Traditional Hemorrhoidectomy: Is It Still Relevant?

Medically reviewed by: Gary H. Hoffman, MD

Who Needs The Traditional Hemorrhoidectomy?

Prior to the advent of newer operative procedures for the treatment of hemorrhoids, the only tool in the armamentarium of the proctologist, also known as a colon and rectal surgeon, was a surgical hemorrhoidectomy.  The surgeon simply cut out the hemorrhoids.  With the advent of PPH (procedure For Prolapse And Hemorrhoids), and THD (Transarterial Hemorrhoidal Dearterialization), the traditional hemorrhoidectomy was relegated to use in only certain specific cases.

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While the newer procedures achieve their goals in different ways, the traditional hemorrhoidectomy achieved its goal through a simple surgical removal of the offending hemorrhoid or hemorrhoids. However, the success of the procedure came at a cost; the cost being intense, prolonged postoperative pain, and a lengthy recovery from the hemorrhoidectomy.

What Is A Hemorrhoid?

When we are born, so too are our hemorrhoids.  They are natural cushions in the anal canal.  They serve to protect the anal opening during the passage of stool.  There are three hemorrhoidal groups in the anal canal.

Each cushion is made up of veins, arteries, nerves and connective tissue.  The connective tissue anchors the complex to the wall of the anus.  For many Americans, hemorrhoids never become a problem; never become symptomatic.  However, for more than 50% of American adults, the hemorrhoids enlarge and cause symptoms.

  • Pain
  • Bleeding
  • Itching
  • Discharge
  • Prolapse (protrusion)

When And How Are Hemorrhoids Removed?

As symptoms begin, your physician will try several medical remedies to stop the symptoms.  Stool softeners, creams, ointments and topical measures are all used.  When these are unsuccessful, more invasive measures are tried.

Finally, when all else fails, surgery will be needed.  Today, a PPH or THD may be used.  However, with external hemorrhoids, with strangulated hemorrhoids, or with hemorrhoids that are so large that they must be surgically removed, they must be removed with the surgeon’s scalpel.

Under anesthesia, the surgeon artfully ties off the hemorrhoid vessels using suture, in order to control any bleeding.  Following this, a scalpel or cautery is then used to cut out the hemorrhoid.  It is as simple as that.

Why Not Always Use A Traditional Hemorrhoidectomy?

The simple answer:  Because in the postoperative period, the operative area is painful.  And it can be painful for up to 4 to 6 weeks.  Commonly, the pain diminishes in 2 weeks.  But a longer pain period is not rare.  The use of the traditional hemorrhoidectomy has decreased with the introduction of PPH and THD.

Los Angeles Colon and Rectal Surgical Associates.  Your Skilled Surgeon.

The board certified surgeons of Los Angeles Colon and Rectal Surgical Associates will try, whenever possible, to treat your hemorrhoids in the most conservative, non-invasive manner possible.  But when an operation is needed, each treatment program will be individualized.

By calling (310)273-2310, you can schedule your confidential consultation and begin the road to education and treatment.  You will be examined and then have a chance to ask questions about the proposed treatment plan.  But you must take the first step and be seen by your physician.

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