Haemorrhoidectomy

okay I would like to talk about an operation called hemorrhoidectomy hemorrhoids are what's commonly referred to as piles and many people have piles and they don't cause them a problem however you may be have been offered an operation for your piles if you're experiencing symptoms for example pain or bleeding. Hemorrhoids occur because of prolapsing of the anal cushions. Anal cushions are part of the inner lining of the anus. There are many techniques to fix hemorrhoids and it may be that in the first instance, depending on the type of hemorrhoid you have, that you are offered a simple banding procedure. This can often be done in the outpatient clinic and it will involve you lying on your side, having an examination of the anus, initially with a finger, and then with a small tube called a proctoscope so that the doctor can have a look at your anus and find the hemorrhoid. Once the hemorrhoid has been located, a small rubber band is placed around the hemorrhoid at the neck of the hemorrhoid with some suction and this technique works quite well as the The rubber band acts as a way to tighten the hemorrhoid right at its neck and it therefore stops any further blood supply to that area and the hemorrhoid will drop off in the days after the procedure. It's very quick and easy to do and you don't need any painkillers or anesthetic for this procedure. After the operation, if you experience any profuse bleeding, that's quite abnormal and you should attend the accident and emergency department. This rarely happens, but there is a very small chance that you may experience this profuse bleeding. You may find that the banding itself requires several attempts before your hemorrhoids are treated. Another technique that you may be offered is a hemorrhoidectomy which means cutting out the hemorrhoids and for this operation you will require a general anaesthetic so you will be asleep for the operation and you won't feel anything during the operation. First of all, the surgeon will have a look inside your anus in order to identify and locate your hemorrhoids and your hemorrhoids will be cut out and a stitch will be placed at the top of the hemorrhoid to stop any bleeding. You will have a sponge dressing initially which will fall off and your hemorrhoid will then heal by secondary attention which means we don't stitch up the wound, they will be left open to heal on their own and this will take a few weeks. You will be given painkillers for 2-4 weeks and you will also require some antibiotics in the first 5-7 days of the operation. Again this is a very safe operation but we We always warn patients having this operation of bleeding, so if you find when you get home you're having profuse bleeding, this is a sign you need to come back to the accident and emergency department. If you notice any fevers or sweats, it may be a sign that you're experiencing an infection. Similarly, if you're experiencing pain, which cannot be controlled with painkillers, you need to recontact your team. We always warn people that there is a small chance that you will lose control of your ability to control flatus, which is passing wind, or you may notice some soilage after the operation of faeces. The reason why this can happen is because your anal cushions contribute to 20% of your continence and therefore it may take some time to regain control of this or you may not be able to regain complete control and therefore there is a balance of when to perform this surgery. It may be that you need more than one operation to fix your hemorrhoids as if you have several hemorrhoids not all of them will be able to be cut out at the same operation and the reason for this is that the surgeon will need to leave healthy skin bridges between your hemorrhoids so that you don't get a narrowing or a stenosis of your anus. We always warn people that there is a chance of recurrence also. The third technique for hemorrhoids is called THD, which is transanal hemorrhoidal dearterialization. It is a newer technique, not offered in all hospitals, and it is not suitable for every type of hemorrhoid, so your surgeon will explain to you if your hemorrhoids are suitable for this technique or not. The technique involves using an ultrasound probe in order to detect the artery supplying the hemorrhoid and then that archery is stitched tight and the hemorrhoid is then stitched up.