Surgery

Stapled Haemorrhoidopexy & Open Haemorrhoidectomy

Why It’s Done (Indications) 

Haemorrhoids (piles) are swollen blood vessels in or around the anus. Surgery is considered when non-surgical options (like dietary changes or banding) haven't worked, or if you experience severe pain, recurrent bleeding, or prolapsed tissue that won't go back in.

How to Prepare (Preparations)

• Fasting (no food or drink) for 6 hours before surgery.
• You may receive a laxative or an enema before the operation to clear your bowel.
• Pause blood-thinning medications as instructed by your doctor.

What Happens (Procedural Details)

Open Haemorrhoidectomy:

• Anaesthesia: You are placed under general anaesthesia (asleep) or spinal anaesthesia (numb from the waist down).
• Positioning & Access: You are positioned comfortably (back with legs in stirrups), and the surgical team cleans the area with antiseptic.
• Excision: The surgeon uses a speculum to gently open the anal canal, identifies the swollen hemorrhoidal tissue, and carefully cuts it away using a scalpel or a heating tool (cautery) to minimize bleeding.
• Wound Management: The surrounding healthy skin and tissue are preserved. Depending on the technique (open vs. closed), the surgical site is either left open to heal naturally from the inside out or closed with dissolvable stitches. A soothing dressing or gauze may be placed over the area. 
   

Stapled Haemorrhoidopexy: 

• Anaesthesia: Performed under general or spinal anaesthesia.
• Insertion of Device: A specialized circular stapling device is inserted into the lower anal canal, above the sensitive pain-sensing nerve area.
• Resection & Lifting: The stapler gathers a ring of excess tissue, cuts it out, and simultaneously places a ring of tiny circular staples.
• Blood Supply Cutoff: This action lifts the prolapsed hemorrhoids back into their normal anatomical position and cuts off their main blood supply, causing any remaining swollen tissue to shrink and wither over the following weeks. 
   

Recovery (Postoperative Care)

• Pain relief medications will be provided; open surgery typically causes more pain for 1–2 weeks than stapled surgery.
• Take warm "sitz baths" (soaking the area in warm water) 2–3 times a day to soothe the area.
• Eat a high-fibre diet and drink plenty of fluids to avoid constipation and straining.
   

Risks (Potential Complications)

• Temporary difficulty passing urine.
• Bleeding or local wound infection.
• Anal stricture (narrowing of the anal canal) or persistent pain (less common).