Hemroid surgery is not the horror that many people expect it to be, in fact, a lot of the procedures being done nowadays can even be done in an office setting as an outpatient procedure. Today’s hemroid surgery options offer quick recovery times and less short term and long term side effects, than surgical options of the not so distant past. Hemorrhoids are graded on a scale of I to IV, with IV being the most advanced case of hemorrhoids, the hemroid surgery you will need is in part determined by the grade of your hemorrhoid.
Options for Hemroid Surgery
Rubber Band Ligation – This is the most commonly performed office procedure for hemorrhoids, it is recommended for Grade II hemorrhoids. Tiny rubber bands are put around the base of the hemorrhoid to cut off the blood supply to the hemorrhoid which causes it to dry up in about 2 to 7 days. This procedure is popular because it can be performed quickly, allows for multiple hemorrhoid bandings in one sitting, results in minimal pain and offers a quick recovery. This treatment has a success rate of about 80%, but goes down with each subsequent treatment and if more than four bands are required, success rates are also lower.
Doppler Guided Hemorrhoid Arterial Ligation (DG-HAL) -
This is a relatively new procedure that was developed in 1995 by Kazumasa Morinaga, a surgeon. This office procedure uses Doppler radar to quickly locate the hemorrhoidal veins where the blood supply to the hemorrhoid is quickly cut off with a stitch. This procedure is recommended for Grade III and IV hemorrhoids. This procedure is quicker than the rubber band ligation and offers a minimum of pain with most patients being back to their regular activities within 2 days. This procedure has a success rate over 90% after 2 years.
Infrared Coagulation – This procedure uses a very focused beam of infrared light to cause a blood clot to form in the hemorrhoid, once this clot forms, the hemorrhoid slowly dries up. This procedure can be used on Grade I to III hemorrhoids. Some of the benefits are that is quick, typically less painful than rubber band ligation and allows for treating multiple hemorrhoids in the same session. Some potential downsides are that this procedure doesn’t have as good a long term success rate as rubber band ligation, multiple sessions may be required and additional treatments will usually be required after one year.
Stapled Hemorrhoidectomy (also called Procedure for Prolapse and Hemorrhoids or PPH) – A stapler is used to reposition the tissue in the anal canal, so that that blood supply to the hemorrhoid is cut off. Once the blood supply is cut off, the hemorrhoid slowly dries up, usually over the course of about 4 to 8 weeks. This surgery is recommended for Grade III and IV hemorrhoids. When this procedure is performed above the dentate line, this hemroid surgery offers minimal pain; this is due to the fact that the upper 2/3rds of the anal canal above the dentate line has no pain receptors. Potential side effects include potential long term damage to the anal muscles which may result in incontinence. Some studies show that the stapled hemorrhoidectomy isn’t as effective at preventing the reoccurrence of internal hemorrhoids as the traditional hemorrhoidectomy.
Hemorrhoidectomy – This hemroid surgery involves cutting off the hemorrhoid with a scalpel, and because the hemorrhoidectomy involves actually cutting into the anal tissue, there is an increased risk of both long term and short term side effects such as bleeding, infection and incontinence. The hemorrhoidectomy is still in wide spread use, but only on the most serious grade of hemorrhoids and usually only after other treatment have already been tried and found to be unsuccessful. This surgery has been found to be better at preventing reoccurrence than the stapled hemorrhoidectomy.
