Piles Surgery: Procedure, Photos, Types, Risk & Recovery

Haemorrhoids, also known as piles, are a common health concern in India. They result from the inflammation of haemorrhoidal tissues in the anal-rectum region. There are different types of piles: external, internal, prolapsed, and thrombosed.

Piles can recur or worsen in severity, which is classified into four grades. Timely treatment is crucial to prevent the problem from progressing.

Piles treatment through Haemorrhoidectomy, is a surgical procedure for treating recurring internal or external haemorrhoids. Surgical procedure is appropriate for patients with severe conditions (Grade III or IV haemorrhoids).

The surgical treatment includes the administration of local or general anaesthesia. Surgery for piles treatment uses various approaches and equipment. Determining the appropriate surgery method depends on the severity of haemorrhoids.

Common techniques include-

1. Conventional Haemorrhoidectomy

2. Stapled Haemorrhoidectomy

3. Haemorrhoidal Artery Ligation and Rectal Anal Repair (HAL-RAR)

4. Laser Piles treatment.
   
   

The anorectal region plays a crucial role in various bodily functions, including waste elimination and maintaining continence. The region comprises the anus, anal canal, and rectum, each with distinct structures and roles. Let's take a closer look at the anatomy of this region.

1. Rectum: The final portion of the large intestine temporarily stores faeces (stool) before elimination. It connects to the sigmoid colon and extends to the anal canal.

2. Anal Canal: Located at the end of the rectum, the anal canal is a short passage ending at the anus. It is around 3-4 cm long, surrounded by muscles that control defecation and maintain continence.

3. Haemorrhoidal Tissue: Clusters of blood vessels, also known as haemorrhoidal cushions, are present in the anal canal. They contribute to maintaining faecal continence and aiding in controlling gas release.

4. Anus: The anus is the external opening through which waste material exits the body. It consists of two muscular rings - the internal anal sphincter (involuntary) and the external anal sphincter (voluntary). These muscles maintain anal tone and regulate bowel movements.

5. Perianal Skin: It is the skin surrounding the anal area. It is susceptible and tends to experience itching, rashes, and infections.

Haemorrhoidectomy is recommended for piles patients in specific cases when non-surgical treatments prove ineffective. A doctor may also recommend this procedure if the patient shows the following piles symptoms:

1. Large Piles: Patient has grade 3 or 4 internal, prolapsed or external haemorrhoids.

2. Severe Pain: The patient experiences severe pain and discomfort due to haemorrhoids.

3. Chronic Bleeding: If haemorrhoids lead to chronic bleeding that affects quality of life and doesn't resolve with non-surgical measures, haemorrhoidectomy could be considered.

4. Recurrent Haemorrhoids: Individuals experiencing recurrent episodes of haemorrhoids despite previous treatments might benefit from surgical removal to address the underlying issue.

5. Thrombosed Haemorrhoids: Haemorrhoids that develop blood clots (thrombosed haemorrhoids) can cause intense pain. If these clots don't resolve on their own, surgical intervention may be required.

Consultation with a doctor is essential to determine the most suitable type of piles treatment for a patient's health needs.

One of the most frequent questions a patient and their family members pose is how piles operation is done. It is typically done on an outpatient basis and follows a standard procedure. The surgery can be done using various methods like-

Conventional Haemorrhoidectomy

Conventional (open) haemorrhoidectomy is the most common surgical treatment for piles. The procedure of conventional piles surgery is highly suitable as external and internal piles treatment. The basic procedure of an open haemorrhoids surgery involves:

1. The patient is administered with an appropriate dosage of anaesthesia.

2. The surgeon excises the haemorrhoidal tissues through perianal

3. The removal of haemorrhoids is done with a trocar.

Stapled Haemorrhoidectomy

A stapled haemorrhoidectomy is a recommended treatment for recurring, painful haemorrhoids. The procedure involves inserting a thin tube and using a unique stapler to remove haemorrhoids. It is necessary for those with consistent risk factors.

1. The surgeon will reposition the haemorrhoids and cut off their blood supply using a stapler-like instrument. Without a blood supply, the haemorrhoid will disintegrate and perish.

2. It can treat haemorrhoids that have prolapsed or slipped out of the anus.

3. Because the haemorrhoid is moved to a location with fewer nerve endings, it hurts less than a standard surgical treatment.

4.  Patients will heal faster with reduced bleeding and itching, with an overall improvement in quality of life.

Haemorrhoidal Artery Ligation and Recto-Anal Repair (HAL-RAR)

HAL-RAR surgical procedure uses an ultrasound-guided instrument to locate and ligate the arteries supplying the haemorrhoids. This causes the haemorrhoids to shrink and fall off. 

If conventional Haemorrhoidectomy treatments haven't worked well enough for piles symptoms, HAL-RAR may be an ideal option.

1. A small ultrasound sensor is introduced into the anus to locate the arteries providing blood to haemorrhoids.

2. Healthcare professionals can identify and block the blood flow to the haemorrhoids by tying off the arteries to inhibit blood supply.

3.  Most of the haemorrhoids are reduced immediately and are no longer evident after a few weeks.

Laser Haemorrhoidectomy

Laser haemorrhoidectomy is a minimally invasive piles treatment surgery. It offers minimal postoperative pain and almost no risk of prolapse and incontinence. Patients can return to work within two or three days unless they have an underlying health condition that may affect their recovery.

1. It is a procedure in which the surgeon burns the enlarged haemorrhoids to shrink them.

2. Alternatively, the surgeon could utilise a small laser beam to focus exclusively on the haemorrhoid and spare the surrounding tissues.

3. It is painless, causes minor bleeding, prevents recurrence and a speedy recovery.

Consult a doctor to determine the best piles treatment depending on patient-centric needs.

Before The Haemorrhoidectomy Surgery

The information regarding the procedure followed in a healthcare facility before haemorrhoidectomy surgery is essential. Being aware about the criteria helps the patients to prepare accordingly specifically mentally. 

Standard steps involved before conducting haemorrhoidectomy are-

1. Medical Assessment: The doctor conducts a physical examination of the doctor to understand the severity of the case. Medical assessment before surgery also helps in determining appropriate surgical procedure for the patient.

2. Pre-operative Guidelines: The patient is informed regarding the surgical treatment, risks, complications, benefits, and preparation methods.

3. Evaluating Risks: Based on the patient’s unique health condition the doctor evaluates and informs regarding the potential risks of the procedure. It also involves assessing the patient’s allergies and existing health concerns.

4. Anaesthesia Selection: Another important step before commencing haemorrhoidectomy is the selection of appropriate anaesthesia depending on the patient’s needs.

5. Fasting: The patients are advised to maintain fasting 6-8 hours before the surgery. Fasting prevents the occurrence of anaesthesia-associated complications.
   

On The Day of Haemorrhoidectomy Surgery

Patient’s awareness concerning the steps involved on the day of the surgery is also important. It helps in overcoming the chances of misguiding procedures, confusion, and anxiety among the patients. Common procedure followed on the day of surgery include:

1. Hygiene: Proper hygiene is mandated before the surgery especially in the surgical site. This allows to overcome the chance of infection and contamination during surgery.

2. Physiological Evaluation: A healthcare practitioner conducts a thorough physical examination before surgery to address accurate surgery preparation and concerns.

3. Anaesthesia administration: An anaesthetist administers the prescribed dosage and type of anaesthesia to the patients.

Patients often get concerned about what happens after piles operation. After the surgical piles treatment, patients undergo a recovery period.

During this recovery time patients effectively adjust to their new health situation and overcome post-operative risks. The estimated recovery time can last 2-6 weeks, depending on the patient's treatment.

Standard precautions and instructions provided for a quick recovery after piles surgery include:

1. Anaesthetic Side-effects: Some patients have side-effects towards the general or local anaesthesia administered during the surgical treatment. Consultation with the doctor is necessary if the patient experiences any discomfort.

2. Pain Management: After a haemorrhoidectomy, patients may experience mild pain. Doctors prescribe pain medications to manage the recovery pain. Standard recovery pain after the piles operation lasts for four weeks.

3. Diet: During the recovery period after haemorrhoidectomy, patients are asked to increase fibre intake or take fibre supplements. Drink six to eight glasses of water every day. This prevents constipation and strenuous bowel movements.

4. Lifestyle: Patients should avoid heavy lifting and straining the pelvic region after surgery. Post-surgery care includes sitz baths, warm water baths, and gentle anal cleaning.
   

5. Quit Smoking: For a rapid recovery after piles surgery, most healthcare practitioners advise patients to quit smoking.

6. Follow-up: Attending the prescribed follow-up after the piles surgery is essential. During follow-up, doctors assess the recovery rate.

Haemorrhoidectomy procedure offers patients with recurring and extensive piles issues to gain long-lasting and rapid cure. A haemorrhoids surgery is not just responsible for curing piles but allows patients to improve their overall quality of life.

Some of the expected benefits of haemorrhoidectomy surgery are discussed below:

1. Long-term Relief: Haemorrhoidectomy removes the source of haemorrhoids, providing long-term relief.

2. Reduced Overall Discomfort: The procedure reduces pain, itching, and discomfort associated with haemorrhoids.

3. Better Physical Activity: Patients can resume their normal activities without any restrictions after recovery.

4. Reduced Bleeding: It lowers the risk of bleeding and infection.

5. Improvised Quality of Life: Haemorrhoidectomy surgery subsequently promotes a better quality of life.

While this procedure is generally safe and effective, like any surgery, there are certain factors to be aware of. Being informed about post-operative risks allows patients to avoid complications, identify any potential health threats, and seek appropriate medical assistance on time.

The risks and complications of haemorrhoidectomy surgery include the following:

1. Bleeding: There may be some bleeding and fluid discharge from the anus, but it is usually minimal within 4-6 weeks.

2. Pain: Another prominent complication observed after haemorrhoidectomy surgery is pain in the pelvic region. The pain after Haemorrhoidectomy also subsides in a few weeks, allowing complete recovery.

3. Urinary Retention: Some patients may experience difficulty in emptying their bladder after the surgery, but this is usually temporary.

4. Infection: Although rare, there is a small risk of developing an infection at the surgical site. Chills, fever, and severe pain may indicate a postoperative infection and should be reported to a healthcare professional immediately.

5. Anal Stenosis: In rare cases, scarring from the surgery can cause narrowing of the anal canal, leading to difficulty in passing stools.

6. Incontinence: Although rare, there is a possibility of temporary or permanent loss of bowel control after the surgery.

If a patient observes any of the above-mentioned risks and complications it is best advised to seek medical assistance from the doctor.

Although, it must be kept in mind that common risks like pain, bleeding, and swelling can subside on their own within 4-6 weeks. If the issues pertain even after the recovery time or are extensively high, consult the doctor.

Haemorrhoids patients are reported to be highly reluctant towards seeking medical treatment for piles owing to social stigma. Although, doctors highlight prominent risk associated with delaying haemorrhoidectomy surgery. It is vital to address severe piles promptly to avoid worsening symptoms and potential complications.

It is essential to understand the potential consequences of postponing the procedure.

1. Worsening Symptoms of Piles: If a patient delays getting a surgical treatment, it can cause increased pain and discomfort, prolonged recovery time, and potential complications such as infection or anal stenosis.

2. Thrombosis: In some cases, untreated piles can lead to complications such as thrombosis, which occurs when a blood clot forms within a haemorrhoid. This can cause severe pain and require more invasive treatment.

3.  Strangulated Internal Piles: Another risk is strangulated internal haemorrhoids, where blood flow to the vein can be cut off. This can quickly form an infection if surgery is delayed.

4. Poor Quality of Life: The progression of piles and worsening symptoms due to delayed surgical treatment can deteriorate the quality of life for the patient.

The estimated haemorrhoidectomy cost in India ranges between ₹ 23,000 to ₹ 1,10,000. This cost can vary depending on multiple factors including:

1. Consultation Fee: Before surgery, it's crucial to understand the procedure, risks, and benefits. It's recommended to consult an experienced doctor, even if their fees are higher than less experienced doctors.

2. Surgeon’s Fee: Piles surgery is a general procedure but requires an expert surgeon who is skilled and well-equipped to perform the surgery. The experience and expertise of the surgeon can add to the piles operation cost.

3. Admission Fee: Haemorrhoidectomy is a daycare procedure requiring hospital admission, which affects the total surgery cost in India.

4. Patient’s Age: Piles can affect anyone regardless of age. However, older patients may experience more complications during surgery, which can impact the cost of the piles operation.

5. Patient’s Medical Condition: Elderly patients with compromised immunity require extra care, which will also impact the overall cost of piles surgery.

6. Type of Hospital: Hospital haemorrhoidectomy surgery is a standard procedure clinics and hospitals offer. The choice of the hospital affects the overall cost.

7. Location or City: The cost of piles surgery in India varies depending on the location of the hospital. Metro cities generally have higher costs compared to smaller and remote cities.

8. Type of Haemorrhoidectomy Surgery: The piles surgery cost in India depends on the technique used (Laser surgery, Stapler Haemorrhoidectomy, Haemorrhoidal artery ligation and rectal anal repair (HAL-RAR), etc.)and other factors like different types of piles and patient's specific requirements.

9. Diagnostic Tests Cost: Before haemorrhoidectomy surgery, patients must undergo diagnostic examinations like digital rectal examination, sigmoidoscopy, colonoscopy and more. The cost of these tests will affect the total piles surgery cost in India.

10. Post-procedure Complications: Complications can arise from piles surgery, and treating these complications will be added to the final operation cost.

The table below provides an overview of the estimated costs for different types of piles surgery in India.

In conclusion, haemorrhoidectomy is a reliable and proven surgical procedure for effectively curing piles. The decision to undergo surgery depends on the condition's severity. Conventional haemorrhoidectomy addresses piles but requires consideration of factors such as surgery types, costs, procedures, and risks.

Before undergoing haemorrhoidectomy surgery, consult with a healthcare provider. Commit to a healthy lifestyle and receive support from a medical team. If you have concerns or symptoms related to haemorrhoids, seek surgical treatment from our expert team at HexaHealth. Contact us today for assistance!

Haemorrhoidectomy Success Stories at HexaHealth

Discover the motivating stories of individuals who have conquered the difficulties of piles. All thanks to the exceptional care and seamless treatments provided by HexaHealth.

Each success story stands as a proof of our dedication for exceptional patient care and simplified surgical experience.

1. Aziz was diagnosed with piles and experienced challenges in everyday life. Let's hear more about his journey of getting piles surgery.
      

2. "Hello, so mera naam Ashwani Kumar Mishra hai. Maine abhi recently ek laser surgery karaya hai Piles ka. So basically main Google pe search kar raha tha. So mujhe HexaHealth ke baare mein pata chala. Waha se HexaHealth ke ek bande ne mujhse coordinate kia. Rajat naam hai unka. Rajat Saha Ji, thanks for coordinating first of all. 

   Phir unhone aake mera pura help kia. Mujhe hospitals, mere appointments se leke sab mera surgery tak. Phir jaese hi main hospital aata hu mujhe ek dusre co-ordinator milte hain. Ajay ji, thank you Ajay for coordinating. Aur Ajay ji ne mera hospital mein aane ke baad first to last tak pura help kia surgery mein.

   Aur main aage bhi future mein mere friends mere group mein HexaHealth recommend karunga for smooth process. Or mera pura process yaha pe insurance ke through Cashless hua hai. Jisme pura credit main HexaHealth ko dena chahta hu. Thank you."

Suggested Reads

1. Haemorrhoidectomy
2. Piles in Men - Causes, Symptoms, Diagnosis and Treatment
3. Piles in Women - Images, Causes, Symptoms & Treatment
4. Cure Piles Permanently at Home in Just 3 Days