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Stapler Surgery for Piles
Haemorrhoids or piles are swollen and enlarged blood vessels in the anal region that can cause discomforts like itching and rectal bleeding. When medications are ineffective in treating piles, doctors recommend surgery. This article describes one of the surgical methods, i.e., stapler surgery for piles, what to expect, and your experience if your proctologist recommends this surgery. Anatomy and Physiology
The anus is the last portion of our digestive system, located right after the rectum. It is the outer end of our digestive system which passes stools out of our body. The anus contains sphincter muscles which help to control the passage of stools. Blood vessels and nerve endings also surround the anal region.
Haemorrhoids can be both External and Internal
Haemorrhoids are external or internal dilated veins located outside or inside, respectively, in your anus.
Internal haemorrhoids can be further classified into different grades or degrees:
- Grade I piles: Haemorrhoids that are not visible from the outside. They might occasionally bleed due to excessive straining or friction
- Grade II piles: Haemorrhoids that come out of the anus due to exertion or while passing stools but go back inside by themselves.
- Grade III piles: Haemorrhoids that come out of the anus due to exertion or while passing stools but require to be pushed back manually or take time to go back.
- Grade IV piles: Haemorrhoids that stay outside the anus and cannot be manually pushed back inside the anus.
Your proctologist will decide the treatment for piles based on the severity of your condition and prolapsed haemorrhoids. They may recommend surgery if you have:
- Piles causing pain, bleeding, and discomfort
- If minimally invasive procedures such as rubber band ligation (a band of rubber is placed surrounding your piles which cuts off the blood supply to the vein), etc., have not been effective in your case
- Grade III or IV haemorrhoids
- Prolapsed piles
- Presence of both internal and external piles
Your proctologist may recommend stapler surgery for prolapsed haemorrhoids if you have grade III or grade IV haemorrhoids. Stapler surgery offers the following advantages:
- It is a minimally invasive procedure (requires fewer cuts)
- It is less painful than other surgical procedures
- It has a quicker recovery period and shorter hospital stay
What to Expect if you Delay Surgery?
You should not delay the treatment for piles as it can lead to complications like:
- Anaemia (a condition characterised by a lack of adequate healthy red blood cells that carry oxygen to the body's tissues)
- Blood clots in the external haemorrhoid tissue
- Flaps of tissue hanging off the skin (skin tag)
- Strangulated piles (anal muscles may cut off the blood supply to the prolapsed internal piles)
Benefits of Stapler procedure for piles
The Benefits of Stapler procedure for pile are
- Short operating time.
- Minimal blood loss.
- Less post-operative complications like pain, and bleeding.
- Short hospital stays.
- Early return to work
Who needs this procedure?
Piles or haemorrhoids are swollen and enlarged blood vessels located in the anal region.
The causes of haemorrhoids include:
- Stapler surgery is recommended for patients diagnosed with higher grades of Haemorrhoids- Third and fourth degrees of haemorrhoids,
- The pressure around the abdominal region increases due to pregnancy or obesity, leading to swelling of blood vessels in the anal area.
- Applying too much pressure while passing stools or while lifting heavy objects. Straining puts pressure on the blood vessels located in the anal region.
Haemorrhoids can cause symptoms like:
- Pain, discomfort, and itching in your anal region
- Bleeding per (from) rectum
- Lumps in the anal area
Stapler Surgery for piles
- During stapler surgery, your proctologist will:
- Gently insert a circular anal dilator into your anal region
- Inserts a suture called a purse-string suture
- Inserts a circular stapler
- Position the stapler opening adjacent to the purse-string suture and ties down the suture to the opening of the stapler
- Pulls the suture, which helps in pulling the haemorrhoidal tissue into the stapler
- 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?
- While you are with your proctologist discussing treatment approaches for haemorrhoids, you can ask the following questions:
- Why do I need surgery?
- What surgical procedure do you recommend for piles?
- How will I benefit from the surgery?
- What possible risks or complications can occur due to surgery?
- What would happen if I chose not to undergo surgery for haemorrhoids?
- How will the recovery process be?
- 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:
- Currently using any prescription, non-prescription, or herbal medications
- Have any health conditions (e.g., pregnancy, diabetes, high blood pressure, breathing problems, heart problems, etc.)
- Are allergic to food or medications
- Have smoking habits (if any)
What to Expect Before Surgery?
- Your proctologist will conduct the following tests before surgery:
- Examine the inside of your anal region via anoproctoscopy
- Carry out a digital rectal examination in which they will insert their gloved, lubricated finger inside the anus to feel the haemorrhoids
- Blood tests
- The proctologist will also examine your medical history
- Do not eat processed foods. Eat foods rich in fibre, minerals, and vitamins before the surgery
- Quit smoking and drinking as they can alter your mood and affect your sleep cycle before the surgery
- 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
- A day before surgery, you will be given an enema to remove any remaining stools from your intestines
What to Expect During Surgery?
- Anaesthesia: Your anesthesiologist will administer general or spinal anaesthesia for stapler surgery.
- 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.
Recovery and Post op care after the procedure
What to Expect After Surgery?
At the hospital:
- Stapler surgery for piles is an outpatient procedure, so you will be allowed to go home the same day
- You might also be given local anaesthesia in the anal region to keep you pain-free for a few hours
- 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
- If you experience some bleeding from the anus, you will be given some pads so that you do not stain your clothes
- Wound care and dressing:
- 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.
- You can use cold compress or ice packs on your anal area for pain relief and reduce swelling
- Use sanitary napkins or soft gauze for controlling drainage from the surgical site
- Take all the prescribed medicines such as painkillers and antibiotics
- Avoid suppositories or enema in your anal region for at least five days post-surgery
- Use stool softeners or eat a fibre-rich diet to ensure the smooth passing of stools
- Incorporate a few lifestyle changes like losing excess weight, following a healthy diet, and exercising
- Stick to a liquid and bland diet and gradually get back to your regular diet after a few days
- Keep yourself adequately hydrated by drinking a minimum of eight big glasses of water every day
- Work-activity restrictions:
- Avoid strenuous activities like weightlifting for at least five to seven days
- Avoid driving or drinking alcohol for at least 24 hours post-surgery or while consuming painkillers
- 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.