The internal hemorrhoids surgical treatment
The internal hemorrhoids surgical treatment Internal hemorrhoids are swollen blood vessels located inside the rectum, often causing discomfort, bleeding, and a sensation of prolapse. When conservative treatments such as dietary changes, topical medications, and lifestyle modifications fail to alleviate symptoms, surgical intervention may become necessary. Surgical treatment for internal hemorrhoids aims to remove or reduce the hemorrhoidal tissue, providing long-term relief and preventing further complications.
One of the most common surgical procedures for internal hemorrhoids is hemorrhoidectomy. This involves physically excising the hemorrhoidal tissue through a surgical incision. Hemorrhoidectomy is considered the gold standard for treating large or prolapsed internal hemorrhoids that do not respond to less invasive methods. The procedure can be performed using various techniques, including the traditional open method, where the surgeon excises the hemorrhoids and sutures the area, or a closed method, which involves suturing the excised tissue. Hemorrhoidectomy typically provides definitive relief but may be associated with postoperative pain, bleeding, and longer recovery periods.
Another minimally invasive surgical approach is the stapled hemorrhoidopexy, also known as the Procedure for Prolapse and Hemorrhoids (PPH). This technique involves using a circular stapling device that resects a ring of the prolapsed mucosa and submucosa. The stapling not only removes the excess tissue but also lifts and secures the remaining hemorrhoidal tissue back into its normal position. Stapled hemorrhoidopexy is generally associated with less postoperative pain and quicker recovery compared to traditional hemorrhoidectomy. However, it may carry a higher risk of recurrence in some cases and is typically reserved for patients with prolapsed internal hemorrhoids.
Another surgical option includes Doppler-guided hemorrhoidal artery ligation (DGHAL). This procedure involves using Doppler ultrasound to identify the arterial blood vessels supplying the hemorrhoids. These vessels are then ligated or tied off, reducing blood flow to the hemorrhoids and causing them to shrink. DGHAL is less painful than traditional hemorrhoidectomy and can be performed under local anesthesia, making it suitable for patients seeking a minimally invasive option.
The choice of surgical technique depends on several factors, including the severity and type of hemorrhoids, patient health status, and surgeon expertise. Preoperative assessment is crucial to determine the most appropriate approach. Postoperative care focuses on pain management, maintaining hygiene, and avoiding constipation to promote healing. While surgical treatment offers significant relief and a high success rate, patients should be aware of potential complications such as bleeding, infection, anal stenosis, and in rare cases, fecal incontinence.
In conclusion, surgical options for internal hemorrhoids are diverse, ranging from traditional excisional procedures to innovative minimally invasive techniques. Advances in technology and surgical methods continue to improve patient outcomes, reduce recovery time, and minimize discomfort. Patients experiencing persistent symptoms should consult a colorectal specialist to discuss the most suitable surgical approach tailored to their individual needs.
