Haemorrhoidectomy is an operation to remove severe haemorrhoids (also known as piles). It is usually a day procedure and is usually carried out under a general anaesthetic. The procedure is common and generally safe, but recovery after the surgery can take a few weeks and can be painful.
During the procedure, small incisions are made in the tissue around the hemorrhoid, and the hemorrhoid is removed. This is the most invasive, and often painful, of all the hemorrhoid surgery options but can provide a permanent solution for severe hemorrhoids.
Closed hemorrhoidectomy is the surgical procedure most commonly used to treat internal hemorrhoids. It consists of the excision of hemorrhoidal bundles using a sharp instrument, such as a scalpel, scissors, electrocautery, or even laser followed by complete wound closure with absorbable suture.
While hemorrhoid surgery is important for severe hemorrhoids, it's not always necessary. Non-invasive procedures such as sclerotherapy, coagulation, or rubber band ligation can treat grade one and two hemorrhoids. Hemorrhoidectomy and stapling are the most effective surgical procedures for treating hemorrhoids.
Piles if left untreated can lead to anemia and strangulated hemorrhoids may occur — when blood supply to an internal hemorrhoid is cut off and the hemorrhoid becomes strangulated, causing extreme pain and leading to gangrene.
There is a chance of inflammations and for symptoms to occur again if a hemorrhoid is left untreated for a long time or treated improperly. If inflammation exists, hemorrhoids will be swollen and enlarged. The condition is clearly visible from the outside and the prolapsed hemorrhoid cannot be pushed back inside.
If someone has grade 3 or grade 4 hemorrhoids, doctors often recommend surgery. A general or local anesthetic is usually needed for this. You then have to stay in the hospital for a few days, and stay off work for some time too.
You may need more than one doctor and additional costs may apply. This is the “Medicare approved amount,” which is the total the doctor or supplier is paid for this procedure. In Original Medicare, Medicare generally pays 80% of this amount and the patient pays 20%.
Your surgery usually takes about 30 minutes and you have a general anaesthetic. This means that you are asleep during the surgery and do not feel anything. If you have day surgery, you should be able to leave hospital on the same day as your surgery.
Avoid strenuous activity for 1-2 weeks after your procedure. Ask someone to drive you to appointments until you are able to sit and move comfortably. Take sitz baths (sit for 15-20 minutes in warm water) at least 3 times a day and after each bowel movement.
Grade 3 - Hemorrhoid protrudes through the anus during straining or evacuation but needs to be manually returned to position. Grade 4 - Hemorrhoid remains prolapsed outside of the anus. Grade 3 hemorrhoids are internal hemorrhoids which prolapse, but do not go back inside the anus until the patient pushes them back in.
Surgery usually cures a hemorrhoid. But the long-term success of hemorrhoid surgery depends a lot on how well you are able to change your daily bowel habits to avoid constipation and straining. About 5 out of 100 people have hemorrhoids that come back after surgery.
In most cases, the patients are discharged from the hospital on the same day of the surgery. But of course, there is a little discomfort for a while that usually stays for one or two days only.
It can take four to eight weeks to recover from a hemorrhoidectomy, although you should be able to return to work in one to two weeks. During this time, you need to adjust your diet to avoid constipation and avoid activities (like heavy lifting) that can disrupt the surgical incision.
With laser piles treatment, a patient can resume regular work-life with just two or three days of rest, provided he or she does not have an underlying health condition that does not alter the post-surgical outcomes.
Typical costs
For patients with private health insurance who had an Excisional hemorrhoidectomy in a private setting across all of Australia, 55% had an out-of-pocket cost. Of those: Patients typically paid: $310, Medicare paid: $680, Insurer typically paid: $650. Typical specialists' fees: $1,700.
Many people need to take 1to 2 weeks off work to recover. Your doctor will probably ask you to return for a check-up sometime after your operation.
If an internal hemorrhoid becomes severely inflamed, it can prolapse, or fall outside of the anus. Many times it will retract on its own but not always. If it can't easily be pushed back in, or it causes pain or bleeding, early hemorrhoid treatment from a doctor is important.
Is Piles surgery safe? Most of the time, hemorrhoid surgery is secure and successful. Typically after a piles surgery, the tissues around the anus could enlarge that may result in some bleeding during the bowel movements but that may reduce with time.
In rare, severe cases, hemorrhoid surgery may be the best treatment option. But, for most people with hemorrhoids, non-surgical treatments are very effective at relieving symptoms or removing the source.
Chronic hemorrhoids can exist indefinitely and can flare-up every few weeks, months, or even years. Fortunately, you don't have to live with the pain and inconvenience of chronic hemorrhoids.
The good news is that, in most cases, they are not serious and can get better at home with over-the-counter medication, lifestyle changes, diet alterations, or with home remedies. For severe conditions, you may have to opt for surgery.