Stapled hemorrhoidectomy


Also known as stapled hemorrhoidopexy.

A surgical procedure that involves the removal of abnormally enlarged hemorrhoidal tissue, followed by the repositioning of the remaining hemorrhoidal tissue back to its normal anatomic position.

It employs a unique circular stapler which reduces the degree of prolapse by excising a circumferential strip of mucosa from the proximal anal canal.

It pulls the hemorrhoidal cushions back up into their normal anatomical position.

Tolerable post-operative pain and is generally reserved for excision for the most severe cases of prolapse, or for patients who have failed to respond to conventional treatments.

Stapled hemorrhoidopexy has unique complications-rectovaginal fistula, staple line bleeding, and stricture at the staple line.

It is indicated for the more severe cases of internal hemorrhoidal prolapse (3rd and 4th degree) where surgery would normally be indicated, and in patients with minor degree hemorrhoids who have failed to respond to conservative treatments.

The procedure may be contra-indicated when only one cushion is prolapsed or in severe cases of fibrotic changes which cannot be physically repositioned.

It usually performed under general anesthesia, but many cases have been performed under local or regional anesthesia.

Patients will usually be discharged either the same day or on the day following surgery, with resumption of normal activities after a few days.

Bleeding is the most common postoperative complication.

Severe postoperative pain could be caused by dehiscence of the anastomosis or due to the fact that the anastomosis is too near to the linea dentate.

Urge incontinence due to lesions of the sphincter muscle or a diminished rectal capacity are common complications, the procedure is not performed properly.

Rectovaginal fistulas and anastomotic diverticula are very rare but possible.

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