Stapled Hemorrhoidopexy

WHAT YOU SHOULD KNOW:

• Stapled hemorrhoidopexy is a surgery to treat hemorrhoids. It is also called stapled hemorrhoidectomy or procedure for prolapse and hemorrhoids (PPH). Hemorrhoids are blood vessels surrounded by cushions of skin tissue inside your anus or rectum. Your anus is the opening where the stool from your bowel movements (BM) leaves your body. Your rectum is the lower part of your bowel just behind your anus. You may have hemorrhoids disease when these blood vessels become swollen and slip out of place. Hemorrhoid disease can occur inside your rectum (internal hemorrhoids), around your anus (external hemorrhoids), or both (mixed hemorrhoids). Sometimes the hemorrhoid may prolapse, which means it extends out of your anus.
  
  
• Your hemorrhoids may be caused by straining during a bowel movement or weak skin tissue around your anus. Anal intercourse (sex) and poor anal hygiene may also cause hemorrhoids. You may need stapled hemorrhoidopexy if your hemorrhoids are large or have prolapsed. A stapled hemorrhoidopexy may also be done if other treatments do not work for you. During this surgery, your caregiver will attach your prolapsed tissues onto your rectal wall using a special stapler. Although the hemorrhoids are not removed, their blood flow is cut off. A stapled hemorrhoidopexy may decrease pain, bleeding, swelling, and itching around your anal area and inside your rectum. It may also help you avoid urine or stool accidents (incontinence).

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

• With hemorrhoidopexy, too much or too little tissue may be removed. The stapled skin tissue may detach from your rectal or anal canal. Even with surgery, you may get hemorrhoids again. After your surgery, you may have pain, bleeding, bruising, or infection. It may be painful or difficult to urinate or have a BM. You may have urine or stool incontinence or suddenly realize you need to have a BM immediately. The tissue in your rectum or anus may have an anal fissure (tear), causing pain or itching. Your anus may also become more narrow.
  
  
• It is possible that you may get a serious infection in your blood. You may also start bleeding so much that you cannot stop it. This is called a hemorrhage. You may need another surgery to fix these problems. Without surgery, your hemorrhoids may continue to grow, hurt, and bleed. You may develop a blood clot called a thrombosis. You might develop a hemorrhoid emergency where you have very bad pain, bleeding, and swelling. Call your caregiver if you have concerns or questions about your surgery, condition, or care.

WHILE YOU ARE HERE:

• Informed consent: A consent form is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.
  
  
• IV: An IV (intravenous) is a small tube placed in your vein that is used to give you medicine or liquids.
  
  
• Antibiotics: This medicine is given to help treat or prevent an infection caused by bacteria.
  
  
• Enema: You may be given an enema to empty and clean out your bowel. An enema is a special liquid that is placed into your rectum to help you have a BM.
  
  
• Pre-op care: You are taken to the room where your surgery will be done and moved to a special table. You may be asked to lie on your stomach or on your back with your knees bent upwards.
  
  
• Anesthesia: This is medicine to make you comfortable during the surgery. Caregivers work with you to decide which anesthesia is best for you.
  
  
  • General anesthesia: Caregivers use this medicine to keep you asleep and free from pain during surgery. They give you anesthesia through your IV or as a gas. You may breathe in the gas through a mask or through a breathing tube placed down your throat. The tube may cause you to have a sore throat when you wake up.
    
    
  • Regional anesthesia: Medicine is injected to numb the body area where the surgery or procedure will be done. You will remain awake during the surgery or procedure.
    
    
  • Local anesthesia: This is a shot of numbing medicine that is put into the walls of your rectum. Medicine to decrease bleeding may be added to the numbing medicine.
  
  
• Monitoring: Your heart rate and blood pressure will be checked during surgery. These help your caregiver see how your heart and lungs are doing during the surgery.

During your surgery:

• Your skin is cleaned and sheets will be put over you to keep the surgery area clean. A special tool is placed in your anus to keep it open. A suction tool may be used to remove stool and mucous inside your rectum. Your caregiver uses a special round staple gun once. Your caregiver uses the stapler to tighten your skin tissue around your anal canal. This is done to help stop your skin tissue and hemorrhoids from prolapsing in the future.
  
  
• At the same time, your caregiver will staple the hemorrhoid to the rectal or anal wall. Stapling at the base of the hemorrhoid stops the blood flow to your hemorrhoid, resulting in decreased swelling. Extra tissue will be taken out and sent to the lab for tests. Injured blood vessels are tied to stop bleeding. You may need stitches depending on how much you bleed around your surgery area.

After your surgery:

You will be taken to a room where you can rest until you are awake. You may be allowed to go home. If you are staying in the hospital, you will be taken back to your room. Your caregiver may remove the special sponge soon after surgery. Do not try to get out of bed until your caregiver says it is OK.

• Medicines:
  
  
  • Medicines to treat pain, swelling, or fever: These medicines are safe for most people to use. However, they can cause serious problems when used by people with certain medical conditions. Tell caregivers if you have liver or kidney disease or a history of bleeding in your stomach.
    
    
  • Stool softeners: This medicine makes it easier for you to have a bowel movement. You may need this medicine to treat or prevent constipation.
    
    
  • Antibiotics: This medicine is given to help treat or prevent an infection caused by bacteria.
  
  

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.