Indications for haemorrhoidectomy
- Fibrosed haemorrhoids
- When the haemorrhoids are both internal and external with the external haemorrhoid being well defined.
- Second-degree haemorrhoids that have not been cured by non-operative treatments
- 3 rd – 4 th degree haemorrhoids
- Surgery is done to alleviate the symptoms especially if the haemorrhoidal bleeding is too much to cause anaemia, haemorrhoidectomy is also strongly indicated.
How is this procedure done?
- The hemorrhoids are usually identified and they are injected with diluted adrenaline to minimize the bleeding during the surgery by vasoconstriction. The areas surrounding the hemorrhoids should also be injected with the dilute adrenaline.
- The hemorrhoids are pulled away with a forceps and the diathermy is used to cut them out while ensuring minimal blood loss prevails.
- The wound is left open for self-healing. Aim to ensure that there is no bleeding after the surgical excision is done.
- A pad of gauze and cotton wool is firmly applied and well bandaged.
- In this technique, the hemorrhoid should be excised together with the overlying mucosa. Then the wound is sutured with an absorbable suture completely. This technique is mainly used for internal hemorrhoids.
Risk of this procedure
- Secondary haemorrhage local use of adrenaline to constrict the blood vessels with blood transfusion and injection of morphine is indicated. After the replacement of blood, the ligation and excision of the piles is required.
- Anal strictures
- Acute retention of urine- this is seen especially in men which may require catheterisation so as to relieve the problem.
- Reactionary haemorrhage
- Very painful anal wound