Surgery to remove hemorrhoidal nodes is one of the most frequent in proctology, since half of the adult population is affected by this disease. Patients do their best to avoid surgical intervention by limiting themselves to conservative treatment, however, unfortunately, these methods do not always work properly. How is the operation to remove hemorrhoids? Preparatory and postoperative period, indications and features.
Reasons for the appearance
At the heart of the onset of the disease is a violation of blood flow in the vessels of the anus, but where do the hemorrhoids come from? There may be several causes:
- hereditary predisposition at the genetic level;
- frequent constipation;
- chronic diarrhea;
- prolonged straining at each bowel movement;
- the use of a large amount of spicy food, which can cause chronic irritation of the mucous membrane of the anus and rectum;
- frequent use of strong tea and coffee;
- heavy physical work or excessive loads during sports;
- excess weight;
- frequent lessons in anal sex;
- some diseases of the pelvic organs.
Having noticed the first symptoms that can occur during and after defecation, you should immediately contact a proctologist, since the disease in the early stages of development is much easier and cheaper to cure without the threat of relapse.
Stages of the disease
There are several degrees of the disease, each of which differs from the previous one:
- 1st degree is characterized by an increase in hemorrhoidal nodes. In this case, the patient may notice minor bleeding after visiting the restroom.
- The 2nd degree is characterized by a rare loss of hemorrhoid cones from the anus during severe straining, however, at the same time, a person can easily adjust them independently.
- At the 3rd degree, the nodules can no longer be repaired independently, which causes discomfort during bowel movements.
- At the 4th degree of the disease, the nodes are so enlarged that they begin to interfere with a person in everyday life, they become inflamed and cause pain even when doing everyday tasks.
Normally, hemorrhoids are hidden by the skin and cannot be seen.
When surgery is needed
Despite the fact that surgical intervention is very common among patients with hemorrhoids, it is necessary to carefully weigh the pros and cons. The following factors can be attributed to indications for the operation:
- 3rd or 4th stage of the disease, when hemorrhoids fall out and thrombose, causing inconvenience and pain to the patient;
- loss of hemorrhoidal veins at each visit to the restroom;
- the development of anemia as a result of frequent bleeding;
- lack of results from drug treatment for a long period of time;
- frequent bleeding that is not associated with bowel movements.
Severe stages of the disease can significantly worsen the quality of life of the patient, therefore, modern methods of surgical treatment are designed to make life easier for a person.
Contraindications
Before they perform an operation to remove hemorrhoids of stage 4, carefully study the patient’s medical record to exclude the presence of possible contraindications to its implementation:
- the presence of fistulas in the lower intestine;
- intestinal infectious diseases;
- oncological diseases localized in the colon;
- diseases of the respiratory system and cardiovascular system;
- poor blood coagulability;
- pregnancy at any time.
Surgery is only possible after resolving the above health problems or childbirth.
Preparation period
How is hemorrhoids removed? The patient reviews, as well as the advice of the doctors, indicate that it is very important to undergo preparation for surgery. It consists of collecting the necessary tests: a blood test, a urinalysis, an analysis for syphilis and other sexually transmitted diseases, tests for HIV, hepatitis, in some cases, an ultrasound of the abdominal organs is necessary.
In addition, for a successful intervention, it is important to follow a diet - to refuse food, which causes increased gas formation and the formation of feces. On the eve of the operation, a cleansing enema is mandatory.
Milligan-Morgan Surgery
How is the operation to remove hemorrhoids with this method? The history of the intervention begins back in 1937. Previously, the operation took place according to this scheme: the hemorrhoidal node and adjacent tissues involved in the pathological process were excised, while the wound remained open and healed independently. After the 1950s, the postoperative wound was sutured, so that the patient had the opportunity to go home on the same day. To date, only pathological tissues are removed, the mucous membrane remains intact, this method significantly reduces the postoperative recovery period.
The Milligan-Morgan operation gives a positive result, but there are also negative points:
- soreness after surgery;
- carrying out under general anesthesia;
- difficult recovery period;
- the duration of the procedure is more than 1 hour;
- high risk of complications.
The operation is effective in severe stages of hemorrhoids.
Longo Method
The medical procedure has been known since 1993. How is the Longo hemorrhoid surgery performed? During the intervention, the tissues that surround the node are cut, and it is pulled up with titanium clips. After such an intervention, the node gradually dies and falls off on its own. The operation has the following advantages:
- use of local anesthesia;
- high speed of carrying out;
- the mucous membrane, which has no nerve endings, is excised, therefore, in the postoperative period, the patient does not feel pain;
- allowed for the elderly, as well as patients with chronic diseases.
The Longo method has an extremely short recovery period of about three weeks, which gives it a great advantage over the rest.
Laser exposure
How is laser hemorrhoids removed? This method is based on the fact that the laser seals the blood vessels that supply the tumor with blood, as a result of which the hemorrhoids die off over time. The advantage of the procedure is that it does not leave behind a wound surface, which shortens the rehabilitation period.
How is the laser hemorrhoid surgery performed? It is done under local anesthesia and lasts only 15-20 minutes, after which the patient can go home. Laser exposure is effective at the 1st and 2nd stages of the disease. The following advantages of the operation are distinguished:
- low invasiveness;
- lack of blood loss;
- painlessness;
- lack of risk of infectious diseases;
- lack of contraindications.
However, despite all the contraindications, this operation is expensive, and therefore not available to all patients.
Infrared coagulation
How is the operation to remove hemorrhoids? Patient reviews and the advice of experienced proctologist surgeons report another commonly used method - infrared coagulation of hemorrhoidal nodes. In this case, the effect is carried out using high temperatures, which, like the laser, seal the vascular system of the nodes. The dead node after surgery leaves the rectum along with feces.
Latex ligation
The essence of this method also lies in “disconnecting” the hemorrhoid from the blood supply. However, a latex ring is used, which is worn on the base of the formation. The procedure is absolutely painless, although it can bring some discomfort to the patient.
Sclerotherapy
How is the operation to remove hemorrhoids and cracks with this method? In this case, a drug is injected into the blood vessels, which glues them and prevents them from filling with blood. This method is effective in the initial stages of the disease, when the nodes are relatively small in size.
Suture ligation
Many are interested in how the operation to remove hemorrhoids goes. Photos are terrifying to patients, but doctors assure that there is nothing wrong with it. Suture ligation intervention involves suturing the vessels that supply the hemorrhoid. The advantages of this method are its high speed, as well as a short recovery period, which is very important for patients.
Postoperative period
Before they perform an operation to remove hemorrhoids of 3 degrees, they must necessarily tell the patient about the behavior after surgery:
- On the first day of the postoperative period, it is strictly forbidden to eat in order to avoid the formation of feces.
- It is recommended to drink more so that there is no dehydration of the body.
- Starting from the second day, the patient is on a strict diet, which requires careful monitoring of the intestines to avoid diarrhea or constipation. This period lasts about a month.
- The use of alcoholic beverages is strictly prohibited, as they can provoke a relapse of the disease.
- In the first time after the intervention, pain in the anus is possible. For its relief, the use of anal suppositories with an anesthetic effect is allowed, as well as oral preparations - Nise, Ketanov, Pentalgin. In case of severe and excruciating pain, drugs are administered intravenously - "Diclofenac", "Dicloberl."
- The healing process can accelerate such ointments - Levomekol, heparin ointment, Anuzol, Relief.
- It is allowed to use traditional medicine, which consists in the use of baths with herbs.
In addition, it is very important to monitor intimate hygiene - to wash twice a day, as well as after each act of defecation. In this case, use only soft toilet paper or wet wipes.
Possible complications
Many patients are justifiably interested in not only the question of how the operation to remove hemorrhoids takes place, but also what complications can occur after it. They can occur after any of the methods used to excise hemorrhoids:
- Severe pain that may haunt the patient for 3 weeks after the intervention. This is due to trauma to the anus and vascular legs of the neoplasm.
- Infectious infections with insufficient care for the wound surface.
- Postoperative bleeding.
- Fecal incontinence when performing extensive excision of nodes, as well as with improperly made incisions that damaged the anal sphincter. This problem may disappear itself some time after surgery.
- Difficulty urinating.
In addition, unfortunately, a relapse of the disease with a new formation of hemorrhoidal nodes is possible.
Hemorrhoids and other diseases
Sometimes, concomitant problems also operate in parallel with hemorrhoidal nodes. This is reported by numerous reviews. How is hemorrhoids and related diseases removed?
It:
- Hemorrhoidectomy with removal of polyps. Such an operation is performed exclusively by surgery. In this case, not only the body of the hemorrhoidal cone is excised, but also the polyp. This is followed by suturing of the wound and plastic surface.
- Removal of hemorrhoids and anal fissure is carried out in the area of soft tissue rupture with subsequent suturing.
- How is the operation to remove hemorrhoids surgically if it is complicated by a fistula? In this case, a part of the rectum with a fistula is removed. This intervention is as traumatic as possible, and therefore has a long rehabilitation period.
- An abscess is always performed before hemorrhoidectomy. For this, the formation wall is excised, pus is removed and a drainage tube is inserted for subsequent washing of the cavity with antiseptic solutions. Only after wound healing can we talk about the removal of hemorrhoidal nodes.
Operations that involve not only the removal of hemorrhoid cones are performed under general anesthesia, since they differ in complexity from classical interventions. In addition, for some time the patient remains in hospital for monitoring wound healing.
Conclusion
Patients are always interested in how they perform an operation to remove hemorrhoids. Photos can scare a sick person, but experienced doctors claim that there is nothing to fear. Most modern techniques for removing hemorrhoidal nodes are minimally invasive, and therefore cause minimal discomfort to the patient after the procedure. In addition, it is much easier to cure the disease at an early stage, since with the 3rd and 4th degrees only surgical treatment by the method of complete excision of the cones is applicable.