Hemorrhoids, also called “piles”, are usually treated non-surgically. Simple sitz bath and high fiber diet can ease the discomfort brought by these piles. That’s because piles do not usually cause severe pain and intolerable discomfort to the patients. However, when the condition gets worse and complications such as persistent bleeding, severe pain, and prolapsed hemorrhoids occur, surgery may be the best option.
There’s more than one surgical procedure to remove the piles. The choice of procedure depends on what kind of hemorrhoid the patient has, which can either be internal or external. The traditional hemorrhoid surgeries, more often called hemorrhoidectomy, are done when the condition is already an external kind, a prolapsed hemorrhoid.
Hemorrhoids are the bulging and enlarged blood vessels in and near the rectum and anus. They are often described and referred to as the varicose veins of the rectum as well as the anus. With reference to its location; there are two types of this medical condition, the internal and the external type. The internal type can be treated through any of the following procedures:
I.HEMORRHOIDECTOMY
Is a kind of procedure often suggested by medical specialists and doctors to treat hemorrhoids. This treatment is of two types:
1.General hemorrhoidectomy
2.Stapled hemorrhoidectomy
GENERAL HEMORRHOIDECTOMY
This is the most common surgical treatment and procedure being resorted to by those suffering from the hemorrhoidal condition. The process involves doing minute incisions on the tissues that surrounds the hemorrhoid. This is followed by the knotting together of such tissues to prevent future bleeding from occurring in the area. As a final process to the procedure, removal of the tissues is made with the use of anesthesia either local or generalized. This surgical procedure lasts duration of up to two (2) hours with the patient being able to go home on the same day after the surgery was done. While the patient can go home after the surgery, the area treated with the surgical treatment is kept protected with a clean and medicated bandage-gauze to prevent an infection from happening on the treated area.
STAPLED HEMORRHOIDECTOMY
Also known as stapling hemorrhoidectomy is the second type of surgical type to treat the medical condition. In this procedure, surgery is done to block the blood going to the hemorrhoidal tissue so that it will eventually wither and fall off. General anesthesia is administered to patients undergoing this procedure. This surgical procedure lasts duration of up to thirty (30) minutes. As compared to the general hemorrhoidectomy treatment, this treatment is less painful, but there was a clinical research made that this treatment has a higher risk of reappearing compared to the first type of surgical treatment.
Open/Closed Hemorrhoidectomy
Open hemorrhoidectomy is a surgical procedure often performed for cases with a prolapsed hemorrhoid. This is done by dissecting the hemorrhoid tissue from the sphincter muscle at the bottom of the anal wall. The resulting wound is then ligated to control bleeding and then left open.
•The Morgan-Milligan technique- is a surgical procedure developed by Drs. Morgan and Milligan in the United Kingdom (at the St. Marks hospital) in the year 1937. In this surgical process three of the major hemorrhoidal blood vessels are excised. To avoid stenosis (narrowing), leaving open pear-shaped incisions are made. The open incisions are made separate by skin bridges and mucosa. This procedure is widely known as ‘Open hemorrhoidectomy’ and is a surgical technique that is referred to as the gold standard of all surgical hemorrhoidectomy procedures.
Closed hemorrhoidectomy is a modified version of the open hemorrhoidectomy. The procedure is quite the same. The difference between the two is that in closed hemorrhoidectomy, the wound is sutured instead of being left open.
•The Ferguson technique- is another surgical procedure developed and pioneered by Dr. Ferguson in the year 1952. This technique modified the Morgan-Milligan technique where the open incisions are replaced with a partially or totally closed incision. The partial and total closure of the incision is made with the use of a running suture that is absorbable.
Preparation for both types of surgeries includes ensuring passage of soft stool through proper diet and treatment of skin conditions that may be present on and around the surgical area. An enema or suppository may also be administered before the procedure to empty the rectal area from fecal contents.
Patients older than 40 years of age are more eligible for open hemorrhoidectomy than the younger ones because the younger patients are more prone for hemorrhoid recurrence. The contraindications for this procedure include AIDS, Chron’s Disease, IBS (Inflammatory Bowel Disease), and cancer. Pregnant women are also not eligible for open hemorrhoidectomy because there will be recurrence of hemorrhoids due to their condition.
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