How is surgery to remove haemorrhoids performed?

A person who has the disease of enlarged haemorrhoids is faced with the question of how operation to remove haemorrhoids is carried out. And this is due to the fact that modern medicine offers a large number of surgical treatment methods.

Haemorrhoids are varicose veins of the rectum. The disease occurs as a result of exposure to risk factors:

• sedentary lifestyle;
• drinking alcohol;
• eating spicy food;
• lifting heavy objects;
• pregnancy and childbirth;
• constipation or diarrhea.

The mechanism of formation of an enlarged haemorrhoidal plexus of the rectum is almost identical for all risk factors. This is an increase in intra-abdominal pressure. Under certain conditions, venous blood stagnates in the pelvis, veins are compressed by the uterus during pregnancy, and irritation of the rectal mucosa occurs.

Haemorrhoidal disease occurs in men and women. Prevalence estimates vary depending on age, population, and how symptoms are recorded; It is incorrect to give a single percentage of the population without a verifiable source. The disease is associated with changes in the vascular cushions and supporting tissues of the anal canal. The diagnosis is established after an assessment of complaints and examination. Read more on the topic: men · women.

A diagnosis of haemorrhoids does not mean that all patients need surgery. For mild symptoms, normalization of stool, fiber, changes in bowel habits and, if indicated, a short course of medications help. If bleeding, node prolapse, or complications persist, outpatient procedures or surgical treatment are considered. The choice is made after examining and discussing alternatives; Neither method provides a lifetime guarantee. The following conditions require separate evaluation, but they cannot be considered an inevitable outcome of every case of haemorrhoids:

• thrombosis of haemorrhoids;
• gastrointestinal bleeding;
• posthemorrhagic anemia;
• acute paraproctitis;
• perianal dermatitis.

The main thing is that varicose haemorrhoids reduce the quality of life of the working population.

The choice of surgical treatment method depends on the patient. After reading this article, you can find answers to the following questions:

1. Types of operations for haemorrhoids;
2. Preparation for surgical treatment;
3. Recommendations in the postoperative period;
4. Prevention of relapse.  

Types of operations for haemorrhoids

Modern proctology service offers patients a huge selection of methods for surgical treatment of haemorrhoids. The types of operations directly depend on certain factors: equipping the clinic with modern medical equipment, the qualifications of the proctologist surgeon, the severity of the pathological process.

Taking into account these factors, surgical operations can be divided into two groups:

1. Radical removal of enlarged rectal veins;
2. Minimally invasive surgical techniques.

Radical operations

Haemorrhoidectomy is performed using one of the following methods:

Milligan-Morgana method in the second modification of the Research Institute of Proctology

The most radical and popular method of removing haemorrhoids. Thanks to this method, all haemorrhoids with underlying tissues are excised. But there are also unfavorable aspects: severe pain in the postoperative period.

Stapler haemorrhoidopexy (Longo operation) 3—4 stages

During the operation, the surgeon separates the enlarged node from the mucosa and, using a special device, compresses the node’s stem. As a result, the blood supply stops, and the node turns into connective tissue. This operation is also called stapled haemorrhoidopexy.

Parks haemorrhoidectomy

When using this technique, the rectal mucosa is preserved, and the enlarged haemorrhoid is completely resected. Higher skills are required from the attending physician.

Minimally invasive surgical techniques

The advantages of minimally invasive techniques for removing enlarged haemorrhoids are that these operations can be performed on an outpatient basis, the rehabilitation period is reduced, and there is virtually no pain. These methods include:

Use of latex rings

The operation is similar to stapled haemorrhoidectomy. The only difference is that when using rings, the surgeon does not violate the integrity of the rectal mucosa.

Use of sclerosing agent

A special substance that has adhesive properties is injected into the enlarged haemorrhoid under visual control. The node seems to stick together and decrease in size, subsequently becoming necrotic.

Electrocoagulation of haemorrhoids

Using special medical equipment, the surgeon cauterizes the nodes. A less popular technique due to the possibility of bleeding.

Preparation for surgical treatment

An important point in the surgical treatment of haemorrhoids, regardless of what technique is used, is high-quality preparation for the operation. The patient must undergo a number of laboratory and instrumental examination methods; as a rule, they are standard for each operation. Additionally, the attending physician may prescribe examination and examination by specialists in the presence of concomitant diseases.

Before the operation, the surgeon decides on the choice of anesthesia. For radical operations, general anesthesia or spinal anesthesia is used. With minimally invasive techniques, the specialist is limited to local anesthesia.

One day before the scheduled date of the operation, the patient is advised to refuse to eat, drink only laxatives, and a cleansing enema is also prescribed.

Recommendations for the postoperative period

The postoperative period differs significantly depending on the surgical treatment method. For example, during radical operations, the patient is prescribed a special diet, dressings are performed daily, and the impact of pain is reduced.

With minimally invasive operations, the patient can lead a normal lifestyle the very next day. The main thing is to exclude the influence of unfavorable factors.

Relapse prevention

The likelihood of recurrent symptoms depends on the type of intervention, the form of the disease, the duration of observation and individual factors. Node excision may provide more durable control for appropriate indications, but comes with its own risks and recovery. Less traumatic procedures sometimes need to be repeated. Neither “95%” nor any other general indicator guarantees a personal result. Correction of stool and observation are useful after any method, but do not completely exclude relapse.

Remember that the choice of surgical treatment method depends not only on the wishes of the patient, but also on the qualifications and professionalism of the doctor and the equipment of the medical center.