Hemorrhoidectomy (Hemorrhoid Surgery) - Risk, Procedure & Cost

Types of Hemorrhoidectomies

Closed Hemorrhoidectomy

Closed hemorrhoidectomy is a medical procedure that is generally used to treat internal hemorrhoids. It involves excising the hemorrhoidal bundles using a sharp instrument, like a scalpel, scissor, or laser. It is then followed by complete wound closure with an absorbable suture. Postoperative care after closed hemorrhoidectomy includes frequent sitz baths, drinking plenty of fluids, and avoidance of constipation. This surgery is successful 95% of the time.

Potential risks and complications include pain, bleeding, urinary tract infection, fecal impaction, and, very rarely, wound breakdown and anal stricture. Although this surgery has a certain amount of postoperative pain and discomfort, it does have the most promising long-term results with low recurrence rates. 

Open Hemorrhoidectomy

Open hemorrhoidectomy is not performed as commonly as closed hemorrhoidectomy. In an open hemorrhoidectomy procedure, hemorrhoidal tissue is excised like in a closed hemorrhoidectomy procedure, but the incision is left open. Surgeons choose this surgery when the location or amount of the hemorrhoidal tissue makes wound closure difficult. Complications after open hemorrhoidectomy are similar to those after a closed procedure.

Stapled Hemorrhoidectomy for Prolapsing Hemorrhoids 

Stapled hemorrhoidectomy is an advanced surgical procedure to treat hemorrhoids. It is mainly used in patients with grade 4 hemorrhoids and those who fail prior minimally invasive treatments. During a stapled hemorrhoidectomy, a stapling device excises a ring of hemorrhoid tissue which helps lift hemorrhoids back to the normal position. Research has shown that stapled hemorrhoidectomy results in less postoperative pain and shorter recovery than conventional surgery but a higher recurrence rate. 

Hemorrhoid banding

Hemorrhoid banding, or rubber band ligation, is a treatment method for hemorrhoids that does not respond to home treatments. This procedure involves tying the base of the hemorrhoid with a band to stop blood flow to it. Rubber-band ligation is conducted in an ambulatory setting, and the procedure causes less pain and has a quicker recovery period than surgical hemorrhoidectomy. 

Lateral Internal Sphincterotomy

Lateral internal sphincterotomy is a simple surgical operation to open the inner anal sphincter muscle. It is sometimes performed during hemorrhoidectomy in patients with high sphincter pressures. In this procedure, the sphincter muscle is cut or stretched. A sphincter is a group of muscles surrounding the anus responsible for restraining bowel movements.

What Happens During Hemorrhoidectomy?

Hemorrhoidectomy is usually an outpatient medical procedure, but in some possibilities, it may need an overnight stay. In this procedure, an IV ( intravenous line) will be inserted into the hand for medications to prevent any swelling, infection, and bleeding.

You will be given either general or local anesthesia with sedation that will put you to sleep and makes you unable to move. Once you are asleep, the doctor will insert a scope into the anal canal to closely inspect internal hemorrhoids and other medical conditions. 

They will then cut the circular hemorrhoidal tissue. The hemorrhoidal tissue can be excised through different hemorrhoidectomy procedures like open hemorrhoidectomy, closed hemorrhoidectomy, or stapled hemorrhoidectomy. However, the kind of surgery that will be performed will depend on the surgeon and the patient’s medical condition. 

Once the surgery is performed, you will be moved to a recovery area where the vital signs will be observed for some hours. You will be able to drink and eat soon after the surgery, and within a few hours, you’ll get discharged when you’re fully awake and stable.