Hemorrhoidectomy is a surgical procedure to treat and manage hemorrhoids or piles. Hemorrhoids are inflamed and swollen vascular structures in the anal canal often associated with increased intra-abdominal pressure, as seen with straining during defecation, irregular bowel habits, etc.
Hemorrhoidectomy is usually done as an elective procedure and may sometimes be done as an emergency.
Hemorrhoidectomy may be of the following types
It is indicated for the management of hemorrhoids in the following circumstances:
Hemorrhoidectomy is contraindicated in the following conditions:
This condition can be handled and treated by giving a pudendal nerve block and performing a laser or chivate procedure.
Some investigations that may be done before hemorrhoidectomy include:
Before hemorrhoidectomy, the following is done:
The individual is placed in a jackknife position, a bilateral pudendal nerve block is done, and a local anesthetic with epinephrine is injected into the area after the buttocks are retracted to expose the anus. A retractor is placed in the anal canal, and the prolapsed hemorrhoid is grasped, sutured first (to minimize blood loss), and then resected with scissors or electrocautery. The wound is then closed with an absorbable suture, and packing is done and covered with gauze. The difference between a closed and an open hemorrhoid is that the anal mucosa is sutured in a closed haemorrhoid. In contrast, in an open hemorrhoid the anal mucosa is left open and not sutured. Using electrocautery or ultrasound energy devices to remove the hemorrhoids is associated with lesser postoperative complications than conventional excision with other surgical instruments.
The individual is placed in a jackknife or lithotomy position, a bilateral pudendal nerve block is done, and a local anesthetic with epinephrine is injected into the area after the buttocks are retracted to expose the anus (general anesthesia lesion may be used sometimes). A retractor is placed in the anal canal, a pursestring suture is applied in the mucosal layer, and a stapler is introduced. The prolapsed hemorrhoid is dissected entirely along with a ring of mucosa and submucosa within the canal, after which the distal mucosa is stapled over the proximal mucosa. The wound is closed with an absorbable suture, and packing is done and covered with gauze.
After the surgery, discharge is usually done on the same day after briefly monitoring for immediate postoperative complications.
Some measures that need to be taken after a Hemorrhoidectomy include:
Some complications that can be seen after Hemorrhoidectomy include:
Stapled Hemorrhoidectomy is associated with lesser postoperative pain, shorter recovery time, and lesser complications than conventional surgery to remove hemorrhoids.
The prognosis for Hemorrhoidectomy is generally good, although there is a risk of recurrence after the procedure. Recurrence is more commonly seen with conventional surgery to remove hemorrhoids.
Hospitalization is usually not required for Hemorrhoidectomy.
Specialists from the Department of General Surgery do hemorrhoidectomy.