Stapled Hemorrhoidectomy is a relatively new procedure designed to treat what are known as third and fourth degree hemorrhoids, which is a more severe hemorrhoidal scenario than a case of first or second degree external hemorrhoids, or internal hemorrhoids.  Prolapsed Hemorrhoids, for which the Stapled Hemorrhoidectomy is designed, refers specifically to variety of hemorrhoid in which hemorrhoidal tissue extends beyond the mouth of the anus.  Typically, the Prolapsed Hemorrhoid presents as a mass of red tissue that is usually accompanied by a mucosal layer that will be apparent after bowel movements either in the stool, or as a residue left on toilet paper.  In some cases, the mucosal substance will leak and soil undergarments, which is also a means of detecting the presence of this particular variety of hemorrhoid. Stapled Hemorrhoidectomies, unlike the traditional Hemorrhoidectomy, which involves completely excising the inflamed tissue, necessitate removing only a portion of the protruding, or prolapsed tissue, using a tool referred to as a Circular Anal Dilator.  The Circular Anal Dilator separates the extended tissue for removal, while making it possible for the remaining tissue to be secured with staples and set back into its initial position.  The objective of the Stapled Hemorrhoidectomy is to starve the hemorrhoid by reducing to the inflamed region the hemorrhoid’s necessary supply of blood.  Stapled Hemorrhoidectomies were introduced by an Italian physician named Dr. Antonio Longo, around 1993. Originally touted as a more efficient and favorable course of action over traditional surgery, it promised fewer complications, and a shorter and less painful recovery period.  Also known as a Procedure for Prolapsed Hemorrhoids, or PPH, this particular treatment has been reported to produce significantly fewer post-operative impediments than the more invasive and traditional Hemorrhoidectomy.

Circular Anal Dilator

Stapled Hemorrhoidectomy enjoys a high success rate for resolving both the hemorrhoidal condition itself, and also attending hemorrhoid symptoms such as bleeding, because its overall treatment objective is to effectively eliminate blood-flow to the infected region. Stapled hemorrhoidectomies are typically used in severe third or fourth degree cases, although on occasion the procedure will be performed on milder cases that have not responded to other modalities of treatment.  Because of the high success rate associated with the procedure, it is a favored option amongst surgeons and patients wishing to adopt an alternative to conventional surgery.  It is not uncommon for patients to be treated with PPH on a same day basis, and they can usually return to daily activities within a few days.  The procedure itself is a relatively short operation, requiring only minimal anesthesia.  In some cases it has been reported that post-operative complications can include what is called fecal urgency, or a severe and persistent need to defecate, in addition to prolonged and severe pain. Because of these factors and risks, as with all surgical procedures and treatment options, one should first consult with their physician to ensure they choose the best possible option that best suits their needs and their circumstances.  In this way, an informed decision can be made as to whether or not the correct course of action is to undergo the Stapled Hemorrhoidectomy.

written by, David Gilbert

[i] Racalbuto, A. et al., Hemorrhoidal stapled prolapsectomy vs. Milligan-Morgan hemorrhoidectomy: a long-term randomized trial. International Journal of Colorectal Disease.

[ii] Cited Wikipedia, http://en.wikipedia.org/wiki/Stapled_hemorrhoidectomy

[iii] Cited Wikipedia, http://en.wikipedia.org/wiki/Stapled_hemorrhoidectomy

[iv] Science Daily, (Oct. 22, 2006)

[v] Racalbuto, A. et al., Hemorrhoidal stapled prolapsectomy vs. Milligan-Morgan hemorrhoidectomy: a long-term randomized trial. International Journal of Colorectal Disease.

[vi] Cited Wikipedia, http://en.wikipedia.org/wiki/Stapled_hemorrhoidectomy

[vii] Ganio, E., Altomare, D.F., Gabrielli F., et al. Prospective randomized multicentre trial comparing stapled with open hemorrhoidectomy. British Journal of Surgery, 2001; 88: 669-674

[viii] 5. Cheetham MJ, et al. Persistent pain and faecal urgency after stapled hemorrhoidectomy. Lancet, August 26, 2000;356:730-3.