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Hemorrhoidectomy: Surgical Hemorrhoid Removal

Typically, a hemorrhoidectomy is only needed for the most severe cases. If a patient has symptomatic hemorrhoids, a less invasive treatment, such as rubber band ligation, can be just as effective without the pain and recovery time.

However, if surgical treatment is needed, several types of hemorrhoidectomies are available and most can be performed on an outpatient basis. They include:

  • Conventional surgical hemorrhoidectomy: This procedure involves clamping, tying off and then cutting the hemorrhoidal tissue away. The wound is then sutured and gauze and antibiotic ointment are applied. This procedure can result in more pain and recovery time than other hemorrhoidectomy methods and may result in a short hospital stay in some cases.
  • Stapled hemorrhoidectomy (PPH): This technique utilizes a special stapling device that cuts through the involved vessels and staples the tissue back together again. This is associated with a bit less pain than a conventional hemorrhoidectomy, and is becoming more popular with many surgeons. However, not all cases are suitable for this type of procedure. While generally resulting in less post-operative pain and disability, there still is a significant recovery time and like any surgical procedure is accompanied by a small risk of significant post-surgical complications.
  • Harmonic scalpel removal: A special scalpel that relies on ultrasound waves is used as a cutting device in this procedure, and also allows for sealing of some of the associated blood vessels. This is commonly used for large hemorrhoids or for situations where the removal needs to be as bloodless as possible. The recovery time and pain involved with harmonic scalpel procedures may be a bit less than for a conventional surgical hemorrhoidectomy.
  • Laser removal: This is an effective hemorrhoid removal procedure that is utilized for certain patients. During this procedure, a laser beam frees up and removes the involved hemorrhoidal tissue. The heat of the laser cauterizes the blood vessels so the hemorrhoid removal procedure is nearly bloodless. This is commonly done on an outpatient basis, and may also be accompanied by a bit less pain than a conventional surgical hemorrhoidectomy.
  • Atomizing: As the name suggests, this hemorrhoid removal procedure involves blasting a hemorrhoid into very small pieces. A small vacuum is used in conjunction with the atomization tool to suck up the tissue. This is one of the latest hemorrhoid removal procedures.

While a hemorrhoidectomy is a valid treatment in some circumstances, 99% of patients can avoid surgery.

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