Surgery treatment of haemorrhoids

In the early stages, hemorrhoids can be treated with conservative methods, but most patients consult a proctologist later. When the size or number of nodes increases, surgical treatment becomes necessary. At Oxford Medical, this is performed using modern minimally invasive techniques:

• ligation of hemorrhoidal nodes with latex rings;
• Doppler-guided HAL-RAR dearterialization;
• infrared photocoagulation;
• laser hemorrhoidoplasty;
• radiofrequency ablation.

These methods allow the removal of hemorrhoidal nodes in one procedure (several sessions may be needed for latex ring ligation), often without the need for hospitalization.

Hemorrhoidectomy — radical excision of hemorrhoidal nodes with a scalpel — is prescribed only in the most severe cases when other techniques are ineffective. About 10% of patients require such surgery.

Hemorrhoids occur due to varicose enlargement of the veins in the hemorrhoidal plexus of the anal canal and are accompanied by the formation of venous nodes. They may be located inside the rectum or outside the anus, and in combined hemorrhoids — on both sides.

At an early stage, the disease is almost asymptomatic, so many patients delay seeing a doctor. Symptoms appear when the nodes enlarge. In such cases, surgical treatment is usually required. The choice of technique depends on the stage of hemorrhoids and the patient’s individual characteristics.

Minimally invasive techniques are used for uncomplicated stage 1–3 hemorrhoids.

Indications for hemorrhoidectomy include:

• Prolapse of internal hemorrhoidal nodes;

• Strangulation of one or more nodes;

• Thrombosis of the node;

• Frequent bleeding;

• Combination of hemorrhoids with anal fissures or rectal fistula;

• Insufficient effect from conservative or minimally invasive methods.

Minimally invasive treatment of hemorrhoids does not require hospitalization and allows the patient to return to work and normal activities within 1–2 days.

The procedures are carried out as follows:

• Ligation with latex rings – a special ligator is used to place a latex ring on the vascular stalk of the node. The blood supply is cut off, and in 2–3 weeks the node turns into connective tissue and heals completely.

• HAL-RAR Doppler dearterialization – an anoscope with a Doppler sensor is inserted into the rectum. Using the sensor, the proctologist sequentially sutures the arteries, blocking blood supply to the hemorrhoidal nodes. Then, mucopexy is performed — the node is lifted and repositioned. The lack of blood supply causes the nodes to shrink and fall off naturally within 1–2 weeks.

• Laser hemorrhoidoplasty – the vascular stalk of the node is punctured using high-frequency infrared radiation, then the node is thermally treated with a laser. Part of the vascular tissue evaporates, the hemorrhoid reduces in size and is replaced by connective tissue.

• Infrared photocoagulation – similar to laser treatment, but uses infrared radiation to heat and coagulate internal hemorrhoidal nodes.

• Radiofrequency ablation – involves the use of radiofrequency energy to irradiate and coagulate hemorrhoidal nodes. The proctologist uses a special device to apply radio waves to the nodes, heating and coagulating the vessels and reducing the nodes.

These procedures do not require general anesthesia. Local anesthesia or sedation (medication-induced sleep) is used for patient comfort.

Radical hemorrhoidectomy requires hospitalization, preoperative preparation, anesthesia, and adherence to postoperative care rules.

At Oxford Medical, hemorrhoidectomy is performed using the Longo method (also known as stapled hemorrhoidopexy), currently considered the most sparing and effective.

The procedure involves removing a circular segment of mucosa and submucosa with vessels, which allows internal nodes to be pulled up and blood supply to be cut off. Deprived of nutrients, the hemorrhoidal nodes gradually shrink.

Oxford Medical operates a high-tech surgical inpatient facility equipped with expert-level devices. This enables both minimally invasive and classical surgical hemorrhoid treatments.

When a patient comes to the clinic, a comprehensive diagnosis is first performed. Based on the results, proctologists and surgeons select the most appropriate treatment method.

Advantages of treatment at Oxford Medical include:

• Use of minimally invasive techniques that do not require hospitalization or anesthesia;

• Longo hemorrhoidectomy for complex cases;

• High professionalism of proctologist-surgeons;

• Advanced equipment from leading European and American manufacturers (for laser and radio wave therapy, infrared photocoagulation, HAL-RAR, etc.);

• Comfortable single and double patient rooms.