At a glance

Haemorrhoids, otherwise known as piles, are vascular structures in the anal canal that become problematic if they become swollen, prolapse or bleed. A haemorrhoidectomy is done to remove severe haemorrhoids when non-surgical treatment options have failed to treat them. If a haemorrhoid becomes thrombosed, meaning it has developed blood clots, an incision and drainage of the clot is performed but dependent on the timing of presentation. A haemorrhoidectomy is done by removing the haemorrhoid and suture ligating the blood vessels that supply the haemorrhoidal tissue.

How to prepare for the procedure

Prior to a haemorrhoidectomy, Dr Maraj will advise you how to prepare for the procedure. You will need to restrict your eating and drinking 6 hours before the procedure and may be given an enema pre-operatively. A haemorrhoidectomy is performed in theatre, under general anaesthesia. You are required to stay in hospital post-procedure, based on intra-operative findings, the effects of the anaesthesia or if any complications occurred.

What a haemorrhoidectomy involves

The procedure is performed while you are under general anaesthesia or a regional spinal block. Dr Maraj will advise you prior to surgery which approach she may take.

Generally, she performs a Milligan Morgan haemorrhoidectomy which involves dissecting the haemorrhoid tissue down to the vascular pedicle and suture ligating the vascular pedicle. Alternative options include rubber band ligation, Doppler-guided haemorrhoidectomy artery ligation and mucopexy. These options will be discussed pre-operatively.

What to expect post-procedure

Afterwards, you can expect some rectal and anal pain and minimal bleeding. You may need to stay in hospital overnight for observation after the surgery. You will be instructed on how to care for your wounds; in some cases, a sitz bath may ease post-surgery discomfort. The recovery time for surgical procedures that remove haemorrhoids vary, but you can expect recovery within 1-3 weeks. You will be discharged and given a regime of stool softeners, analgesics, sitz-bath and dietary modifications.

This is a guide to assist you with a basic understanding of the procedure. If you require any further information, please ask Dr Maraj directly.

Risks & complications

Guidelines and protocols are followed to prevent complications, you will be closely monitored for complications such a bleeding, infections, fecal incontinence, damage to surrounding tissues and perforation, recurrence, urinary retention and pain. This will be appropriately treated and may require hospitalisation and further intervention.