Hemorrhoidectomy Techniques

Hemorrhoide ctomy

Most cases of hemorrhoids can be treated with over the counter medications, in the  home treatments, and changing one's diet and nutritional habits but some times more drastic measures need to be taken.

In a single cases, surgical operation must be used to take care of patient with hemorrhoides. Management of such care in such way will help to reduce recidives. But the main problem will be with the management of post surgery pictures.

Treatment of hemorrhoids has focused on alleviating sphincter hypertonia, conservative therapy, consisting of sitz baths, topical anesthetics, and the use of bulking supplements. This aims to alleviate pain and dilate the sphincter with large soft stools and is for many years.

Several surgical techniques (hemorrhoidectomy) are used to alleviate hemroids. Hemorrhoidectomy is different that other way to remove hemorrhoids, most of which procedures can be performed as an outpatient.

Definition of hemorrhoidectomy: it’s an operation or a surgical procedure to remove hemorrhoids. This means all techniques that can remove hemorrhoids can be placed under hemorrhoidectomy label.

Different procedures for hemorrhoidectomy:

When the case is severe and out of any control, the physician may want to remove the hemorrhoid containing the clot with a small incision. This outpatient procedure generally provides relief and is performed under local anesthesia to put up the persistent pain.

There exists one operative therapy that decreases sphincter pressures either by forceful dilation-increasingly of historical interest only or, now far more commonly, by lateral internal sphincterotomy.

Fundamental drawback of hemorrhoidectomy is its potential to cause minor but sometimes permanent alterations in the control of gas, mucus, and occasionally stool although this technique is a simple and effective outpatient surgical procedure performed under local anesthesia.

Two approaches have been identified, motivated a quest for pharmacologic ways to create a temporary or reversible "sphincterotomy". One sphincterotomy" that would lower sphincter pressures only until the hemorrhoids have healed.

The use of botulinum toxin is the other pharmacologic approach to hemorrhoids. The purpose is to decrease the resting anal pressure by preventing the release of acetylcholine from presynaptic nerve terminals.

Known as a lethal poison, botulinum toxin has found its way into the therapy of a number of skeletal-muscle disorders, including strabismus, blepharospasm, and spasmodic torticollis. Botulinum toxin has also been used for smooth-muscle disorders, including achalasia and detrusor dysfunction. This is once again the aim of the therapy.

Double-blind, placebo-controlled study of botulinum toxin A has been recently conducted in 30 patients with chronic hemorrhoids. The results show a convincing therapeutic effect, in spite of the discrepancies in the randomization that more men and older patients in the control group.

Resting anal pressure decreased significantly in the treated patients but not in the controls. 87 percent of the treated patients had symptomatic relief and 73 percent were healed, as compared with 27 percent and 13 percent, respectively, of the controls, for two months period of time.

Scanty data are presented with respect to alterations in continence, but it appears that only one patient who received toxin suffered temporary flatus incontinence. It shows that all four patients with initial treatment failure healed after retreatment, as did 70 percent of the controls who crossed over to botulinum-toxin injection.

Eight patients had early relapses, and seven had temporary gas or stool incontinence, results, recently reported by Jost, who noted healing in 79 of 100 patients six months after botulinum-toxin injection.

Additional hemorrhoidectomy techniques and treatments are:

Ligation- special instrument, which fastens a tiny rubber band around the base of the hemorrhoid and ties it tightly and cuts off its blood supply, which works well on internal hemorrhoids that protrude with bowel movements. . Mild discomfort and bleeding can be a result of the treatment but the hemorrhoid and the band fall off in a few days and the area heals in one to two weeks. It is called "the rubber band treatment".

Rubber Band Ligation of Internal Hemorrhoids- A tiny rubber band is applied at the base of hemorrhoid for about 7 to 10 days later, the banded hemorrhoid has fallen off leaving a small scar at its base.

Aggressive hemorrhoidectomy- the best method for permanent removal of hemorrhoids, known as "surgery to remove the hemorrhoids"

A Hemorrhoidectomy is necessary when:

(1) external hemorrhoids formed in clots;

(2) ligation is useless in cases of internal hemorrhoids;

(3) medication for reducing the size haven't been taken 

(4) uncontrollable bleeding

A hospital stay may be required, depending on the severity of the hemorrhoids, because a hemorrhoidectomy is done under anesthesia.

Much more expensive and no less painful are the performed hemorrhoidectomies using a laser, but they do not offer any advantage over standard operative techniques.

Injection and Coagulation. Both methods are relatively painless and cause the hemorrhoid to shrivel up and can also be used on bleeding hemorrhoids that do not protrude.

Other surgery treatments or hemorrhoidectomy- some other methods exist- cryotherapy, BICAP coagulation and direct current. The first one consists of freezing hemorrhoidal tissue with liquid nitrogen.

 This is not highly recommended for hemorrhoids because it is very painful. This treatment is a temporary relief from symptoms and is not a "cure" for hemorrhoids. The other two methods are- BICAP Coagulation and direct current treatment, neither hemorrhoidectomy method is very popular but both shrink the hemorrhoid.