Major surgery in the form of hemorrhoidectomy is usually reserved for the treatment of severe and chronic piles that have not been cured by the other simpler means of treatment.
Hemorrhoidectomy involves the cutting off of the pile tissues of the inflamed butt, and the old traditional form of this operation makes use of the conventional surgical blade to cut off the pile tissue.
Recently however, a simpler and neater version of the surgery called stapled hemorrhoidectomy was developed, other names of this new form of surgery are Procedure For Prolapsed Hemorrhoids (PPH) and Circumferential Mucosectomy.
Although this procedure can be used to treat second degree internal piles, it is usually reserved for the treatment of the more severe third degree and fourth degree internal piles.
This procedure does not require any special preparation, you might just need to have an enema passed the night before the operation and you do not need to use any antibiotics prior to the operation.
During the operation you would have to lie facing down on the operating table with your backside thoroughly exposed upwards. Anesthesia to numb the pain of the operation might be achieved with the use of either local or regional anesthesia, you do not need to be gassed to undergo this procedure.
A special hemorrhoid stapling device is used to cut off the excess redundant tissue inside the anal canal after which, the remaining anal tissue inside the anal canal is tied together with sutures to make the anal tissues firmer.
Once this is done, the hemorrhoid tissue will be lifted back into the anus and blood flow into these tissues will diminish causing them to shrink and wither off after a while. This manner of hemorrhoids removal helps to restore the pile tissue back to its former normal position.
What are the advantages of this procedure?
1-Quick recovery time: Unlike after conventional major hemorrhoidectomy, when full recovery usually takes place in about two weeks, patients that undergo stapled hemorrhoidectomy can resume their normal daily activities within two to four days.
2-Less post operative pain: Since this procedure does not leave any anal wound it is usually not associated with significant post operative pain.
What are the potential side effects of this procedure?
(1) Damage of the rectal wall: The wall of the rectum can be damaged if excessive muscle tissue is drawn into device.
(2) Poor control of stooling: The muscles of the internal sphincter could be damaged causing poor control of defecation.
(3) Infection: Some people have developed pelvic sepsis after the procedure. The rate of post operative infection is however very small.
(4) Anal tightening: Tightening of the anus by strictures occurs in about 9% of the cases treated with this procedure. However, this anal narrowing is usually mild and it can be resolved by the surgeon passing his or her finger into the anus to re-open up the anus.
(5) Re-occurrence of symptoms: Re-occurrence of symptoms of piles could occur especially if it is used to treat large hemorrhoids. This procedure has a higher recurrence rate of symptoms than the use of conventional scalpel hemorrhoidectomy.
Although this new form of major hemorrhoid surgery has a lot of advantages over the former type of major surgery, it still has its own fear of possible terrible side effects and it has a fairly high rate of recurrence of symptoms, which means that it’s use should also be reserved as a last resort treatment of pile symptoms which do not respond to simpler treatments.