Surgical Removal of Hemorrhoids
Hemorrhoid surgery (hemorrhoidectomy) involves the surgical removal of one or morehemorrhoids.
These are swollen veins in the rectum or anus that can occur either internally or externally.
What Is a Hemorrhoidectomy?
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There are different surgical techniques used to remove hemorrhoids.
Depending on the procedure, general, regional, or localanesthesiamay be used.
Surgery for External Hemorrhoids
External hemorrhoids are located near the anus and often cause itching and bleeding.
Get our printable guide for your next doctor’s appointment to help you ask the right questions.
When surgery is warranted, most external hemorrhoids are surgically cut out or excised.
This is called ahemorrhoid excision.
Alternatively, anincisional hemorrhoidectomymay be performed for a thrombosed external hemorrhoid.
With this punch in of surgery, a cut is made over the skin of the hemorrhoid.
Just the clot (located within the hemorrhoid) is removed.
Surgery for Internal Hemorrhoids
Internal hemorrhoids are located inside the rectum and are not typically visible.
For internal hemorrhoids, the whole hemorrhoid is usually cut out and removed.
This is called aconventional hemorrhoidectomy.
A procedure called astapled hemorrhoidopexymay also be performed to remove internal hemorrhoids.
With this technique, no incision is made.
Instead, the hemorrhoid is lifted and stapled back into the anal canal using a special circular stapling rig.
A stapled hemorrhoidopexy may result in less post-surgical pain than the conventional approach.
However, with the former, the hemorrhoids are more likely to return.
An additional option for internal hemorrhoid removal is a surgical procedure calleddoppler-guided transanal hemorrhoidal artery ligation (HAL).
This is called an anoscopy.
The blood supply is closed off in a process called ligation.
Complications of both of these approaches are similar.
Purpose of Hemorrhoid Surgery
The purpose of hemorrhoid surgery is to remove external or internal hemorrhoids.
The upside of hemorrhoid surgery is that it often has a better success rate than office-based procedures.
The downside, however, is that it can also cause more pain and prolong recovery.
Medications
You may be advised to stop taking certain medications several days prior to surgery.
You will also be instructed to undergo acleansing bowel regimenprior to the procedure.
Typically, the colon cleansing products can be purchased over the counter.
Leave all valuables, including jewelry, at home.
check that you bring your driver’s license, insurance card, and a list of your medications.
If you are staying overnight in the hospital, pack a bag the night before your surgery.
A surgical nurse will review your medication list, record yourvitals(heart rate, blood pressure, etc.
), and place an intravenous (IV) line into a vein in your arm.
Your surgeon will then greet you and review the operation with you.
Withregional anesthesia, the surgeon injects a numbing medication into your spine.
You may feel a stinging sensation as the medication is being injected.
Local anesthesiaalso involves a numbing medication, but it is injected into the area around your anus.
You will also probably be given a sedative to help you relax or fall asleep during the surgery.
The hemorrhoidectomy technique used in your procedure will be dependent on your specific situation.
If you are staying in the hospital, you will be wheeled on a gurney to your hospital room.
It’s important to follow up with your surgeon as advised.
Wound Care
Mild bleeding and a yellow-red discharge from the anal area are common after surgery.
This drainage usually lasts seven to 14 days.
Mild bleeding may increase with bowel movements and activity.
Check with your surgeon, but you’re able to probably shower the day after surgery.
What if the Discharge Smells?
Physical Activity
You will have specific activity guidelines to follow after surgery.
If you are struggling with constipation, talk with your healthcare provider about taking an occasionallaxativeor using an enema.
That said, if surgery is needed, know that it’s often very effective.
It will also require a commitment to your post-operative care.
Get our printable guide for your next doctor’s appointment to help you ask the right questions.
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