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Hemorrhoidectomy is surgery to remove hemorrhoids. You will be given general anesthesia or spinal anesthesia so that you will not feel pain.
Incisions are made in the tissue around the hemorrhoid. The swollen vein inside the hemorrhoid is tied off to prevent bleeding, and the hemorrhoid is removed. The surgical area may be sewn closed or left open. Medicated gauze covers the wound.
Surgery can be done with a knife (scalpel), a tool that uses electricity (cautery pencil), or a laser.
The operation is usually done in a surgery center. You will most likely go home the same day (outpatient).
There is a procedure that uses a circular stapling device to remove hemorrhoidal tissue and close the wound. No incision is made. In this procedure, the hemorrhoid is lifted and then "stapled" back into place in the anal canal. This surgery is called stapled hemorrhoidopexy. People who have stapled surgery may have less pain after surgery than people who have the traditional hemorrhoid surgery. But the stapled surgery is more expensive. And people who have stapled surgery are more likely to have hemorrhoids come back and need surgery again.footnote 1
Doppler-guided hemorrhoidectomy is a procedure that uses a scope with a special probe to locate the hemorrhoidal arteries so that less tissue is removed. Some studies show that it is less painful but more long term studies are needed to compare it with other procedures.footnote 1
Recovery takes about 2 to 3 weeks.
Hemorrhoidectomy is appropriate when you have:
Surgery usually cures a hemorrhoid. But the long-term success of hemorrhoid surgery depends a lot on how well you are able to change your daily bowel habits to avoid constipation and straining. About 5 out of 100 people have hemorrhoids come back after surgery.footnote 2
Pain, bleeding, and an inability to urinate (urinary retention) are the most common side effects of hemorrhoidectomy.
Other relatively rare risks include the following:
The success of hemorrhoidectomy depends a lot on your ability to make changes in your daily bowel habits to make passing stools easier. Hemorrhoidectomy may provide better long-term results than procedures that cut off blood flow to hemorrhoids (fixative procedures). But surgery is more costly, has a greater risk of complications, and usually is more painful.
Most internal hemorrhoids improve (they get smaller and discomfort decreases) with either home treatment or fixative procedures. When compared with surgery, fixative procedures involve less risk, are less painful, and require less time away from work and other activities.
Surgery is not recommended for small internal hemorrhoids (unless you also have large internal hemorrhoids or internal and external hemorrhoids).
Lasers are often advertised as being a less painful, faster-healing method of removing hemorrhoids. But none of these claims have been proved. Lasers are more expensive than traditional techniques. The procedure takes longer, and it may cause deep tissue injury.
Lumb KJ, et al. (2010). Stapled versus conventional surgery for hemorrhoids. Cochrane Database of Systematic Reviews (9).
Society for Surgery of the Alimentary Tract (2008). SSAT Patient Care Guidelines: Surgical Management of Hemorrhoids. Available online: http://www.ssat.com/cgi-bin/hemorr.cgi.
Current as ofNovember 7, 2018
Author: Healthwise StaffMedical Review: Anne C. Poinier, MD - Internal MedicineAdam Husney, MD - Family MedicineKenneth Bark, MD - General Surgery, Colon and Rectal Surgery
Current as of:
November 7, 2018
Anne C. Poinier, MD - Internal Medicine & Adam Husney, MD - Family Medicine & Kenneth Bark, MD - General Surgery, Colon and Rectal Surgery
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