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Hemorrhoid Surgery

Hemorrhoid (also known as piles) is a condition in which internal and/or external veins around the anal canal dilate or bulge. The treatment of hemorrhoids may vary from minimally invasive to surgical depending upon its intensity.

Hemorrhoids are classified into four degrees on the basis of severity:

  • In the first degree, the hemorrhoid bleeds but it does not protrude from the anal canal.
  • In the second degree, it protrudes outside the anus, typically during bowel movement and retracts normally.
  • The hemorrhoid does not retract spontaneously in the third degree, and has to be manually placed back inside the anus.
  • In the fourth degree, the hemorrhoid is in the form of a protruded tissue that has to be thrombosed because it cannot be replaced manually.
Among the common symptoms of hemorrhoids are bleeding, itching, pain and mucus discharge. Many cases of hemorrhoids can be treated through topical medications, dipping in warm water and by dietary modifications to alleviate symptoms of swelling and pain temporarily. There are also some non-surgical methods that are effective in treating hemorrhoids permanently, without causing any pain. Many cases are treated through non-surgical procedures for long-term and satisfactory relief. If the hemorrhoids protrude to a large extent, it can be treated by a variety of surgical techniques.

Traditional Surgical Methods of Treating Hemorrhoids

The following are the two traditional ways to surgically treat hemorrhoidal diseases:

Milligan-Morgan Technique: This technique was developed in 1937 by Drs. Milligan and Morgan in the United States. It involves the excision of the three major hemorrhoidal vessels. This technique is regarded as the gold standard against which most other surgical techniques of treating hemorrhoids are compared.

Ferguson Technique: This technique was developed by Dr. Ferguson, in the US, in 1952. It is the modified version of the Milligan-Morgan technique. Although this technique is advantageous in healing the wound, it has shown greater efficacy in reducing pain or postoperative morbidity.

Main Types of Hemorrhoid Surgery

When all home remedies and other non-invasive techniques fail, it is best to opt for surgery as a treatment for hemorrhoids. Surgery is the best option when the hemorrhoid symptoms start impacting your lifestyle severely. A surgical emergency may arise in case of non-stop bleeding or when the pain in the rectal region becomes excruciating due to pus or blood at the anus. The following are some popular surgical treatments for hemorrhoids:

Hemorrhoidectomy: The tissue around the hemorrhoid is incised and the swollen vein is tied off to prevent bleeding. Then, the whole hemorrhoid is removed. Some stitches may also be needed. The wound is covered with medicated gauze. Chances of recurrence are very less following hemorrhoidectomy. Performed in a surgery center, this surgical procedure involves anesthetizing the patient using general or spinal method with sedation.

Stapled Hemorrhoidectomy: This is the newest surgical technique that is faster than the traditional hemorrhoidectomy. In traditional hemorrhoidectomy, the patient must bear the post operative pain which may last for days. Stapled hemorrhoidectomy is performed in case of internal as well as external hemorrhoids. However, stapled hemorrhoidectomy involves risks such as anal fissuring, bleeding, infection, persistence of hemorrhoids, and, in rare cases, trauma to the rectal wall.

Laser Therapy: Laser therapy is typically performed by skilled surgeons. The level of precision and accuracy is unparalleled with the use of infinitely thin laser beams resulting in healing. The patient experiences lesser discomfort and medication is also lesser. In most cases, there is no need of hospital stay. This intrinsically therapeutic technique involves closing the nerve and blood vessels through an invisible light. The sealing of tiny blood vessels enables proctologist to conduct the surgery in a controlled and bloodless condition. In a study involving 750 patients, 98% cases were successful with 99% patient satisfaction rate.

Sclerotherapy: In this procedure, a chemical solution is injected into the hemorrhoid around the anus, leading to the hardening of the hemorrhoid.

Given that there are different ways of treating hemorrhoids surgically, it makes sense to learn the basis of every procedure. This prepares you to get an informed consultation from doctor.

It is important that patients take all the necessary precautions post-surgery to prevent recurrence.