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
- Anal strictures
- Acute retention of urine- this is seen especially in men which may require
catheterisation so as to relieve the problem.
Getting ready for the procedure
You are required to show up to the health care facility about a day prior to the surgery. This will
give the care givers enough time to run the lab blood tests required and other tests that might
be required prior to the surgery. This will give a clear picture of the current status of the
Recovery after surgery
The patient needs to be reassessed after 4-6 weeks after discharge to assess if the piles are
healing well or are well healed.
Chance of recurrence is very low after hemorrhoidectomy. A patient is normally discharged the same day of surgery with a median of about 6 weeks of recovery.