Stapled haemorrhoidectomy is an operation for haemorrhoids (commonly known as piles) that are too large for clinic based treatments or have recurred after previous clinic treatments. The operation has become popular as it is associated with substantially less pain and much quicker healing than traditional surgical techniques.

What does the surgery involve?

The surgery is performed under a general anaesthetic either as day case surgery or with an overnight stay (depending on your wishes and level of discomfort). The haemorrhoids are drawn into a circular stapling device (gun) which is then “fired” and the haemorrhoids are cut out by a circular knife inside the instrument and the edges are stapled together with two circumferential rings of tiny titanium staples. There are no incisions to see on the outside of the anus and the staple line is above the sensitive skin of the lower half of the anal canal thus avoiding the pain of traditional open haemorrhoidectomy.

What can I expect after Surgery?

Most patients experience “pelvic pain” in the first few hours after surgery that is treated with strong short acting pain killers. On discharge from hospital you will be given a combination of pain killers including regular paracetamol. (Avoid aspirin based medications unless indicated for cardiovascular indications)

What can I expect when I go home?

The pain of the operation will gradually diminish over the ten days following your operation. Take your pain killers regularly as instructed. After ten days you should have little or no discomfort. Some bleeding is normal but if you experience persistent of heavy bleeding please contact the hospital directly.

If you tend towards constipation take a mild laxative such as kiwi fruit or processed variants (Kiwi crush or Necta) or magnesium supplements. If needed take some extra fibre as Konsyl-D or Metamucil, or a gentle laxative such as Lactulose for the two weeks following surgery.

What are the alternative treatments?

Generally stapled haemorrhoidectomy is advised if haemorrhoids are too large for or have failed injection sclerotherapy and or banding. Prolapsing haemorrhoids are ideally suited to this operation. The alternative open haemorrhoidectomy is occasionally preferred for large external haemorrhoids.

What are the possible complications?

Infection and bleeding may complicate haemorrhoid surgery. You will be given a single dose of an antibiotic, metronidazole, during surgery to reduce the incidence of post-operative infection.  Bleeding is largely prevented by meticulous inspection of the staple line during surgery. Bleeding may however occur as a rare late event up to 10 days after surgery.

Questions?

“Informed consent for surgery is a process not a piece of paper”! The expected outcome of surgery (return to health) must be weighed against the small chance of an adverse outcome or complication. If you require more information on any aspect of your condition or proposed treatment please make an appointment to discuss your concerns.

Useful websites

www.cssanz.org

www.fascrs.org

www.acpgbi.org.uk