Stapled hemorrhoidectomy surgery is a surgical procedure for treating hemorrhoids. Generally, the procedure is used as a treatment option for third-degree hemorrhoids. Third-degree hemorrhoids are hemorrhoids which bulge with straining, and they can be visualized via a physical examination outside the anal margin. The surgery is considered as a misnomer, because it does not remove the hemorrhoids, but it removes the abnormally lax and the extended hemorrhoidal supporting tissue which made the hemorrhoids to prolapse outward.
Stapled hemorrhoidectomy is mostly indicated in the case of severe cases of internal hemorrhoidal prolapse, mostly 3rd and 4th degree hemorrhoidal prolapse. The procedure can also be indicated for patients with 2nd degree hemorrhoids which are non-responsive to conservative treatment methods. Stapled hemorrhoidectomy can be contra-indicated in severe cases of fibrotic pile which can’t be repositioned physically or in case one cushion is prolapsed.
Also, a doctor can recommend stapled hemorrhoidectomy because of the following:
During stapled hemorrhoidectomy surgery, the surgeon inserts a circular, hollow tube into the canal. The tube is used to introduce a long suture thread, which is woven circumferentially within the anal canal, above the internal hemorrhoids. A hollow tube known as anoscope is then used to bring out the ends of the suture out of the anus. Then, a stapler, known as PPH, with a circular stapling device at the end is used. PPH means procedure for prolapse hemorrhoid.
The surgeon inserts the stapler through the first hollow tube and then pulls the ends of the suture. Once the suture is pulled, the expanded hemorrhoidal supporting tissue is also pulled as purse string into the stapler’s jaws. Next, the hemorrhoidal cushions are then pulled back into their original position in the anal canal. The surgeon then fires the stapler. Once fired, the stapler cuts off the circumferential ring of the extended hemorrhoidal tissue confined in the stapler. At the same time, the stapler staples together the lower and upper edges of the cut tissue. After firing the staple, the stapler should remain in place pressed for around a minute to prevent capillary bleeding.
Even though stapled hemorrhoidectomy can be used to treat second-degree hemorrhoids, it is mostly reserved from serious hemorrhoids, mostly third and fourth degree. Apart from the internal hemorrhoids, there can also be external hemorrhoid which can be still problematic. But, the external hemorrhoids can be less problematic once the stapled hemorrhoidectomy procedure is complete.
In stapled hemorrhoidectomy, the arterial blood vessels which travel within the stretched hemorrhoidal tissue to the hemorrhoidal vessels are cut. This procedure is very critical as it reduces the blood flow to the hemorrhoidal vessels, thus reducing the size of the hemorrhoids. As the patient heals, scar tissue forms around the cut tissue staples and the scar tissue positions the hemorrhoidal cushions in their ordinary position. The staples should be in place until the tissue heals, and then fall off and pass through the stool after a few weeks. This is rarely noticed. The procedure is meant to treat internal hemorrhoids, but it can also be used to reduce external hemorrhoids.
Link to you-tube animated video- https://www.youtube.com/watch?v=Xv2y8XtGCCY
Stapled hemorrhoidectomy surgical procedure takes a shorter time compared to traditional hemorrhoidectomy. If the surgeon is experienced, the procedure takes approximately 30 minutes. Also, the procedure is less painful than traditional hemorrhoidectomy, and the patient can resume their usual activities faster.
Complications after stapled hemorrhoidectomy surgery are infrequent. Sometimes there may be complications such as bleeding or trauma to the rectal wall. Rarely there may be other complications and the doctor will explain to you in detail during your consultation. However, many patients are very comfortable with the outcome of stapled hemorrhoidectomy and usually recover without any complications.
After stapled hemorrhoidectomy surgery, a patient should expect degree of anal and rectal pain. The doctor will, however, prescribe pain medication to deal with the pain. But, a patient can aid his or her recovery through:
Patients should avoid activities which involve heavy pulling and lifting. Some patients find that sitz baths assist in easing postsurgical discomfort. A sitz bath is where a patient soaks his or her anal area in warm salty water several times every day.
Even though patient recovery time is not the same, most patients recover within around 10 to 14 days after stapled hemorrhoidectomy. Complications are very rare, but a patient should seek immediate medical attention in case they feel dizzy, have pain while urinating or cannot urinate at all or if they have a fever.
But, it is important to understand that stapled hemorrhoidectomy surgery success depends on the patient’s ability to change their daily bowel habits to ease the passing of stools. Most internal hemorrhoids tend to get smaller, and the pain reduces with stapled hemorrhoidectomy or home treatment. When compared to open surgery, stapled hemorrhoidectomy involves less risk, less painful and it allows the patient to recover faster.
The average cost of stapled hemorrhoidectomy surgery varies depending on the type of the hospital, type of room selected and duration of stay in the hospital. Most of the times this is a day care procedure. Cost may also vary as per the type of stapler used.