Hemorrhoid Surgeries

• Hereditary predisposition
• Constipation
• Excessive straining
• Age
• Diarrhea
• Pregnancy
• Alcohol
• Yeast and acidic drinks
• Standing or sitting for long periods of time
• Excessive consumption of spicy food

It may cause hemorrhoid formation.

What are the symptoms;

• Bleeding
• Pain
• Swelling
• Itching
• Discharge
• Burning and Wetness Feeling
• Diagnosis;

The diagnosis of hemorrhoidal disease is easily made by examination. Anascopic examination is essential.

In the differential diagnosis, anal cancers, ulcerative colitis, and rectal prolapse should be considered along with other benign diseases of the anal canal. Colonoscopic examination must be performed in necessary cases.

Hemorrhoidal disease is examined under two main headings as internal and external hemorrhoids, depending on the location in the anal canal.
Hemorrhoidal disease is classified in 4 stages according to the symptom and location.

Stage 1: There is bleeding and itching in the anus.

Stage 2: In addition to bleeding and itching, pain begins to occur. Swelling occurs in the anus during defecation. It disappears after defecation.

Stage 3: In addition to Stage 1 and Stage 2, prolapsed hemorrhoids after defecation need to be pushed manually to return to their normal position.

Stage 4: In addition to stage 1 and stage 2, prolapsed hemorrhoids cannot be pushed to the normal position.

Treatment;

Treatment of hemorrhoidal disease depends on the location and stage. It varies depending on. Appropriate treatment selection is essential for success.

Medical treatment should be tried in selected cases. Forced treatment may cause the disease to progress and treatment options to be narrowed.

Infrared Coagulation:

1. and is very successful in 2nd degree internal hemorrhoids. It does not require anesthesia. It causes heat damage to the vascular bundle that feeds the hemorrhoid bundle and causes the hemorrhoid bundle to shrink.

Band Ligation:

1 . It is an effective treatment for stage 2 and appropriate stage 3 internal hemorrhoids. It is known as the binding method. With the help of a tool developed for this method, a rubber band is placed on the base of the hemorrhoidal packet and the hemorrhoidal packet is allowed to fall off on its own. It does not require anesthesia.
Sclerotherapy:

It is used in the treatment of 1st and 2nd degree internal hemorrhoids. It is a method we do not prefer due to its side effects and extreme pain. It is a form of treatment performed by injecting a sclerotherapeutic substance (astringent, destructive) into the hemorrhoid pack.

De Longo (Stapler):

3rd degree and It is especially preferred in internal hemorrhoids that progress with prolapse. It should not be preferred in the presence of intense external hemorrhoids or concomitant anal disease (fissure, etc.). With the help of a disposable tool called stapler, cut the threaded line approximately 4 cm. A circular tissue is excised over it and the sagging hemroidal tissue is pulled up. In this method, the nutrition of the hemorrhoids is reduced as the vascular integrity is disrupted. Over time, internal and external hemorrhoids shrink.

It can be done with general or regional anesthesia. Postoperative pain is quite minimal. Very good results are obtained in suitable cases.

Hemorrhoidal Artery ligation:

It is a successful technique in 1st, 2nd and 3rd degree, especially bleeding and intense internal hemorrhoids. .

The method is based on finding and connecting the arteries feeding the hemorrhoids using a Doppler ultrasound device. There is almost no pain in the postoperative period. There is no need for dressing and recurrence is very rare.

Ligasure:

It is used in 3rd and 4th stage internal and external hemroids. It is known as seamless and bloodless surgery. With a special device called Ligasure and an attached tool, hemorrhoidal pouches can be removed without the need for a scalpel or stitches. It is a form of treatment that we use quite frequently. Pain is less in the postoperative period and surgery time is considerably shorter.

Laser:

Coagulation in 1st and 2nd degree hemorrhoids; It is used for excision in 3rd and 4th stage hemorrhoids.

With the Nd Yag Laser device, especially 1st and 2nd degree hemorrhoids can be successfully treated. Using laser for excision We do not recommend. We prefer the device that uses high frequency sound waves for excision. In this way, wound healing is faster and the risk of infection is reduced.

Surgery:

3. and 4. It is preferred in stage internal and external hemorrhoids. Scalpel, scissors, cautery, ligasure and laser can be used during the operation. There are two different techniques: closed and open hemorrhoidectomy. We prefer the open technique using ligasure or cautery. Proper technique and good surgery reduce postoperative pain and prevent complications such as stenosis.

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