Stapled hemorrhoidectomy is the newest surgical technique for treating hemorrhoids third and fourth degree and it can be used to treat patients who have both internal and external hemorrhoids, but there is also an option to combine a stapled hemorrhoidectomy to treat the internal hemorrhoids and a simple resection of the external hemorrhoids.
Hemorrhoids are masses of tissue within the anal canal that contain blood vessels and the surrounding, supporting tissue made up of muscle and elastic fibers. They are present in everyone, but when enlarged, they cause problems and are considered abnormal or a disease. This occurs equally in men and women and mostly between 45 and 65 years of age.
During the procedure, a circular, hollow tube is inserted into the anal canal and through this tube, a suture (a long thread) is placed within the anal canal above the internal hemorrhoids and the ends of the suture are brought out of the anus through the hollow tube.
The stapler, a disposable instrument with a circular stapling device at the end, is placed through the first hollow tube and the ends of the suture are pulled. Pulling the suture pulls the expanded hemorrhoidal supporting tissue into the jaws of the stapler.
The hemorrhoidal cushions are pulled back up into their normal position within the anal canal and the stapler is fired. When it fires, the stapler cuts off the circumferential ring of expanded hemorrhoidal tissue trapped within the stapler and at the same time staples together the upper and lower edges of the cut tissue.
The procedure takes approximately 30 minutes.
During the healing of the cut tissues around the staples, scar tissue is formed and it anchors the hemorrhoidal cushions in their normal position higher in the anal canal. Then the staples fall off and pass in the stool unnoticed after several weeks.
The advantage of stapled hemorrhoidectomy is much less pain than traditional hemorrhoidectomy so the patient usually returns earlier to work.
The risks of stapled hemorrhoidectomy include:
- Anal (tearing of the lining of the anal canal)
- Narrowing of the anal or rectal wall due to scarring
- Persistence of internal or external hemorrhoids
- Rarely,trauma to the rectal wall