ​After hemorrhoid operation it is common to experience some discomfort and:
• Bruising
• Swelling
• Scars
• Inflammation
• Bleeding after defecation
• Local pain
It is common to experience some pain and ache for about 2 to 4 weeks. You may need to take antibiotics after the operation to reduce the risk of infection. For a few days after surgery, you should drink liquids and eat a bland diet such as plain rice, bananas, dry toast or crackers, applesauce. You can return to regular foods and gradually increase the amount of fiber in your diet.
You should avoid heavy lifting and strenuous activities for about 4 to 6 weeks. Recovery usually takes around 4-6 weeks but it can take up to 6 months for the swelling to go away and see the full effect of the operation. Some bleeding is possible till the healing process is complete.
Risks
As with any major surgery, hemorrhoid surgery carries risks such as:
• Incontinence
• Constipation
• Delayed healing
• Urinary retention
• Bleeding
• Infection
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