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. The following are the two techniques of traditional surgeries done for hemorrhoids:
Milligan-Morgan Technique
Developed by the surgeons Dr. Milligan and Dr. Morgan in the year 1937 in St. Mark’s Hospital in UK, this technique is used to remove large types of hemorrhoid. It can also be applied for the small types but it’s not very much recommended.
In open hemorrhoidectomy, the surgeon will isolate the hemorrhoid tissues or “pillows” by making a band around them. The surgeon will dissect the pillows from the muscle. The wounds are then ligated to reduce bleeding. The wounds are left open for natural healing process. No sutures are made in open hemorrhoidectomy.
Ferguson Technique
In the year 1952 in the US, Dr. Ferguson developed a modification on the Milligan-Morgan open hemorrhoidectomy. The preparation and contraindications are the same with the open technique. Ferguson’s technique differs with Milligan-Morgan’s technique in such a way that the wounds, instead of being left open, are closed off with absorbable sutures. Experts say that there’s less pain in closed hemorrhoidectomy compared with the open technique.
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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