Hemorrhoids are a problem for about ten million people in the United States alone and millions more worldwide. Hemorrhoids are areas of abnormal tissue growth in the anus, very near the anal sphincter. They are usually caused by enlarged blood vessels (almost always veins) and include the inflamed tissue around them. While there are blood vessels in this region normally, they are not called hemorrhoids until they cause some symptom. While there are a number of medical treatments for hemorrhoids, surgery is the definitive treatment. Of the various surgical treatments available, stapled hemorrhoidectomy has several distinct advantages. We will discuss stapled hemorrhoidectomy in relation to other hemorrhoid treatments.
There are two types of hemorrhoids, internal and external. The distinction is made between the two types depending on which tissue is affected by the hemorrhoid. Both internal and external hemorrhoids can prolapse, or come outside of the body through the anal sphincter, but the originating tissue is what makes the distinction. In general, internal hemorrhoids are not usually painful unless they become inflamed while external hemorrhoids are exquisitely irritating and painful even if they are very small.
For the most part, stapled hemorrhoidectomy is used to treat internal, not external hemorrhoids.
Stapled hemorrhoidectomy is a relatively recent addition to hemorrhoid removal surgery. While stapled hemorrhoidectomy surgery was pioneered only a decade ago, it has fast become one of the primary hemorrhoid treatment surgeries. Stapled hemorrhoidectomy uses a circular stapling device that is inserted in the anus. The stapling device takes a hold of the large intestine several centimeters into the rectum. The intestine is a large circular tube, of sorts, and the stapled hemorrhoidectomy device takes a band of tissue within the rectum all the way around the circumference. The tissue, which is really just the first layers of the inside of the rectum, is removed and stapled closed. This pulls back the prolapsed hemorrhoid and holds it in place.
While not much hemorrhoid tissue is removed during a stapled hemorrhoidectomy, the blood vessels that supply the hemorrhoids are squeezed shut. This reduces the size of the hemorrhoid or inflamed blood vessel. Even though stapled hemorrhoidectomy surgery is performed on internal hemorrhoids, the squeezing of this internal blood vessels and pulling back of the anatomy into a normal position tends to correct external hemorrhoids as well.
Stapled hemorrhoidectomy has met with some controversy and, being a relatively new procedure, was not widely adopted initially. However, head to head trials with other hemorrhoidectomy surgeries, namely excision hemorrhoidectomy, showed it to be associated with less pain and quicker recovery. Excision hemorrhoidectomy is a procedure in which the hemorrhoid tissue is cut out directly without pulling back prolapsed (hanging out) tissue. Many colorectal surgeons predict that stapled hemorrhoidectomy may become the new gold standard hemorrhoid surgery. The procedure is faster than excision hemorrhoidectomy, is less painful during recovery, and patients return to work faster.
Stapled hemorrhoidectomy or stapled hemorrhoid surgery is also known as procedure for prolapsing hemorrhoids (PPH). The approach may not be effective for treating hemorrhoids that are not prolapsed (sticking out or threatening to stick out of the anus).