Stapler Surgery for Piles

Procedure 

1. During stapler surgery, your proctologist will:
2. Gently insert a circular anal dilator into your anal region
3. Inserts a suture called a purse-string suture 
4. Inserts a circular stapler
5. Position the stapler opening adjacent to the purse-string suture and ties down the suture to the opening of the stapler
6. Pulls the suture, which helps in pulling the haemorrhoidal tissue into the stapler 
7. Fires the stapler that helps cut the portion of haemorrhoids trapped inside the stapler. This helps interrupt the blood supply, thereby allowing it to shrink and be reabsorbed.

What to Ask and Tell Your Doctor?

1. While you are with your proctologist discussing treatment approaches for haemorrhoids, you can ask the following questions:
2. Why do I need surgery?
3. What surgical procedure do you recommend for piles?
4. How will I benefit from the surgery?
5. What possible risks or complications can occur due to surgery?
6. What would happen if I chose not to undergo surgery for haemorrhoids?
7. How will the recovery process be?
8. It is also essential that your proctologist knows a few details about you so that your surgery can undergo smoothly. Therefore, during the appointment, you should inform your proctologist if you:
9. Currently using any prescription, non-prescription, or herbal medications
10. Have any health conditions (e.g., pregnancy, diabetes, high blood pressure, breathing problems, heart problems, etc.)
11. Are allergic to food or medications
12. Have smoking habits (if any)

What to Expect Before Surgery? 

1. Your proctologist will conduct the following tests before surgery: 
2. Examine the inside of your anal region via anoproctoscopy
3. Carry out a digital rectal examination in which they will insert their gloved, lubricated finger inside the anus to feel the haemorrhoids
4. Blood tests
5. The proctologist will also examine your medical history
6. Do not eat processed foods. Eat foods rich in fibre, minerals, and vitamins before the surgery
7. Quit smoking and drinking as they can alter your mood and affect your sleep cycle before the surgery
8. You might be asked to stop taking anticoagulants (blood-thinning medications) if you are taking any to reduce the risk of bleeding during the stapler surgery
9. A day before surgery, you will be given an enema to remove any remaining stools from your intestines

What to Expect During Surgery?

1. Anaesthesia: Your anesthesiologist will administer general or spinal anaesthesia for stapler surgery.
2. Patient position: You will remain in lithotomy position for stapler surgery for piles. In lithotomy position, you will be placed on your back with legs flexed and separated.[12]

What to Expect After Surgery?

At the hospital:

1. Stapler surgery for piles is an outpatient procedure, so you will be allowed to go home the same day 
2. You might also be given local anaesthesia in the anal region to keep you pain-free for a few hours
3. If an anal plug has been inserted, it will be removed in a few hours or will pass along with your first stools after surgery
4. If you experience some bleeding from the anus, you will be given some pads so that you do not stain your clothes

At home:

1. Wound care and dressing:
2. You should take a sitz bath for a few days post-surgery to relieve muscle spasms and pain. A sitz bath is simply submerging your bottom in plain and warm water.
3. You can use cold compress or ice packs on your anal area for pain relief and reduce swelling
4. Use sanitary napkins or soft gauze for controlling drainage from the surgical site

Medications:

1. Take all the prescribed medicines such as painkillers and antibiotics
2. Avoid suppositories or enema in your anal region for at least five days post-surgery
3. Use stool softeners or eat a fibre-rich diet to ensure the smooth passing of stools
4. Incorporate a few lifestyle changes like losing excess weight, following a healthy diet, and exercising
5. Stick to a liquid and bland diet and gradually get back to your regular diet after a few days
6. Keep yourself adequately hydrated by drinking a minimum of eight big glasses of water every day
7. Work-activity restrictions:
8. Avoid strenuous activities like weightlifting for at least five to seven days
9. Avoid driving or drinking alcohol for at least 24 hours post-surgery or while consuming painkillers
10. You can expect to recover within 10-14 days after the surgery 

First Follow-up Appointment

You will have to schedule a follow-up appointment with your proctologist two to three weeks after the surgery to check for any issues.