Types of operations on hemorrhoids and how they are conducted

There are many methods of treating hemorrhoids, one of which, the most radical, is surgical intervention. Surgery to remove hemorrhoids is performed as a last resort, when conservative methods do not bring a positive result, when the disease progresses, the working capacity of the ill falls sharply and it is impossible to help him any more.

Surgical intervention requires maximum caution and unconditional argumentation from the doctor. Before agreeing to an operation to remove hemorrhoids, it is necessary to discuss all the nuances, in particular, to find out the reasons for the operation, the level of risk, the prognosis in the case of the development of the disease and the consequences of the operation of hemorrhoids after surgical intervention.

The main indication for a removal operation is frequent or rare, but profuse, anemia-causing hemorrhoidal bleeding. And also constant, at each defecation loss of nodes, high risk of thrombosis or infringement. The main task of surgical intervention is to remove all inflamed hemorrhoids.

In large city hospitals, an operation to remove hemorrhoids is performed quite often, but, in specialized hospitals for proctology, surgery takes one of the first places. Young people with copious and non-stop bleeding, which quickly lead to anemia, the operation is unconditionally indicated( in the case of unsuccessful minimally invasive methods of treatment).In middle-aged people with a constant loss of internal nodes or with a tendency to seasonal exacerbations, the operation is also indicated. Completed by modern technologies and techniques, the operation gives a good lasting result.

When and how to perform an operation to remove hemorrhoids

But there is a large group of patients with hemorrhoids - people aged, suffering from constipation and cardiac or pulmonary disorders, which can not be performed in any case. For them, in most cases, the methods of palliative conservative treatment will be effective. First, to perform an operation of such a patient only in occasion of bleeding that does not cause anemia, in most cases it is inappropriate. Secondly, the elimination of constipation and the performance after the defecation of some requirements for anus ankle, the use of candles, the observance of a sparing diet together with special therapeutic gymnastics, give the patients a satisfactory effect and very often the need for the operation itself disappears.

With properly selected treatment and when receiving the effect as a result of conservative treatment, patients begin to cherish their health. Small bleeding for them is safe, and constant monitoring of the chair and toilet after emptying has not been useless to anyone. In addition, surgery to remove hemorrhoids in elderly patients poses a certain danger. Since the position of the patient on the back with the legs brought to the abdomen, the decreased regenerative ability of wound healing in the anus, the risk of urinary dysuria after operation in men, the frequent purulent complications of hemorrhoidectomy and the development of an inadequate anal beetle in some cases after a usual divorcesphincter. Very dangerous, especially for the elderly, such complications after the operation of hemorrhoids.

To date, in practice, many different surgical modifications have been used. The surgeon, based on the characteristics of the development and course of the disease, as well as the patient's anatomical features, selects the most appropriate method. After this, with the consent of the patient and following the chosen method, he performs the assigned task. And the cost of an operation to remove hemorrhoids costs differently, depending on the applied method of surgical intervention.

Minimally Invasive Treatments

• Sclerotherapy. This type of minimally invasive treatment is used mainly in patients with stage 1-3 hemorrhoids, and also as a method of stopping bleeding. The essence of the method is to introduce sclerosing drugs into the hemorrhoidal nodes with the help of an anoscope and a special syringe. Under the influence of drugs, the vessels in the nodes are replaced with connective tissue.
• Infrared coagulation. For this procedure, a special device called a photocoagulator is used. With the help of an anoscope, the optical fiber tip is brought to the node. The heat flux passing through the light guide coagulates the surface of the node. This method is carried out closer to the leg and is used only to stop bleeding.
• Ligation of hemorrhoids using latex rings. This small operation for the treatment of hemorrhoids is carried out using a vacuum or mechanical ligator. During the procedure, latex rings are put on internal hemorrhoids. Gradually, the node, together with the latex ligature, is rejected after about two weeks. At the site of rejection of the node remains a stump, covered with a connective tissue.
• Cryotherapy. In most cases, this procedure is performed under local anesthesia. During the operation, the hemorrhoidal nodes are frozen for 3-4 minutes using liquid nitrogen. When thawing occurs, the node dies immediately, and in its place a small wound is formed, which is treated with various preparations.

The above minimally invasive methods of treatment do not require the use of general anesthesia and hospitalization. However, laser therapy or cryotherapy will still require anesthesia, local or epidural anesthesia. A significant disadvantage of any of the minimally invasive methods is that they do not eliminate the main reasons for excessive blood flow to the hemorrhoids.

One of the newest modern methods to eliminate this problem is the laser operation of hemorrhoids, called laser coagulation. It is known that the laser has an excellent cutting and burning properties, which has found application in many fields of medicine, including proctology. Operation of a hemorrhoids by the laser is possible at internal and external sites, even after their thrombosis. During the operation, the inner node is burned internally with a laser, after which the connective tissue develops inside the node and it decreases. With external hemorrhoids, the hemorrhoidal node is simply cut off by the laser, and the tissues are immediately soldered together without bleeding.

As for surgical operations, these procedures are performed under general anesthesia and, of course, require hospitalization of the patient for the duration of the operation and the rehabilitation period. Recovery after a hemorrhoids operation can last in different ways, depending on many factors.

Types of operations on hemorrhoids

There are the following methods of operative treatment of hemorrhoids:

• Hemorrhoidectomy. This is a standard operation to remove hemorrhoids, used by many surgeons everywhere. Using this method, the surgeon cuts out part of the perianal skin, anoderm and rectum mucosa located above the hemorrhoidal node and cross. The doctor then fixes the mucosa to the underlying tissues. This surgical intervention gives very good results and after the operation to remove hemorrhoids, relapses are rarely observed. To avoid pain after hemorrhoids and urine retention( as the most frequent complications after hemorrhoidectomy), you should not tampon the anal canal. Patients are advised to temporarily limit the intake of fluid.
• Transanal resection of the mucosa by the Longo method. This operation when removing hemorrhoids is a good alternative to the classical method. Its essence lies in circulatory resection and suturing of hemorrhoids. During the operation, the Longo method removes only that portion of the rectal mucosa that is located slightly above the dentate line. The existing mucosal defects are stitched together by titanium brackets using the "end-to-end" method. As a result of the operation, the inflamed nodes are not removed, but are pulled upward, greatly diminishing in volume as a result of a decrease in blood flow to the veins. As a result of a decrease in blood flow, the hemorrhoidal nodes gradually empty out, covered with connective tissue. The disadvantage of the method is the impossibility of removing hemorrhoids located outside.
• Desarterization. The essence of this innovative method lies in bandaging the hemorrhoidal arteries. This method of treatment is the most effective and painless for all stages of hemorrhoids. The main advantage of the operation is the absence of wounds and bleeding, as well as a short rehabilitation period( 4-5 days).

When removing hemorrhoids with the help of any of the operations there is a risk. Despite the fact that the treatment of hemorrhoids after the operation in the future may not be required, no one will give a one hundred percent guarantee that the hemorrhoids will again manifest themselves after the operation. Therefore, in any case, before deciding on an operation, it is worthwhile to weigh all the pros and cons, to consult not one but several doctors.