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.

Getting Ready

Before your surgery:

• Bring your medicine bottles or a list of your medicines when you see your caregiver. Tell your caregiver if you are allergic to any medicine. Tell your caregiver if you use any herbs, food supplements, or over-the-counter medicine.
  
  
• You may need to take an antibiotic medicine before your surgery. This medicine helps kill bacteria (germs) that may cause an infection. Ask your caregiver if you need to take this kind of medicine.
  
  
• You may need to have certain lab tests and x-rays done. Your caregiver may need to look inside your bowel and check your hemorrhoids using a special scope. This scope is a long bendable tube with a camera on its end. Ask your caregiver for more information about these tests and other tests that you may need. Write down the date, time, and location of each test.

Night before your surgery:

• Ask caregivers about directions for eating and drinking.
  
  
• You may need to have an enema to empty and clean out your bowel the night before surgery. An enema is a special liquid that is placed into your rectum to help you have a BM.

Day of your surgery:

• Write down the correct date, time, and location of your surgery.
  
  
• You or a close family member will be asked to sign a legal document called a consent form. It gives caregivers permission to do the procedure or surgery. It also explains the problems that may happen, and your choices. Make sure all your questions are answered before you sign this form.
  
  
• You may need to have an enema to empty and clean out your bowel before surgery. During this procedure, caregivers will put liquid into your rectum through a tube. This liquid helps you have a BM.
  
  
• Caregivers may insert an intravenous tube (IV) into your vein. A vein in the arm is usually chosen. Through the IV tube, you may be given liquids and medicine.
  
  
• Your caregiver may put antibiotic medicine into your IV before your surgery. Antibiotics may be given to help you treat or prevent an infection caused by germs called bacteria.
  
  
• An anesthesiologist may talk to you before your surgery. This caregiver may give you medicine to make you sleepy before your procedure or surgery. Tell your caregiver if you or anyone in your family has had a problem using anesthesia in the past.

Treatment

What will happen:

• Your skin will be cleaned and sheets will be put over you to keep the surgery area clean. You may be placed either on your stomach or face up with your knees bent upwards. A special tool will be placed in your anus to keep it open. Your caregiver will use a special round staple gun once.
  
  
• Your caregiver will tighten then skin tissue on the wall of your rectum or anal canal. He will also staple the hemorrhoid to the rectal wall at the base of the hemorrhoid. This will stop the blood flow to your hemorrhoid, resulting in decreased swelling. Extra tissue will be taken out and sent to the lab for tests. A small pack (sponge) may be put into your anal canal to help stop bleeding.

After your surgery:

You will be taken to a room where you can rest until you are wake up. You may be allowed to go home. If you are staying in the hospital, you will be taken back to your room. Do not try to get out of bed until your caregiver says it is OK.

Waiting area:

This is an area where your family and friends can wait until you are able to have visitors. Ask your visitors to provide a way to reach them if they leave the waiting area.

Contact a caregiver if

• You cannot make it to your surgery on time.
  
  
• You get sick (a cold or the flu).

Seek Care Immediately if

• Your hemorrhoids become very painful.
  
  
• Your hemorrhoids begin to bleed and do not stop.

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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.