Hemorrhoidectomy

Hemorrhoidectomy is the name given to the surgical procedure to remove severe hemorrhoids. Surgery is performed under general anesthetic so, during the operation you will not feel any pain.
Surgeons use different tools to cut out the swollen hemorrhoid tissue including a scalpel, an electric scalpel or medical grade saw and, in the past few years lasers have also been introduced. Some surgeons use a stapling technique which does not remove the hemorrhoid but pushes it back inside the anal wall and is secured using a stapling device.
During the procedure any veins leading to the hemorrhoid are closed with stitches that dissolve after a few weeks. The wound, which can be stitched or left open, is padded after surgery.

After Surgery

You are normally able to leave hospital on the same day however, because of the anesthetic you should not drive. You will be given pain killers and antibiotics, as post surgery pain can be quite uncomfortable. Expect to see some bleeding especially when you pass a stool although this should not last for more than a day. Bowel movements can be painful after a hemorrhoidectomy and locally administered pain relief should be considered.
Make sure you are prepared with ice packs, take fiber supplements before and after surgery to help your digestive transit and drink plenty of fluids.
After 14 to 21 days your surgeon will want to see you again to check that the wound is healing and there are no complications.

Who should have a Hemorrhoidectomy?

If you suffer repeatedly from severe hemorrhoids and earlier procedures and treatment have failed this surgery may be the best option. If you are in a lot of pain from external hemorrhoids, have tried rubber band ligation and the condition is affecting your everyday life and ability to wash properly after bowel movements then you may be recommended for hemorrhoid surgery. Those with prolapsed or thrombosed hemorrhoids may have a procedure called PPH — procedure for prolapsed hemorrhoids — which is basically a stapled hemorrhoidectomy.

Surgery is not usually performed on minor internal hemorrhoids however, severe cases or cases where you have both internal and external hemorrhoids you may require treatment.

After surgery — if not before — you need to be able to address the reasons that your hemorrhoids have required surgery. You may be unlucky and have a natural weakness or bowel complaint that predisposes you to the condition. Even so a healthy, balanced diet and healthy lifestyle that incorporates regular exercise is a must for anyone who has had a hemorrhoidectomy.

After undergoing this surgery you have a 95% chance that your hemorrhoids will never come back, subject to you leading a healthier lifestyle.

Complications

Perhaps the most serious complication is a fistula or anal fissure — tear in the anal canal — which can lead to severe infection and death. This is rare and surgeons make every effort to stop this from happening. Another risk is that you become incontinent or have a constriction of the anal canal causing constipation although stool softeners may help.
Several weeks post surgery, you may well still be feeling pain and although you should try to stop taking painkillers after this length of time you can still help the post operative recovery time shorten. Sitz baths are recommended as are stool softeners. A sitz bath is simply a way to soak the anal area in a small bath using alternate hot and cold water.