Hemorrhoids are one of the most common ailments known in both men and women, but many suffer in silence rather than discuss hemorrhoid treatment with their doctor.

What are hemorrhoids?

Hemorrhoids are described as masses or clumps (“cushions”) of tissue within the anal canal that contain blood vessels and the surrounding, supporting tissue made up of muscle and elastic fibers. The anal canal is the last four centimeters through which stool passes as it goes from the rectum to the outside world. One reason people do not talk about hemorrhoid problems with their doctor is because they anticipate a painful, traditional hemorrhoid surgery.

Symptoms include painless bleeding while passing stools and sometimes tissue coming out of anus.

What is stapled hemorrhoidectomy?

Stapled hemorrhoidectomy is the newest surgical technique for treating hemorrhoids, and it has rapidly become the treatment of choice for second & third-degree hemorrhoids. Stapled hemorrhoidectomy removes the abnormally lax and expanded hemorrhoidal supporting tissue that has allowed the hemorrhoids to prolapse downward and bleed.

PROCEDURE

Longo’s technique is based on the principle that the disruption of the feeding vessels that supply the haemorrhoids would be sufficient to relieve engorgement of the distal anal cushion structures, hence decreasing haemorrhoidal symptoms. This involves a circumferential mucosectomy where a ring of rectal mucosa, containing the superior haemorrhoidal arteries, is removed above the base of the haemorrhoids. This important second part of the procedure “creates” a “new” haemorrhoidal suspensory ligament and may be important in preventing recurrence. All these are performed with a special anorectal circular stapling kit, and avoids any incisions into sensitive anoderm and skin below the dentate line. This therefore theoretically lessens the pain following the procedure. Longo’s technique revolutionised haemorrhoidal surgery as it is based on the correction of the pathophysiology of piles symptomology. This is as opposed to conventional surgical haemorrhoidectomy which is merely an ablation of symptoms i.e. excision of troublesome piles without regard for their anatomical significance. Stapled haemorrhoidectomy is done to achieve both correction of anatomy and ablation of symptoms utilizing surgical and physiological principles.

NOTE

One should never assume that a common symptom of haemorrhoids like rectal bleeding is definitely just from haemorrhoids. Proper consultation and examination is essential and then treatment options can be tailored.