Haemorrhoidectomy

What Are the Types of Haemorrhoidectomies?

• Closed Haemorrhoidectomy

  This surgical procedure involves excising hemorrhoids using a scalpel, scissors, electrocautery, or laser. The resulting wound is then closed with absorbable sutures. This helps facilitate healing and reduce post-surgical discomfort.

• Open Haemorrhoidectomy

  Similar to the closed approach, this technique removes hemorrhoids through excision. However, the wounds are left open to heal naturally. While it may result in increased postoperative discomfort and a higher risk of complications compared to other methods, open hemorrhoidectomy is often considered highly effective for complete hemorrhoid removal, particularly in complex cases.

• Stapled Haemorrhoidectomy

  This technique is suitable for internal, grown, and prolapsed haemorrhoids. During the procedure, the surgeon uses a circular stapling device to staple the hemorrhoidal tissue back into place in the anal canal. Benefits include less post-operative pain and faster recovery compared to traditional excision.

• Laser Haemorrhoidectomy

  This minimally invasive technique uses laser energy to shrink and remove haemorrhoids, resulting in minimal scarring, less pain, and faster recovery. However, it may not be suitable for severely prolapsed or thrombosed hemorrhoids, which often necessitate traditional excision.

Why Do You Need a Haemorrhoidectomy?

• Prolapse – A prolapsed haemorrhoid occurs when a swollen tissue has fallen from inside the anus and cannot go back on its own. It is a gradual process that also tends to worsen over time.
• Thrombosis – A thrombosed prolapsed haemorrhoid forms when a blood clot develops within the veins of an external haemorrhoid. This can lead to rupture, causing severe pain and bleeding.
• Strangulation – Strangulation happens when Grade IV haemorrhoids prolapse and lose their blood supply. This serious and rare complication does not resolve on its own, often leading to tissue death.
• Recurrence – In some cases, haemorrhoids can recur even after non-surgical treatments. Haemorrhoidectomy provides a more permanent solution by completely removing the haemorrhoidal tissue.

What Can You Expect After a Haemorrhoidectomy Procedure?

What Are the Potential Risks and Complications of Haemorrhoidectomy?

• Slow healing
• Urinary retention
• Excessive bleeding
• Adverse reactions to anaesthesia
• Wound infection

How to Speed Up Haemorrhoidectomy Recovery

• Prioritise rest to allow your body time to heal.
• Take sitz baths several times daily to relieve discomfort.
• Take all prescribed oral and topical pain medications as directed.
• Apply ice packs to the surgical wound to reduce swelling.
• Introduce high-fibre foods into your diet a few days post-surgery to ease bowel movements.
• Elevate your hips with a pillow or cushion when sitting to reduce anal pressure.
• Drink plenty of water throughout the day to soften stools and prevent constipation.

FAQs

When can I return to work after a haemorrhoidectomy?

• The recovery time after a haemorrhoidectomy varies depending on the type of haemorrhoidectomy performed and the extent of the surgery. Most patients can return to work in two to four weeks.

Are there non-surgical alternatives to haemorrhoidectomy?

• Yes, non-surgical hemorrhoid treatments include rubber band ligation, radiofrequency ablation (RFA), transanal hemorrhoidal dearterialisation (THD), and hemorrhoidal artery ligation (HAL).

Can haemorrhoidectomy treat all types of haemorrhoids?

• While effective for various haemorrhoid types, haemorrhoidectomy is generally reserved for severe haemorrhoids, particularly Grade III and IV types, or when other treatments fail. It addresses both internal and external haemorrhoids, especially large or complicated cases causing significant symptoms or complications like thrombosis.

Can haemorrhoidectomy be performed as an outpatient procedure?

• Yes, haemorrhoidectomy can be performed as an outpatient procedure, particularly for patients with uncomplicated cases and those who can recover safely at home.

Are there any age restrictions for undergoing haemorrhoidectomy?

• No, there are no strict age restrictions for undergoing haemorrhoidectomy. However, older adults and younger patients should be carefully evaluated before the surgery to determine their suitability for surgery and post-operative recovery.