Hemorrhoidectomy is often required when a patient’s hemorrhoids cannot be treated through dietary changes or over-the-counter medications. This is a safe surgical procedure that is effective and lasts long-term, especially if you have large hemorrhoids that come with bleeding and pain.
Types of Hemorrhoidectomy
- Open hemorrhoidectomy — This procedure involves surgically cutting the hemorrhoid tissue. However, as opposed to closed hemorrhoidectomy where the wound will be closed, the incision from an open hemorrhoidectomy will be left open. Surgeons go this route when the hemorrhoid’s location will not make it possible to close the wound. This is also the preferred choice when there’s a high risk of infection.
- Closed hemorrhoidectomy — This procedure is the most common choice for internal hemorrhoids (those located inside the rectum). The hemorrhoid tissue will be surgically cut and the wound will be closed with an absorbable suture. Although postoperative discomfort and pain are most felt with this procedure, it has a success rate of 95% and has the lowest rate of recurrence.
- LigaSure™ hemorrhoidectomy — This procedure is the best route for those with external hemorrhoids and for those who have protruding hemorrhoids. LigaSure™ hemorrhoidectomy uses an electro-thermal device that helps with surgical precision, reduces collateral damage to surrounding tissues, and seals a patient’s blood vessels.
When is hemorrhoidectomy recommended
Plenty of hemorrhoid cases can be treated by dietary changes or medications. However, if you have the following symptoms, then hemorrhoidectomy may be recommended:
- Presence of both internal and external hemorrhoids
- Repeated flare-ups of internal hemorrhoids despite non-surgical treatment
- Large internal hemorrhoids
- Large external hemorrhoids that disrupt daily life and make it impossible for the patient to clean the area
- Previous hemorrhoid treatment did not work
What to expect during a hemorrhoidectomy
Hemorrhoidectomy is often done as outpatient procedures, meaning you can go home on the same day. You will either be put under general anesthesia (you’ll fall asleep) or local anesthesia (you’re awake but the area will be numb). If you’re going to be given local anesthesia, don’t worry as you will be relaxed throughout the procedure.
Incisions will be made and the wound will either be sewn closed or left open, depending on your doctor’s chosen hemorrhoidectomy (this will be discussed with you beforehand).
Since the area to be operated on is very sensitive, you can expect tenderness and pain after the surgery. Typical recovery takes a couple of weeks, but you may need 3 to 6 weeks to feel normal again.
Hemorrhoidectomy aftercare
- Take medications as directed by the doctor, be it for the pain, infection, or stool softening
- Expect some bleeding during your first bowel movement post-operation
- Drink lots of liquids and eat a bland diet for a few days (e.g. crackers, plain rice, bananas), then introduce regular food gradually
- Increase fiber in your diet
- Numbing medicines and ice packs can help with pain and swelling, especially before and after bowel movements
- Sitz baths can also relieve pain and muscle spasms
- Go back to your doctor after 2 to 3 weeks