Patients with piles, now have a reason to smile. Piles or Haemorrhoids is a common condition that affects a significant part of the population. The condition is painful and unbearable. But most patients who need surgical help tend to suffer with the problem in silence than undergo surgery, as the post-operative pain is even more severe. Now all that will change.
Procedure for Prolapse and Haemorrhoids (PPH) or Stapled Haemorrhoidectomy is the latest procedure in the treatment of piles or haemorrhoids. This procedure is miracle surgery for patients with piles as the procedure is short with a faster recovery period and very few postoperative complications. Postoperative pain, which is the most disabling complication after traditional piles surgeries, is minimal after this procedure.
Haemorrhoids are commonly known as piles is a common finding in majority of the population. They can be described as masses or clumps (cushions) of supporting tissue within the anal canal.
The terminal part of the large intestine is divided into the rectum, anal canal and the anus. The anus is the external opening of the gastrointestinal tract. The waste products of digestion are passed out of the body through the anus during defecation. This clump of supporting tissue has a large number of blood vessels within it. When these veins get dilated and engorged with blood, they descend downwards pulling with themselves the supporting tissue as well (haemorrhoids).
As a result the nerve endings in the anal canal get stretched causing severe pain. The number of nerve endings is more in the terminal part of the anal canal towards the anus as compared to the rectum or the upper part of the anal canal. As a result the haemorrhoids near the anus are more painful (external haemorrhoids) as compared to the haemorrhoids near the rectum (internal haemorrhoids).
Stapled hemorrhoidectomy is at least as good as conventional haemorrhoidectomy and is less painful. Some have been skeptical about this surgery. But if it is performed by skilled minimal access surgery the SH is less painful.
Stapled hemorrhoidectomy is surgical technique for treating hemorrhoids, and is the treatment of choice for third-degree hemorrhoids
Also known as stapled hemorrhoidopexy, this surgical procedure involves the removal of abnormally enlarged hemorrhoidal tissue, followed by the repositioning of the remaining hemorrhoidal tissue back to its normal anatomic position. Severe cases of hemorrhoidal prolapse will normally require surgery. Newer surgical procedures include stapled transanal rectal resection (STARR) and procedure for prolapse and hemorrhoids (PPH).
It is also called as Procedure for Prolapse and Hemorrhoids or Circumferential Mucosectomy or Stapled Haemorrhoidopexy.
The procedure involves removal of the loose connective tissue and repositioning of the hemorrhoids within the anal canal. It is the procedure of choice in 3rd and 4th degree prolapse or minor hemorrhoids that have not cured by conventional methods.
The procedure can be combined with conventional haemorrhoidectomy in few cases if required. The procedure is contraindicated in severe fibrotic piles in which physical repositioning is not possible. Also in enterocele and anismus, the procedure is not advised.
It is a short surgery of 30 minutes and can be performed under local anaesthesia with sedation or spinal or epidural anaesthesia. In few cases general anaesthesia may be required.
The patient is made to lie on his stomach on the operation table or in the lithotomy position. No special preoperative preparation is required. During the healing of the cut tissues around the staples, scar tissue forms, and this scar tissue anchors the haemorrhoidal cushions in their normal position higher in the anal canal.
The staples are needed only until the tissue heals. They then fall off and pass in the stool unnoticed after several weeks. Stapled haemorrhoidectomy is designed primarily to treat internal haemorrhoids, but if external haemorrhoids are present, they can be reduced as well.
Since the postoperative pain and discomfort is less the patient is usually discharged on the same day or the next day. Patients can resume their normal activities within a week’s time.
The procedure has very few complications. They include post PPH syndrome (inflammation of internal sphincters for which anti-inflammatory medications are given), bowel discomfort, slight bleeding, anal fissuring (tearing of the lining of the anal canal), narrowing of the anal or rectal wall due to scarring, persistence of internal or external haemorrhoids, and, rarely, trauma to the rectal wall. These complications occur only in very few cases.
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