subject: Procedure For Prolapsing Hemorrhoids [print this page] Operative resection is reserved for patients with third- and fourth-degree hemorrhoids, patients who fail nonoperative therapy, and patients who also have significant symptoms from external hemorrhoids or skin tags. Laser hemorrhoidectomy, as opposed to conventional scalpel and electrocautery techniques, is associated with many myths.
Hemorrhoidectomy factories have touted painless or decreased pain and shortened healing times as advantages to performing hemorrhoidectomies by laser. No documented studies support these claims. In fact, one prospective study found no difference between scalpel and laser hemorrhoidectomy.
Stapled hemorrhoid surgery, or procedure for prolapsing hemorrhoids (PPH), has become prominent. It was first described in 1997-1998. During PPH, a specially designed circular stapler with smaller staples is used. The technique involves placing a suture in the mucosal and submucosal layers circumferentially, approximately 3-4 cm above the dentate line. The stapler is placed and slowly closed around the purse string.
Care is taken to draw excess internal hemorrhoidal tissue into the stapler. The stapler is fired, resecting the excess tissue and placing a circular staple line above the dentate line. This results in resection of excessive internal hemorrhoidal tissue, pexy of the internal hemorrhoidal tissue left behind, and interruption of the blood supply from above. PPH can be done as an outpatient procedure, using local anesthesia with intravenous sedation.
PPH is mainly used to treat internal hemorrhoids that are not amenable to conservative and nonoperative therapies. Narcotic use and recovery is significantly decreased compared with conventional operative hemorrhoid surgery. PPH does not directly affect the external tissue. Reports have described shrinking of external hemorrhoidal tissue after PPH, probably from decreased blood flow.
In patients receiving PPH, pain seems to be less severe and of shorter duration than it is in patients who undergo conventional surgery. The use of PPH is suggested in patients with large internal hemorrhoids and minimal external component. This procedure can be done in an outpatient setting with local anesthesia, similar to the protocol used for conventional hemorrhoid surgery.
Operative resection is reserved for patients with hygiene trouble caused by large skin tags, a history of multiple external thromboses, or internal hemorrhoid trouble. Perform the operation in the outpatient setting. Proper anesthetic care, attention to perioperative fluid restriction, and careful postoperative instructions can ease the patient's recovery.
Patients with ulcerative colitis can tolerate aggressive surgery if it is needed. Treat underlying acute disease before any elective anorectal surgery. Avoid aggressive treatment in patients with Crohn disease, especially if the rectal mucosa is acutely inflamed. Drain abscesses as soon as possible, despite active disease elsewhere.
PPH factories claim that these are the advantages of anal laser surgery, though there are no documented studies to support these claims. CURED have combined certified organic medicinal plant extracts with healing botanicals to create their hemorrhoid cures. These extracts display a remarkable array of pharmacological and biochemical actions to reverse hemorrhoids.
They have been shown to be an excellent cures for hemorrhoids in scientific trials. The therapeutic result of HemorrhoidCure in eliminating hemorrhoids is accomplished via its rapid absorption into cell membranes and deep penetrating action. The active certified organic ingredients in this cure for hemorrhoids are lipophilic, highly astringent, and have a low molecular weight.
The lipophilic tendency means they are soluble in fatty or skin tissue, allowing them to be absorbed by cell membranes. As a result, the treatment readily passes into rectal tissue where the astringent properties safely and gently contract blood vessels, ideal for hemorrhoid cure. Swelling of hemorrhoids is therefore greatly reduced upon application, easing pain in the nerve endings.
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