Stapled hemorrhoidectomy is also known as stapled hemorrhoidopexy or Procedure for Prolapse and Hemorrhoids. This surgical procedure is reserved for severe cases like those who have internal hemorrhoids or prolapsed hemorrhoids (hemorrhoids that extend outside the anus). Compared to other procedures, this causes less pain.
When is stapled hemorrhoidectomy recommended
Stapled hemorrhoidectomy does not actually remove the hemorrhoids. Instead, it removes the supporting tissue that caused the hemorrhoids to extend outside the anus.
As such, stapled hemorrhoidectomy is recommended when the hemorrhoids have reached third degree (hemorrhoids that can be pushed back inside the anus with a finger after bowel movements) or fourth degree (hemorrhoids outside the anus). This procedure is also the course of action for patients who have minor hemorrhoids but did not respond to previous treatments.
Stapled hemorrhoidectomy can also help patients who are experiencing bleeding, as well as those who have a combination of internal hemorrhoids and small, external hemorrhoids that come with pain.
However, if the patient only has one anal cushion that is protruding or if the patient’s fibrotic piles cannot be physically repositioned (as is the case for the most severe ones), then stapled hemorrhoidectomy will not be recommended.
What to expect during a stapled hemorrhoidectomy
Stapled hemorrhoidectomy will only take approximately 20 to 30 minutes on the surgical table—much faster than its surgical counterparts. This is often an outpatient procedure. You will either have local anesthetic or general anesthesia. You will also recover faster and go back to your normal activities within a few days.
This procedure involves using a medical circular stapler to reposition the hemorrhoids and disrupt their blood supply. Without blood going to the veins, the hemorrhoids will eventually shrink. Because this procedure operates on an area with fewer nerve endings, patients experience less pain than other hemorrhoidectomy procedures.
The actual procedure involves inserting a circular, hollow tube inside the anus. A long thread will then be inserted through the hollow tube, weaved around the anal canal, then pulled back out again.
The surgeon will then insert the stapler inside the tube and pull the ends of the suture. This will cause the cushions to go back to normal positions and the hemorrhoid tissues to get into the stapler’s jaws. The surgeon will fire the stapler, cutting off the circumferential ring of the tissue and stapling the upper and lower edges of the tissue.
Note that while this has the least amount of postoperative pain, recurrence rate is higher.
Stapled hemorrhoidectomy aftercare
- Expect to feel a sense of fullness or pressure in your anus (will resolve in a few days)
- Expect some light bleeding with bowel movements
- External hemorrhoids will regress within 3 to 6 months
- Staples will fall off within a few weeks when you pass your stool (you may not even notice them)
- First bowel movement will be in a day or two post-surgery
- Gauze may be removed before you go home or several days after (surgeon may advise you to remove it at home instead)