Haemorrhoidectomy (Piles Surgery)

What is a Haemorrhoidectomy?

Haemorrhoidectomy (Piles Surgery) is the surgical excision or ablation of severe internal or external hemorrhoids—swollen and inflamed veins in the rectum and anus. While mild piles are managed conservative or in-clinic non-surgical methods, advanced cases require surgical intervention to achieve lasting relief.

Who Needs Piles Surgery?

Surgery is indicated for persistent, advanced hemorrhoidal disease that impairs quality of life.

Key clinical indicators include:

• Grade III Piles (prolapsed hemorrhoids requiring manual reduction).
• Grade IV Piles (permanently prolapsed, non-reducible hemorrhoidal tissue).
• Chronic, painless bright red rectal bleeding causing anemia.
• Severe pain associated with thrombosed external hemorrhoids.
• Failure of non-surgical treatments (dietary fiber, rubber band ligation, sclerotherapy).

Surgical & Minimally Invasive Options

• Laser Haemorrhoidoplasty (LHP): Advanced minimally invasive procedure using laser energy to shrink hemorrhoids without open cuts.
• Stapled Hemorrhoidopexy (MIPH): Circular stapling device pulls prolapsed tissue back into place and cuts off blood supply.
• Conventional Excisional Haemorrhoidectomy (Milligan-Morgan): Surgical excision of swollen vascular cushions; ideal for large, complex piles.

Benefits of Modern Piles Surgery

1. Complete, permanent resolution of rectal bleeding and prolapse.
2. Laser and stapled options offer minimal post-operative pain.
3. Rapid recovery and return to work within a week.
4. Prevents recurrence and chronic skin tags.

What to Expect Before Surgery?

• Proctoscopy / Anoscopy: Clinical examination to grade the hemorrhoids and rule out rectal lesions.
• Bowel Preparation: Enema administered the night before or morning of surgery to clear the rectum.
• Fasting: 6-8 hours fasting prior to spinal or general anesthesia.

Complete Procedure (Laser / Stapled / Open)

1. Administration of spinal or general anesthesia.
2. Patient positioned comfortably (lithotomy or prone jackknife position).
3. Laser Technique: A laser fiber is inserted into the hemorrhoidal node to vaporize and shrink the vascular tissue from within.
4. Stapled Technique: A specialized circular stapler excises excess tissue above the dentate line and restores anatomical positioning.
5. Open Technique: Excision of hemorrhoidal bundles followed by ligation of mucosal pedicles.
6. Sterile dressing and local anesthetic infiltration applied for pain control.

What to Expect During Surgery?

Procedure duration ranges from 20 to 45 minutes. With modern regional anesthesia, you feel no discomfort during the operation.

Laser Piles Surgery vs Traditional Excision

Success Rate and Safety

Modern laser and stapled piles surgeries have a success rate exceeding 95% with low recurrence rates when high-fiber dietary habits are maintained.

Piles Surgery Cost Estimate

Disclaimer: Final pricing depends on the technique selected (Laser vs Stapler), hospital class, and severity grade.

Recovery Guide & Post-Operative Care

Recovery Timeline

• Day 1: Urination and initial sitting up; commencement of oral liquids and high-fiber diet.
• Day 2-3: Warm Sitz baths (sitting in warm water) recommended after bowel movements.
• Week 1: Significant reduction in pain; return to normal light activities and office work (especially after laser).
• Month 1: Complete mucosal healing.

Post-Op Precautions & Care

• Prevent Constipation: High-fiber diet (fruits, vegetables, psyllium husk) and adequate hydration (2.5 - 3L water/day).
• Sitz Bath: 10-15 minutes in warm water 2-3 times daily to soothe anal tissues and maintain hygiene.
• Avoid Straining: Never strain on the toilet seat; keep bathroom visits under 5 minutes.