Hemorrhoidopexy

A hemorrhoidopexy is a surgical procedure that healthcare providers sometimes use to treat hemorrhoids. Hemorrhoids are swollen, enlarged veins that form inside your rectum and around your anus (butthole).

During a hemorrhoidopexy (pronounced “HEM-roido-pek-see”), a surgeon lifts the hemorrhoid tissue up into your rectum. Then, they use a special stapler to secure it in place. This helps reduce symptoms like swelling, bleeding and soreness. The procedure uses a surgical stapler. So, you may also hear the term “stapled hemorrhoidopexy.”

When is this procedure used?

Hemorrhoidopexy is different from regular hemorrhoid removal surgery. It’s only used for internal hemorrhoids, not external ones. Healthcare providers don’t use it as often as other hemorrhoid procedures. It’s less common than rubber band ligation and hemorrhoidectomy.

Providers mostly use hemorrhoidopexy to treat large or prolapsed hemorrhoids. These are internal hemorrhoids that have slipped down or bulged out of your anus.

Good candidates for the procedure include people with severe hemorrhoids who haven’t responded to home treatments, like:

• Changes to what you eat
• Over-the-counter (OTC) medications
• Sitz baths

A surgeon may use this procedure if other techniques haven’t worked. Some surgeons prefer it because it often causes less pain and has a quicker recovery. But it’s not available at all hospitals because it requires special equipment and training.

How should I prepare for this procedure?

Before surgery, your surgeon will give you instructions to follow. You may need to:

• Fast: You may have to stop eating or drinking for several hours before the procedure.
• Adjust your medicines: Your provider may tell you to stop taking certain medications for a short time.
• Empty your colon: You may have to clean out your bowels with medicine or an enema.
• Arrange a ride home: You won’t be able to drive yourself home after surgery.

You should also stop smoking and avoid alcohol before and after surgery. Always follow the specific directions your provider gives you.

What happens during a hemorrhoidopexy procedure?

First, a healthcare provider will insert an IV into one of your veins. Through this tube, you’ll get anesthesia so you don’t feel any pain.

Then, your surgeon will:

1. Insert a smooth tube called a dilator into your anus to gently stretch open your anal canal.
2. Place a circular stitch in the tissue of your rectum, just above the hemorrhoid.
3. Insert a tool called a circular stapling device.
4. Pull the hemorrhoid up into your rectum.
5. Tie the stitches together to gather the hemorrhoid tissue into the stapler.
6. Staple the excess tissue to your rectum.

The procedure cuts off the blood supply to the hemorrhoid, which makes it shrink.

How long does this procedure take?

Hemorrhoidopexy usually takes about 30 to 45 minutes. This doesn’t include time spent preparing for and recovering from surgery.

What are the potential benefits and risks of this procedure?

It’s important to discuss the benefits and risks of hemorrhoidopexy with your surgeon before making a decision.

Benefits may include:

• Treats severe hemorrhoids: It works for prolapses and other internal hemorrhoids that need advanced treatment.
• Minimally invasive: You may have a shorter hospital stay and faster recovery.
• Less pain afterward: Compared to traditional hemorrhoidectomy, many people have less pain during recovery.

Risks may include:

• Infection: Rarely, the surgical site can get infected.
• Bleeding: You might notice bleeding a few days after surgery.
• Return of hemorrhoids: There’s a higher chance of hemorrhoids coming back than with traditional surgery.
• Damage to your anal sphincter (rare): Injury to anal tissues can occur.

What happens after this procedure?

After surgery, your provider may place gauze or a foam dressing in your anus to stop the bleeding. It will come out the next time you poop.

A provider will take you to a recovery room. Your healthcare team will watch you closely as the anesthesia wears off. You may feel groggy or confused after it wears off. You might also feel sick to your stomach or like you might vomit. Your providers may give you medication to relieve these symptoms.

What is the hemorrhoidopexy recovery time?

People usually go home the same day. Healing time is typically a couple of weeks. Most people return to light activities sooner than with traditional hemorrhoid removal surgery. But you’ll need to avoid more demanding activities for two to four weeks.

It’s normal to feel some pressure or soreness in your anus after surgery. Your healthcare provider may prescribe a pain medication. They may also recommend:

• Using a stool softener
• Eating foods high in fiber
• Drinking plenty of water
• Taking warm sitz baths

Make sure to follow up with your surgeon after surgery. They’ll want to check the results and make sure you’re healing properly.