Is it worth cutting out hemorrhoids. How an operation is performed to remove hemorrhoids - types of surgical intervention, the course of the procedure, rehabilitation. Feedback on hemorrhoid surgery

Removal of hemorrhoids remains the fastest and effective way forget about the problem. And what operations are currently being performed in clinics?

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Untimely treatment of hemorrhoids necessitates the use radical methods treatment. For this purpose, removal operations are carried out. Consider the most effective.

Indications for surgery to remove hemorrhoids

hemorrhoid thrombosis

1. When they fall out.
2. When pinched hemorrhoids.
3. Thrombosis.
4. Frequent bleeding. This is due to the fact that anemia develops with the frequent appearance of blood.
5. When the node protrudes, as this leads to inflammation on the skin.
6. For severe pain.

Before hemorrhoids are removed, the state of the body is assessed, which allows you to choose the right type of surgical intervention.

Removal of hemorrhoids surgically is not performed:

• with oncological diseases;
• heart failure;
• in immunodeficiency states;
• with diabetes;
• with intestinal diseases;

If there are contraindications, hemorrhoids are removed. Due to the fact that not everyone is allowed to do surgery, the patient undergoes a comprehensive diagnosis before it is carried out.

Preparation for treatment

• Before removal of external hemorrhoids, the possibility of complications, as well as contraindications to intervention, is assessed.
• A blood test, urine test, etc. is preliminarily given.
• The intestines are cleansed with enemas and laxatives. It is recommended to follow the diet.
• Eliminate foods that irritate the intestines from the diet.

Kinds

Sclerotherapy

Painless operation, performed with small nodes. The bottom line is the thermal effect on hemorrhoids by injection. Operate within 15-20 minutes. On the same day, the patient is allowed to go home.

Ligation

ligation with latex rings

It consists in the fact that a latex ring is put on the knot, after which it dries up and disappears. After the operation takes place, the nodes fall off within 4-6 days.

Laser surgery

Hemorrhoids are affected by laser radiation.

Hemorrhoidectomy

Relevant to and disease. Before the operation, you should undergo an examination. The nodes are removed by excision and cauterization.

The patient will be admitted to the hospital. With this method, you can remove permanently.

Parkes Method

It is carried out by the method of excision of the cone. When removal occurs, the mucosa is not affected. The duration of the operation is 30-60 minutes.

Operation Milligan-Morgan

The operation takes place in stationary conditions. During the operation, the hemorrhoid is completely cut out. An anoscope is inserted into the anus, a lump is captured with a clamp, which limits the flow of blood. Further, the knot is dissected and stitched, and its leg is sutured with a thread.

Recovery is 3 weeks, at which time there will be pain, so painkillers are taken. It's better to take a vacation at work.

Surgery for hemorrhoids is not performed:

• during pregnancy;
• with inflammatory processes in tissues;
• with AIDS;
• Crohn's disease;
• in oncological processes.

Longo method

Probably one of the most popular operations. It happens as follows: a section of the mucous membrane of the colon, located above the hemorrhoid, is removed. Anesthesia is used during the procedure. The duration of the operation is 20 minutes. Relevant for 3-4 stages of hemorrhoids in stationary conditions. The recovery period is 5 days.

The instrument used is an anoscope. The anus is stretched using special clamps, and a dilator is inserted into the anus, which is sutured to the skin. To fasten the edges of the wound, the surgeon uses titanium staples.

External hemorrhoids cannot be cured by this method.

Advantages:

1. It is possible to delete several nodes at the same time.
2. After the intervention, there is no postoperative wound.

Rehabilitation

The type of surgical intervention directly affects the features of the rehabilitation period.

In order to prevent irritation and inflammation of the intestines, a special diet is used, which is developed individually by the doctor.

If you do not follow the rules in the postoperative period, then complications may arise:

• bleeding;
• fistula;
• urinary retention;
• purulent processes;
• pain syndrome;
• narrowing of the anal canal.

The cause of bleeding is that the edges of the mucosa diverge, and the feces press on the rectum. If a person cannot urinate on his own, then he is prescribed a bladder catheterization.

If the nerve channels are injured during the surgical intervention, this will lead to rectal prolapse. After a few months after the intervention, a fistula may form. In this case, a second operation is needed.

Surgical intervention to remove the bumps is performed in the last stages of this disease. The appointment of the operation and the choice of its type is carried out by the doctor in accordance with the indications. In order to avoid the occurrence of complications, it is necessary to properly undergo preparation and the postoperative period.

All materials on the site are prepared by specialists in the field of surgery, anatomy and specialized disciplines.
All recommendations are indicative and are not applicable without consulting the attending physician.

The operation to remove hemorrhoids is considered one of the most frequent in proctology. This is not surprising, because the disease itself is widespread among the adult population of most countries of the world. Patients with hemorrhoids try to avoid surgery by applying conservative methods of treatment. In many cases, this approach is fully justified, since any operation carries a certain risk, and even more so, interventions on the vessels.

However, it happens that conservative treatment, coupled with a diet and regimen, no longer brings relief, varicose nodes reach large sizes, fall out and thrombose, and the patient experiences excruciating pain and is forced to abandon his usual way of life.

When surgical treatment becomes the only way to get rid of hemorrhoids, a proctologist evaluates the patient's condition and chooses best way removing nodes. Below we will try to understand the indications and methods of operations to remove hemorrhoids.

Indications for removal of hemorrhoids

When planning surgical treatment, it is necessary to weigh the expected benefits and risks of surgery, the indications for which are limited, although in proctology, hemorrhoidectomy occupies almost the first place in terms of frequency among all interventions.

Removal of hemorrhoids in elderly patients suffering from hypertension, diabetes, colitis and constipation can not only be quite risky, but is not always justified. In most patients, rational conservative therapy, hygiene and diet give such a good result that the need for surgical intervention may disappear.

Indications for hemorrhoidectomy are:

• 4 stage of the disease; hemorrhoids of the 3rd degree - with a significant increase in nodes.
• Prolapse of hemorrhoidal veins with every act of defecation.
• Development of anemia due to recurrent bleeding.
• Lack of results from conservative therapy.
• Thrombosis of hemorrhoids.

The general condition of the patient and the presence of other pathologies (anal fissure, fistulas, polyps in the rectum), the age of the patient, etc. are always taken into account. For example, surgery may be contraindicated for pregnant women, and the elderly may require preliminary thorough preparation.

In addition to indications, there are also contraindications, particularly acute or exacerbation chronic diseases large intestine, malignant tumors, severe decompensated pathology of internal organs, acute infectious diseases, blood clotting disorders. In these cases, the operation will have to wait.

Preparing for a hemorrhoidectomy

Any type of hemorrhoidectomy does not apply to abdominal operations, and often only local anesthesia is sufficient, however, the preoperative preparation of the patient does not lose its relevance from this. It is important to prevent infectious complications, bleeding in the early postoperative period, and also prepare the rectum itself for surgery.

Before the planned treatment, you should undergo the necessary minimum examinations: a general and biochemical blood test, a urine test, a test for syphilis, HIV, hepatitis, and a coagulogram. According to the indications - ultrasound of the abdominal organs. Mandatory examination and digital examination of the rectum, anoscopy, in some cases - sigmoidoscopy.

Particular attention should be paid to the diet, which determines the course of the subsequent postoperative period. Before the planned operation, you should refuse food that causes gas formation and the formation of excess feces, and preference should be given to fermented milk products, eggs, white bread. In addition, you need to drink more fluids.

On the eve of the operation and on the day of the intervention, a cleansing enema is indicated, which can be replaced with special preparations that cleanse the intestines (fortrans). By this time, if the patient has taken blood-thinning drugs, they should be discontinued.

Classic hemorrhoid surgery is performed under general anesthesia, the patient lies on his back, and the lower limbs are fixed on special stands. Foreign surgeons often perform the operation with the patient in the prone position, since this improves the outflow of venous blood from the dilated plexuses, which facilitates the process of their removal.

In preparation for minimally invasive interventions, the same procedures are necessary as for radical hemorrhoidectomy, but hospitalization is usually not carried out, and the patient is treated on an outpatient basis and can go home the same day.

Types of operations to remove hemorrhoidal veins

To date, the most effective radical methods for removing hemorrhoids are recognized as the classic Milligan-Morgan hemorrhoidectomy and resection of the rectal mucosa using the Longo method. Each of them has both advantages and disadvantages, but the first type of intervention is more common, although Longo's operation can compete with him.

Hemorrhoidectomy

The Milligan-Morgan operation has undergone many modifications and continues to improve. Its essence is to remove both external and internal hemorrhoids after stitching the vascular pedicle. At the beginning of the operation, the surgeon excises the skin of the anal region and the rectal mucosa over the dilated venous plexuses, then ligates the veins and removes them. Finally, the inner wall of the intestine is fixed to the underlying tissues, and the wounds in the wall of the organ can either be sutured or left open. The approach depends on the experience and preferences of the surgeon, it does not make a fundamental difference for the patient.

The stages of the operation include anesthesia and expansion of the anal canal, treatment of the intestinal mucosa with disinfectants and drying with a cotton swab. Hemorrhoidal veins are removed in a certain sequence. The surgeon, mentally imagining the watch dial, first captures the "bumps" located at three o'clock, then at seven and eleven. Having seized the node with a clamp, the doctor stitches its leg and cuts it off. It is advisable to use an electric knife, which leads to minimal trauma and does not contribute to bleeding. After removing the nodes, the wound is sutured and treated with an antiseptic.

Some doctors pack the rectum after a classic hemorrhoidectomy, but this contributes to pain and urinary retention, so most specialists do not pack the rectum. To maintain sensitivity in the anus and avoid narrowing of the anal canal, mucocutaneous bridges are left in the wound area.

The Morgan-Milligan operation is quite traumatic and requires general anesthesia, which means that the preparation for it must be thorough and serious. Its advantage is the possibility of excision of not only internal, but also external varicose veins.

Another option for surgical treatment of hemorrhoids is the intervention by the Italian surgeon Longo, who proposed to cross the rectal mucosa and vessels that carry blood to the hemorrhoids, circularly, eliminating vein prolapse. The Longo operation can be an alternative to classical hemorrhoidectomy and is successfully used in the West, but in Russia it was only started to be performed about five years ago.

Longo technique

Longo's operation is more gentle than the classic hemorrhoidectomy, since a small area of ​​the mucous membrane is resected, and the nodes are not excised, but, as it were, pulled up and fixed. The blood flow to the veins decreases and they are gradually replaced connective tissue. To suture the mucous membrane at the resection site, titanium staples are used, which are applied using special staplers.

The operation according to the Longo method takes about 15 minutes, and local anesthesia is sufficient for its implementation. Minor injury, but still great healing effect, low likelihood of complications and relapses make it preferable in elderly patients, those with severe comorbidities.

Despite the undoubted advantages, the removal of hemorrhoids by the Longo method also has some disadvantages, including the impossibility of excision of externally located dilated veins, the need to monitor the patient for at least a week after the operation. In addition, due to the relatively short period of application of this operation, it is still impossible to judge the long-term consequences of the treatment.

In addition to the described types of hemorrhoidectomy, in the arsenal of modern doctors there are also minimally invasive ways to deal with the disease, which can be used both for internal hemorrhoids and for external formation of nodes:

• Treatment with a laser;
• radio wave treatment;
• Desarterization;
• Ligation;
• Sclerosis and thrombectomy.

Excision of hemorrhoids with a laser very efficient. The advantages of the method are the speed of the procedure, quick recovery, low pain. For laser treatment, local anesthesia is used, and after a few hours the patient can go home.

Radio wave therapy involves the excision of nodes by means of a radio knife (Surgitron apparatus). Under local anesthesia, the doctor performs the removal of varicose veins. Undoubted advantage This method of treatment is considered the almost complete absence of contraindications. The procedure is carried out quickly, with it the surrounding tissues of the intestine and anus are not damaged, which means that the likelihood of scarring and bleeding is reduced to zero.

Desarterization- a new method of dealing with hemorrhoids, which consists in "turning off" the blood flow through the arteries of the rectum. Expanded venous plexuses at the same time subside, decrease in volume and are eventually replaced by connective tissue. The patient needs only a few days to recover, and the procedure itself is painless.

Ligation- the most popular sparing way to deal with hemorrhoids, when using a special apparatus, latex rings are placed on varicose nodes. After about a week, hemorrhoidal "bumps" are rejected along with such a ring, without causing significant inconvenience to the patient. Ligation, carried out according to indications, avoids hemorrhoidectomy in the vast majority of patients.

ligation

Sclerosis is a widely used method of dealing with varicose veins veins of any localization, the rectum is no exception. A special substance is injected into the hemorrhoids, causing them to "glue" and sclerosis.

Often the disease occurs with thrombosis of the hemorrhoidal veins, which causes severe pain and requires mandatory treatment. One of the options for minimally invasive operations in such cases is thrombectomy, when blood clots are removed from the veins using a laser or radioknife. The procedure is performed under local anesthesia on an outpatient basis. In addition, in this way it is possible to remove the nodes of external hemorrhoids at any stage of the disease, if they cause discomfort to the patient, but there are no indications for their radical excision yet.

Minimally invasive approaches to the treatment of hemorrhoids are used in 80% of patients in Europe and the USA, while in Russia three-quarters of patients undergo radical surgery. Minimally invasive procedures are carried out in the early stages of the disease, and thrombosis of the nodes, the formation of an anal fissure, acute and chronic inflammatory processes in the rectum and perineum can become a contraindication to them.

After operation…

The postoperative period usually proceeds quite well, but the need to defecate and ensure the painlessness of this process can bring significant inconvenience. On the first day after the intervention, the appearance of stool is highly undesirable, as it can cause severe pain and trauma to the postoperative wound, and in order to avoid this, a complete refusal to eat is shown while maintaining a good drinking regimen.

From the second day, food is gradually introduced that does not contribute to intestinal irritation and the formation of a dense stool: light soups, cereals, sour-milk products. Be sure to drink plenty of water. In the first few days, many patients experience severe pain, for the elimination of which analgesics are prescribed. In order to accelerate the healing of the rectum, baths are carried out with a weak solution of potassium permanganate, a decoction of chamomile flowers. Drug treatment consists in the use of ointments and suppositories with methyluracil, which improves regeneration processes.

To prevent possible urinary retention, the rectum is not plugged after the intervention, and the patient is advised to consume a sufficient amount of liquid. This complication is especially common among men and often requires the insertion of a urinary catheter to empty the bladder. Spasm of the sphincter of the rectum helps to remove the cream with nitroglycerin.

The patient must comply with all necessary hygiene procedures that the clinic staff will tell him about, do not ignore dressings and examinations. The post-surgery diet should contain enough fiber to make stools easier. You need to empty your bowels immediately, as soon as such a desire arises, but you should not linger in the restroom for too long, pushing or straining. If necessary, laxatives may be prescribed.

No matter how hard the surgeons try, it is still not always possible to avoid the adverse consequences of the operation. Among them, the most likely are:

• Bleeding, which may be associated with insufficiently complete suturing of blood vessels, slipping of ligatures;
• Anal stenosis that occurs in the late postoperative period is treated with special dilators or even plastic surgery;
• Infectious and inflammatory processes, suppuration of the wound in case of non-compliance with the rules of asepsis during treatment;
• Recurrence, the likelihood of which persists with any type of surgical treatment.

Hospitalization for radical treatment takes about 7-10 days, after which the stitches are removed, the rectum is examined and, if all is well, they are allowed to go home. One and three weeks after hemorrhoidectomy, a digital examination of the intestine is mandatory to exclude the formation of a narrowing of the lumen of the organ and monitor the results of treatment.

Recovery after surgery takes about 2 weeks, but rehabilitation after removal of hemorrhoids is not limited to the time spent in the hospital. To consolidate the positive effect of treatment and prevention of relapse, the risk of which persists regardless of the stage of the disease and the type of operation, the patient will have to constantly monitor the condition of the rectum, adhering to some rules:

• Do not lift weights;
• It is necessary to exclude physical activity with tension in the abdominal press;
• If possible, avoid prolonged sitting or standing positions;
• Normalize the diet;
• Ensure adequate physical activity.

Nutrition and movement - the first thing that even those patients who could not deny themselves a cup of strong coffee or a bar of chocolate will have to come to terms with . Spicy dishes, an abundance of spices, alcohol, chocolate, marinades and smoked meats, coffee and carbonated drinks should be excluded from the diet. Any of these products can lead to exacerbation of hemorrhoids. In addition to products that provoke the disease, you need to remove from use those that contribute to constipation (flour and sweets, in the first place).

If, due to the nature of professional activity, it is not possible to avoid prolonged sitting, then, if possible, you should take short breaks, get up and walk. Walking is an excellent means of preventing the recurrence of the disease.

The cost of surgical treatment of hemorrhoids depends on the method and volume of the operation. Removal of one node costs from 7,000 rubles, reaching 15-16 thousand in some clinics, ligation - 6,000, sclerotherapy - 5,000 rubles. It is possible and free treatment, but in this case, the patient may be faced with the need to wait in line. Patients who are indicated for urgent treatment for massive bleeding or thrombosis of the nodes, it is carried out free of charge in a surgical hospital.

Removal of the venous plexuses, what we call hemorrhoids, is a measure that is required when drug therapy is not effective. It turns out that the indications for surgical treatment are not a rare practice: often already for patients with the second stage of the disease, the doctor recommends a surgical solution to the problem. It does not yet follow from this that the patient, who first appeared at the doctor, goes straight to the operating table. There are minimally invasive techniques for removing hemorrhoids, and they are not as traumatic and complicated as a classic operation.

But the fact remains: if hemorrhoids fall out, the situation is no longer amenable to medical correction - excision of the hemorrhoid or alternative actions to remove it is required. The classical operation is performed today not so often: at the final stages of the disease, associated with complications of the pathological process.

When surgery is needed for hemorrhoids, the doctor decides. For a classic operation, serious indications are required, because this is a violation of the integrity of tissues and by no means a simple rehabilitation.

The doctor insists on a surgical solution for hemorrhoids when:

1. Cavernous formations () come out of the anus not only when the rectum is emptied, but also with any tension;
2. The patient complains of frequent and massive bleeding;
3. The sizes of the cones themselves are interpreted as large;
4. The patient has a physiological predisposition to thrombosis in the hemorrhoidal veins;
5. Pain, discomfort, bleeding and burning cross out the patient's usual regimen;
6. All applied conservative methods were powerless in the face of the problem of varicose veins of the rectal vessels.

The final word is up to the doctor: but without the consent of the patient, the patient will not be operated on. The doctor chooses in what period and how the surgical correction of vascular pathology will be carried out.

Surgery is not always possible. There are situations that in themselves will be a contraindication to such therapy. For example, classical hemorrhoidectomy is associated with excision of the skin, mucosa, and choroid. This is associated with possible complications, therefore it is important for the doctor to calculate all potential risks.

For example, very rarely, hemorrhoidectomy is prescribed for elderly patients, since general anesthesia and a difficult rehabilitation period are excessive loads for them. Yes, and the existing chronic pathologies in every way impede the operation.

Very rarely, if we analyze the situation with examples, hemorrhoid surgery is recommended for patients with diagnosed diabetes. Chronic hypertension is another point that makes surgery an undesirable intervention.

Serious contraindications for surgery include:

• Fistulas developing in the lower rectum;
• Infection in the large intestine;
• Decompensated stage of chronic diseases;
• Pregnancy;
• Poor blood clotting;
• Genetic susceptibility to bleeding.

But, again, these cases will not be an unequivocal and permanent contraindication to surgery. You can wait for a favorable period when the operation will be a real way out and the doctor will also take into account all the risks. It should be noted that minimally invasive technologies are more flexible in this sense: they do not have such a large list of contraindications.

How to Prepare for Hemorrhoid Surgery

One of the radical
methods of treatment of hemorrhoidal disease - operation hemorrhoidectomy. This is preceded by preparation: firstly, an instrumental examination, which will accurately determine the location of the nodes and their size. Anoscopy and sigmoidoscopy are usually performed. Secondly, on the eve of the operation, a person will have to pass a series of standard tests.

These appointments include:

1. UAC. Among the functions general analysis blood - identifying the duration of bleeding, as well as fixing the period of blood clotting and platelet count.
2. OAM (urine must be taken).
3. Biochemistry of blood. Needed to determine the level of glucose, as well as indicators of cholesterol, urea, etc.
4. Setting the blood group and Rh factor.
5. Blood test for syphilis, hepatitis and HIV.

Remember, a full-fledged operation is not just a preliminary examination, but also some procedural points. One of them is colon cleansing. This is usually done with an enema, but taking special laxatives can be an alternative.

A couple of days before the scheduled operation, you need to stop taking medications, among the actions of which is blood thinning. This, I would like to note, anticoagulants, antiplatelet agents, as well as some NSAIDs.

Do I need psychological preparation for surgery?

Fortunately, today many medical institutions employ full-time psychologists who communicate with patients on the eve of surgery.

This is a really good, proven practice. For many patients, surgery is not just stress, but an event that they are very afraid of. The psychologist does not just talk with such a patient, he can do exercises with him that help to relax, normalize breathing, and relieve tension.

If you feel that nervous trembling and intense fear appear even at the thought of how hemorrhoids are operated on, you need to seek help from a specialist. The more prepared you are both physically and psychologically for the operation, the more successful it will be.

Hemorrhoidectomy: how it works

This is a classic intervention for excision of cavernous bodies. Another name for the intervention is the Milligan-Morgan operation. This technique was developed a very long time ago, in 1937. Coloproctologists in the course of time changed the nuances of the operation, in particular, its end.

Today it is done in two ways:

• . This is the same, the primary version of the operation. Doctors remove not only the nodule itself, but also neighboring tissues. So, the doctor does not suture the edges of the wound, it is assumed that the tissues will heal naturally. The doctor wields either a scalpel knife or an electrocoagulator.

• Closed hemorrhoidectomy. It was developed in the early 50s of the last century, and this is already a Ferguson operation. The difference from the above method is the suturing of the wound after completion of the work. It is sometimes done on an outpatient basis.
• Submucosal hemorrhoidectomy. This method suggested surgeon Parkes. This operation is not easy - the doctor removes only the node, leaving its base, while the mucosa itself is not injured. Such an action is more easily tolerated than the two above-mentioned options.

The doctor chooses the most preferred option, discussing the upcoming options with the patient. The specialist and the patient discuss the disadvantages of the operation, which, of course, exist.

This operation used to be common, but today only 15% of patients with hemorrhoids who need surgical correction undergo hemorrhoidectomy. Firstly, minimally invasive hemorrhoid removal techniques have appeared in the practice of coloproctologists, and secondly, the disadvantages of this operation are too significant.

The disadvantages of hemorrhoidectomy include:

1. The duration of the operation;
2. The need for general anesthesia;
3. Massive blood loss;
4. Pain syndrome;
5. The threat of complications;
6. Long rehabilitation.

But it happens that there is simply no other way out, and the patient has to decide on this operation. The doctor will explain how hemorrhoids are removed, what the patient expects after the operation, what are the risks of complications, etc.

How is the operation

The operation takes place in several stages. Shortly before surgery, the entire surgical field is shaved for the patient. An immutable moment is the disinfection of the anus and rectal canal.

The patient needs to lie down
on the back in a comfortable chair (proctological). But sometimes the operation is performed when the patient is in a prone position with a slightly raised pelvis. In this position, there is an outflow of blood from the cones, which facilitates the process of excision for the surgeon. The patient is then given anesthesia. Under what anesthesia the hemorrhoids are removed, the doctor decides - they often use general anesthesia for such a cardinal intervention.

The doctor inserts a dilator with a rectal mirror into the rectum - this is necessary for better visualization of the nodes and their availability. The doctor grabs the knot with a tool, pulls it out, and then the leg is stitched with catgut. The bump is excised with an electric coagulator (in order to avoid bleeding).

The final stage of the operation depends on its type. If you choose a closed type of hemorrhoidectomy, then the wound is sutured, and a swab with ointment is inserted into the anus for 4-5 hours.

Postoperative period: what awaits the patient

It is always true to say that the healing process is 50% dependent on the doctor and 50% on the patient himself. There is no need to shift the entire responsibility for undergoing recovery to physicians.

From the doctor it is necessary to perform the operation with high quality, strictly according to indications, to cope with all intraoperative nuances and competently explain to the patient what needs to be done next and how to control the wound healing process.

The patient needs discipline and trust in the doctor. It is necessary to put aside fear, fatigue, whims and other moments, which, of course, have a place to be. When the operation is completed, active work passes from the doctor to the patient himself. Now he needs as much as necessary to insert candles into the anus, do ointment rubbing, and follow a diet.

The patient may not expect sensation to change in the anal canal. He sometimes does not even understand whether he really wants to go to the toilet, or this is a deceptive feeling. Defecation can be multiple - up to 6 times a day. And this will take some time to get used to. Wounds will heal in about two months or less. But the most difficult days for the patient are one and a half to two weeks after the operation. It is really not easy, therefore, when deciding on an operation, you must understand that recovery is a difficult period for which you need to be prepared.

The doctor who will operate on you explains how the operation is done for hemorrhoids, and also talks in detail about recovery period. Recommendations will be individual, but there are some general points.

The standard postoperative recovery scheme includes:

If after the operation, despite all the efforts of the patient, he is still tormented by constipation, the doctor will prescribe him special laxatives.

Can there be complications after hemorrhoidectomy?

Not always everything goes smoothly, and complications can really overshadow the recovery period.

Usually, doctors in every possible way prevent the course of events and do everything so that the negative scenario does not come true, but even the most experienced coloproctologist will not give a 100% guarantee of the success of the operation.

What complications are more common:

1. Bleeding - possibly due to deformation of the seams, poor cauterization of blood vessels.
2. Urinary retention - more often fixed in men, they are unable to empty the bladder, you have to use a catheter.
3. Psychogenic constipation - appears due to the fact that the patient is afraid of going to the toilet.
4. Narrowing of the rectal canal. This can be explained by the mistake of the surgeon - to expand the anal canal, the doctor uses special tools or recommends plastic surgery.
5. Prolapse of the lower segment of the rectal canal. If the coloproctologist accidentally damages the muscles and nerve endings, then the removal of the mucosa beyond the boundaries of the anus cannot be ruled out.
6. Fistulas. These are abnormal tubules that connect the rectal passage to nearby tissues.
7. pus formation. Inflammation and suppuration are not such a rare complication of the postoperative period. This is due to the accumulation of pathogenic bacteria in the operation area. Pustules will have to be opened, or the correction of this condition should be limited to antibiotic therapy.

But, once again it is worth noting that many complications can be prevented. The patient must be especially careful to follow the hygiene instructions after the operation.

Hemorrhoidopexy: how is this operation performed

This method was invented and patented by the Italian physician Antonio Longo about twenty-five years ago. Specifically, hemorrhoidopexy actively replaces the classic operation today, i.e. hemorrhoidectomy. This is explained by the less invasiveness of the Longo operation (otherwise called hemorrhoidopexy).

The essence of the operation is the excision of the mucosal zone of the rectal canal in a circular way, slightly above the hemorrhoids. The surgeon pulls the pathological formation up and fixes it there with titanium clips. During the intervention, the blood circulation of the cavernous body is disturbed, therefore, after some time, it becomes smaller, and then disappears completely.

Advantages of hemorrhoidopexy:

• Complete painlessness. In operated areas, no a large number nerve clusters. Local anesthesia is required only for the introduction of a special dilator.
• The operation can be performed even by the elderly. Hemorrhoidopexy is done to people with serious chronic ailments and to patients "in position".

• manipulation speed. A competent surgeon will carry out all the actions in 25 minutes.
• Hassle-free recovery. And this is true: the patient recovers quickly and relatively easily.

But, as expected, it was not without its downsides. For example, it is impossible to carry out hemorrhoidopexy with an external form of hemorrhoids. Finally, this is an expensive operation: doctors work with disposable instruments, which are quite expensive.

Alternative Therapy: Minimally Invasive Techniques

Gentle techniques are a great opportunity to solve the problem of hemorrhoids without serious trauma. Minimally invasive techniques are, in fact, "one day" operations with a quick recovery, with minimal risks of complications. But not at all stages, not in all cases, it is possible to solve the problem by these methods.

Among the popular minimally invasive techniques:

1. Ligation with latex rings - the coloproctologist puts a ring of ecological latex on the leg of the nodule, it stops the flow of blood;
2. Laser coagulation - the bump is negatively affected by directional radiation, then the tissues and blood vessels coagulate;
3. Desarterization - an apparatus is inserted into the anus canal, pulling the artery that feeds the hemorrhoid formation;
4. Sclerotherapy - an adhesive composition is introduced into the deformed vessels, which disrupts their work, feeding the nodes;
5. Infrared photocoagulation - hemorrhoids suppress infrared rays, tissues coagulate and bake;
6. Cryodestruction - manipulations are carried out using liquid nitrogen, it freezes and simply destroys the veins altered by varicose veins.

These techniques are effective, but they are rarely carried out for free. True, the minimum complex of negative aspects that accompanies them covers the need for costs.

The treatment of any disease by surgery requires the patient to make some changes in his lifestyle. A person must understand that the situation is critical, and the opportunity to improve the quality of life is work, and on his part too. Hygiene, nutrition, physical activity, positive attitude, finally.