Hemorrhoidectomy

Hemorrhoidectomy is outpatient surgery to remove hemorrhoids. It is done using general anesthesia or spinal anesthesia for pain. There are a couple of different ways to do a hemorrhoidectomy: 1. Incisions are made around the hemorrhoid. The hemorrhoid is removed and the swollen vein inside is tied off to prevent bleeding. The surgical area can be stitched back together or left open. 2. There is another procedure that uses a circular stapling device. This device does not require any incisions. The hemorrhoid is just lifted up, and then the device staples underneath it. Surgery can be done with a scalpel, cautery pencil, or laser.

When is surgery used?
Hemorrhoidectomy is used when you have:

• Large internal hemorrhoids
• Recurring internal hemorrhoids
• Large external hemorrhoids that are very painful
• Exhausted all other means of hemorrhoid removal

Complications

• Pain
• Bleeding from the rectum area
• Inability to urinate
• Hematoma (blood collecting in surgical area)
• Incontinence (uncontrollable bowel or bladder)
• Infection
• Fecal Impaction (feces trapped in rectum canal)
• Narrowing rectum canal
• Additional hemorrhoids
• Abnormal passage that forms between the rectum canal and other areas
• Rectum prolapse

Recovery

You will experience some pain after the surgery. If your doctor provides a prescription for pain killers, take them as prescribed. Ask your doctor what over the counter medication is ok for you to take. Some bleeding is normal, but if you experience excessive bleeding, seek medical attention. Numbing medicines can be applied before and after bowel movements to help with pain. Ice packs applied to the rectum area can help with swelling and pain. Frequent soaks in warm water (sitz bath) are recommended to help with pain and muscle spasms. Some doctors may prescribe an antibiotic to reduce the chance of infection. Stool softeners are recommended to help keep bowel movements smooth. Straining during bowel movements may cause recurrence of hemorrhoids. Expect a follow-up exam with the surgeon 2 to 3 weeks after the surgery.

What to Consider

It is imperative that you make changes in daily habits to help reduce strain in bowel movements. Hemorrhoidectomies may provide better long term results than other hemorrhoid treatments. However, surgery is more costly and comes with a greater risk of complications and pain.

Most Internal Hemorrhoids can either be treated with home treatments and remedies, or fixative procedures. Fixative procedures involve less risk, less pain, and require less time away from work when compared with surgery.