Effectiveness of Stapler Surgery for Piles

Stapler surgery for piles

Piles, otherwise known as haemorrhoids of the first and second degree, can be treated easily and effectively with a conservative approach by dietary modifications and appropriate medications. More severe haemorrhoids of third- and fourth-degree are more commonly corrected by standard surgical procedures that are unfortunately associated with a high incidence of complications because of the wide external wounds in the sensitive anal skin.

Stapler surgery for piles, as an alternative to surgical haemorrhoidectomy, has come as a boon in reducing postoperative complications. This approach of stapler surgery as a new piles treatment procedure aims to reduce the size of internal haemorrhoids by interrupting their blood supply and thus proves to be a simple, safe and effective method that results in reduced postoperative pain and early recovery and shorter hospital stay.

Stapler surgery for piles – Procedure

The Stapler surgery for piles was developed in 1998 by world-renowned colorectal surgeon Dr Antonio Longo. It has currently become the gold standard procedure for treating Grade 3 and 4 piles. Stapler surgery is a procedure that uses a stapling device to get rid of haemorrhoidal tissue.

This surgery requires no external incision. This procedure is usually recommended for patients whose haemorrhoids have prolapsed or become abnormally large or for patients who have shown little or no improvement with conservative management. A circular stapler device is used to ‘lift up’ or reposition the prolapsed mucosa and to reduce blood flow to the internal haemorrhoids that shrink in due time.

The best treatment of choice for piles that protrude as third-degree haemorrhoids while straining and seen on physical exam outside the anal verge could be stapler surgery. Stapler surgery for piles removes the abnormally lax and expanded hemorrhoidal supporting tissue that has allowed the haemorrhoids to prolapse downward.

Stapler surgery for piles is faster than traditional piles removal, taking only 30 minutes approximately for an experienced surgeon to perform the procedure. During the procedure, a circular, hollow tube is inserted into the anal canal through which a long woven thread called the suture is placed circumferentially within the anal canal above the internal haemorrhoids.

Through the hollow tube, a disposable instrument with the circular stapling device is placed at the end, and the tips of the suture are brought out of the anus and pulled. The expanded hemorrhoidal supporting tissue gets pulled into the jaws of the stapler while pulling the sutures. Thereby the haemorrhoidal cushions are placed back up into their normal position within the anal canal.

Thereafter, the stapler is fired to cut off the circumferential ring of expanded haemorrhoidal tissue trapped within the stapler. At the same time, the upper and lower edges of the cut tissues also get stapled. As another alternative, simple excision of the external haemorrhoids, if present, may be performed along with stapler surgery.

Stapler surgery for piles – Effectiveness

Stapler surgery for piles as a minimally invasive procedure is more effective than traditional surgery. The healing process is associated with much less pain and complication than the traditional technique. Traditional surgery for piles is operated upon using a scalpel and suture in the area below the dentate line of the anal canal, causing a lot of pain because of the many sensitive nerve endings located in the region.

Whereas, piles surgery in Chennai using the stapler technique involves the operating field that is above the dentate line of the anal canal, devoid of sensory nerve endings.

Stapler surgery technique is highly effective as the arterial blood vessels that travel within the expanded hemorrhoidal tissue and feed the hemorrhoidal vessels are cut, thereby reducing the blood flow to the haemorrhoidal vessels and reducing the size of the haemorrhoids.

Stapler surgery for piles is more effective because of the advantages that the technique offers, which may include:
- Shorter operating time
- Minimal blood loss
- Reduced risk of postoperative complications
- Much lesser pain as compared to traditional surgery
- Short postoperative hospital stays
- Early return to work

Patients experience less bleeding, swelling, and itching around the anus and inside the rectum after stapler surgery. Additionally, stapler surgery is also known to reduce the chance of incontinence after the procedure.

Stapler surgery for piles - Recovery

Though stapler surgery is relatively a new surgical technique, it has rapidly become one of the most popular treatments of choice for piles surgery in Chennai. Stapler surgery has shown better results and early recovery in the treatment of piles.

Due to less postoperative pain and high patient satisfaction, this procedure has been widely accepted by most surgeons. Recovery from stapled haemorrhoidectomy is also associated with fewer complications and earlier return to work.

Recovery from stapled haemorrhoidectomy surgery is faster because the procedure removes the abnormally lax and expanded hemorrhoidal supporting tissue that has allowed the haemorrhoids to prolapse downward and not the haemorrhoids themselves.

The procedure pulls up the prolapsed mucosa and allows the haemorrhoids to shrink on their own by cutting off the blood supply. Thus, this technique makes it easy to recover. Stapler surgery for piles is, although usually reserved for higher grades of internal haemorrhoids, if there are small external haemorrhoids, it becomes less problematic after the stapled haemorrhoidectomy.

The recovery period is associated with much less pain than traditional surgery for piles, and patients usually return earlier to work. Recovery from stapler surgery is also reported to be more comfortable because of reduced postoperative incidence of urinary retention, haemorrhage, constipation or faecal impaction and prolonged wound healing.

Stapler surgery for piles - Risks

Risks are uncommon in stapler surgery for piles. However, there may be some drawbacks which are usually further minimized when the procedure is performed by an experienced surgeon.

The risks may include:
- Feel the needing to rush to the toilet.
- Bleeding
- Restraints from the staple line
- Infection

Complications that have been recorded from various studies after stapler surgery has been at a negligible rate, with recurrence of prolapse in 1 %, anal stenosis in 2 %, and perianal thrombosis in 3 % of patients. Expertise in providing screening, diagnostic and treatment measures such as piles treatment procedure can significantly improve patient outcomes.

Dr. Karthik Gunasekaran