Stapled hemorrhoidectomy, a circular, hollow tube is inserted into the anal canal. The stapler which is made by ethicon company is a disposable instrument with a circular stapling device at the end. This is also called as PPH stapler. PPH stands for procedure for prolapse and hemorrhoid. Stapler is placed through the first hollow tube and the ends of the suture are pulled. Pulling the suture pulls the expanded hemorrhoidal supporting tissue as purse string into the jaws of the stapler. The hemorrhoidal cushions are pulled back up into their normal position within the anal canal.
The internal hemorrhoids shrink in a few weeks Stapled hemorrhoidectomy is a misnomer since the surgery does not remove the hemorrhoids but, rather, the abnormally lax and expanded hemorrhoidal supporting tissue that has allowed the hemorrhoids to prolapse downward. For stapled hemorrhoidectomy, a circular, hollow tube is inserted into the anal canal.
It is relatively new surgical technique for treating hemorrhoids, and it has rapidly become one of the treatment of choice for third-degree hemorrhoids. Stapled hemorrhoidectomy is a misnomer since the surgery does not remove the hemorrhoids but, rather, the abnormally lax and expanded hemorrhoidal supporting tissue that has allowed the hemorrhoids to prolapse downward. Once the blood supply of hemorrhoidal tissue is cut off it is cured and the prolapsed mucosa will be pulled up.
Stapled hemorrhoidectomy, although it can be used to treat second degree hemorrhoids, usually is reserved for higher grades of hemorrhoids - third and fourth degree. If in addition to internal hemorrhoids there are small external hemorrhoids that are causing a problem, the external hemorrhoids may become less problematic after the stapled hemorrhoidectomy.
During stapled hemorrhoidectomy, 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 hemorrhoidal vessels and reducing the size of the hemorrhoids.
Stapled hemorrhoidectomy is faster than traditional hemorrhoidectomy, taking approximately 30 minutes to perform the surgery in experienced hand. It is associated with much less pain than traditional hemorrhoidectomy and patients usually return earlier to work.
Stapler surgery for piles is associated with much less pain than the traditional technique. This is because in Stapler surgery, the operating field is above the sensitive portion of the anal canal (i.e. above the dentate line. A person has sensations below the dentate line). In the traditional haemorrhoidectomy done using scalpel and sutures, the area below the dentate line is operated upon, affecting many sensitive nerve endings, typically causing a lot of pain.
Interestingly, in one study done for stapler hemorrhoidectomy, 65% of complications occurred after the surgeon had done 25 or more cases, suggesting that the learning curve phenomenon does not apply. Septic complications in this study, and others, have been very rare. Bacteraemia after haemorrhoidectomy is more common with stapled hemorrhoidectomy rather than after conventional hemorrhoidectomy, but this does not seem to have clinical relevance.
Although uncommon, Stapler surgery may have some drawbacks. These are further minimized when performed by an experienced surgeon. The risks include but are not limited to:
