Hemorrhoid Surgery
Options for Hemorrhoid Surgery
There are many options when it comes to treating hemorrhoids, and in most cases, surgery is only necessary for severe, or class three or four, hemorrhoids. Although most of the hemorrhoidectomies performed today are still done in the traditional manner, with a scalpel and sutures, or with staples, medical advances now enable surgeons to perform hemorrhoidectomies with both ultrasonic and laser equipment as well.
Traditional hemorrhoid surgery varies as well, with both Milligan-Morgan technique and Ferguson technique in common use. These differ essentially only in the degree to which the wound is left open or closed after the surgery. In all of the above cases, the hemorrhoidal vessels are surgically removed along with some of the surrounding tissue, and the wound is either left open, as in Milligan-Morgan technique, or partially or fully closed, in Ferguson technique. With all of the above types of surgery, there is a risk of urinary tract infections, severe bleeding, fecal impaction, extreme pain, abscesses, and a long term narrowing of the anal canal.
Stapling is another surgical option for hemorrhoids. Also known as the Procedure for Prolapse and Hemorrhoids (PPH), in this surgery, a machine is inserted into the anus, and the swollen tissue of the hemorrhoid fed into the machine. It is there cut off, and the remaining tissue stapled back together, which restores the tissue to its original position. With this surgery, there is a risk of too much tissue being fed into the machine, resulting in tears, pain, and stretching of the other anal muscles. However, there is less chance of severe bleeding, and recovery time is generally quicker.
Needless to say, the biggest risk with traditional hemorrhoid surgeries is bleeding. Almost every hemorrhoidectomy patient will experience a degree of bleeding, which often occurs as blood in the stools. In most cases, any untoward bleeding is stopped with an anal pack, however, in some cases, patients have experienced bleeding that did not respond to vasoconstrictors or cauterization, and require additional surgery.
Newer methods of hemorrhoid surgery include both ultrasonic and laser treatment, which both work essentially the same way. In both instances, an ultrasonic or laser scalpel is used to cut off the hemorrhoid, and then seal the affected area, much like cauterization. Surgeons report much less bleeding with both procedures, as well as decreased patient pain and a quicker recovery time. Possible complications are much the same as any other surgery, and include complications with anesthesia, possible delayed healing, and infection.
There are non-surgical alternatives to treating severe hemorrhoids, including a number of homeopathic and natural remedies, most popularly, the H Miracle system, psyllium treatments, and witch hazel pads. For very severe hemorrhoids, however, the current doctors recommendation remains surgery.
