Types of operations for hemorrhoids. How is hemorrhoid surgery performed?

Mulled wine is a drink made from hot wine with the addition of various spices. Answering the question whether it is possible to drink hot wine with a cold and SARS, it must be said that it is not only possible, but also necessary to use in moderate doses. Mulled wine is especially effective in the early stages of the disease. Persistent cough and runny nose, fever and a feeling of cold are symptoms of a cold that can be prevented with mulled wine.

The benefits and harms of wine

Many professors of medicine discussed this issue. But so far they have come to a mutual decision regarding the question of whether it is possible to drink hot wine at a temperature - mulled wine is useful if consumed in moderation. The world has long been using such a method of preventing and treating colds as drinking hot wine.

Of course, warm wine for colds has been consumed since ancient times. It is especially useful warmed up. Such a drink dilates blood vessels and removes toxins well. Wine is most beneficial when taken before bed, as it is very relaxing and sleepy. There are a lot of recipes for making such wine.

The main ingredient of this medicine is, of course, red wine, as it contains a lot of useful trace elements.

Citrus fruits are added to the wine, which are rich in vitamin C. The beneficial substances of mulled wine protect the cells of the body from the effects of various viruses, strengthen the nervous system and give energy for the whole day. It is a natural substance that supports the immune system.

Mulled wine will become even more useful when a small amount of natural honey is poured into the already slightly cooled agent. It is a natural remedy for colds and together they give a very good effect.

If a person starts to get sick with the flu, then mulled wine is exactly what you need to drink. Hot drinks help a lot with fever.

Hot wine and mulled wine

It is necessary to distinguish between two types of drink, such as mulled wine and hot wine. The latter is simply a warm drink with minimal spices and is easy to prepare. And do not confuse it with mulled wine, the recipe of which is more complicated.

hot wine

Such a drink can be prepared using the wine itself, which needs to be warmed up, add cinnamon, sugar, bay leaf and other spices to taste. In this form, wine can be served to the patient.

In this case, the wine is not infused with spices and is not impregnated with them, but simply heated with the addition of spices. It can also be used as a medicine in small quantities, simply heated, without the addition of spices.

Useful mulled wine

Mulled wine is prepared in a completely different way. First you need to prepare all the ingredients, such as cinnamon, orange slices (you can just zest), tangerines, black and red peppercorns and cardamom. You can immediately buy a ready-made set for mulled wine, so as not to make a mistake with the ingredients. Such sets are very often found in stores.

Then you need to heat up to almost a boil and add all the prepared spices. Next, you need to put the pan to languish on a small fire. The drink should languish for 30-40 minutes. During this process, the drink absorbs all the flavor properties of spices and, thus, we get mulled wine. After languishing, you need to increase the heat and bring the drink to a boil. Then you can give to the patient.

If you wish, you can add strong tea, cognac, vodka (37-38%), beer or rum to this drink, then you get a drink like grog. It is not necessary to abuse such a drink, since it is very strong, and can only harm the patient in a weakened body during illness. Moreover, just a hot drink has never failed in the treatment of colds. And, most importantly, here do not overdo it with the dose of the consumed drink, and then it will be possible to understand whether alcohol helps with a cold.

Hot wine contraindications

Many doubt can you drink alcohol with a cold. But the answer is obvious. Not everyone can be treated with hot mulled wine. If a person has serious chronic diseases, then this can cause serious side effects. Such side effects may occur under the influence of one of the components of mulled wine.

A hot drink should not be taken in the following cases:

• Pregnancy. This may affect the development of the fetus. Possible premature birth.
• Weak heart. The drink dilates blood vessels, which is not particularly desirable for some diseases.
• It is forbidden to treat people with problems of the gastrointestinal tract with mulled wine, as it increases acidity.
• If there are a lot of herbs in the drink, then people suffering from hypertension increase their blood pressure.
• It is strictly prohibited for minors and infants. This may cause intoxication.
• It is also not recommended for people with Pitt's syndrome to use.

As you can see from the list, problems can arise due to the effects of alcohol. It is also worth paying attention to the fact that the drink can cause allergies, the consequences of which may not be stronger than the cold itself.

Rules for making mulled wine

Mulled wine is quite easy to prepare. But in order for the drink to really fight colds well, you need to know a few important points regarding preparation.

In order to get the most out of mulled wine effective against colds, you need to follow these rules:

If you do not disdain these simple rules, then mulled wine will turn out really useful and will bring a lot of strength and energy to your body.

cooking recipes

To create a cold drink, you need to have spices available, which are in almost every home, and if not, then buying them in the store will not be difficult. And, of course, you need red wine. His choice just needs to be approached very carefully.

Which alcohol to choose- already at the discretion of everyone, depending on preferences and desires. But it is worth noting that too sweet alcohol will make mulled wine very cloying.

If the drink has been aged for many years, then it will lose all that flavor range when heated, which it has acquired over many years.

They mainly use dry or semi-dry red with an alcohol level of no more than 12 percent. Some craftsmen say that mulled wine can be made from rose or even white wine, but you need to carefully select all the elements.

A hot drink is prepared like this:

If you approach the issue reasonably and take into account all contraindications, mulled wine during a cold can become salvation for the sick.

Excision of hemorrhoids is a traditional surgical operation, which is performed at such stages of the development of the disease, when low-traumatic techniques are no longer indicated.

Traditional surgery is a serious procedure, which is characterized by a record low percentage of relapses of the pathology. Doctors recommend timely removal of pathological elements - this will allow you to fully restore health and prevent the development of numerous complications of hemorrhoids.

Surgical removal of nodes in City Clinical Hospital No. 31 is performed under anesthesia in a hospital. To guarantee the success of the operation, you must first clean the intestines and follow all the doctor's recommendations during the rehabilitation period.

Diagnostics

Diagnosis of hemorrhoids is necessary to establish the number and localization of pathological elements, the presence of complications and concomitant diseases of the rectum.

Enlarged hemorrhoids are often combined with other pathologies:

proctitis (inflammation of the mucous membrane of the terminal intestine);
rectal polyps;
malignant tumor.

The necessary amount of information can be obtained with the help of If there is a suspicion of damage to the overlying sections of the large intestine,

If the proctologist decides on surgical intervention, all standard examinations will be needed:
general urine and blood tests,
coagulogram,
tests for blood-borne infections,
ECG, consultation of the therapist, anesthetist and gynecologist (for women).

Types of surgical interventions

All types of surgical interventions for hemorrhoids can be divided into two large groups: minimally invasive (non-surgical) techniques and traditional operations to remove hemorrhoids.

Low-traumatic interventions performed without the use of a surgical scalpel. The main mechanism of action of such techniques is the cessation of blood supply to the node. As a result, the pathological element decreases in size.

Less traumatic methods include:
(bonding of vessel surfaces under the influence of an intravenously administered sclerotant);
ligation of the node with latex rings;
radio wave coagulation.

These methods are characterized by a short recovery period with minimal side effects. However, they are not suitable for everyone. In cases where minimally invasive techniques cannot be used, proctologists turn to surgical excision of hemorrhoids.

Indications for traditional surgical methods

Surgical removal of chronically enlarged hemorrhoids is performed when minimally invasive techniques are technically difficult or doomed to failure due to an increased risk of recurrence.

The most popular indications for excision with a scalpel:
IV stage of the disease (the nodes cannot be set into the rectal cavity);
Stage III with large nodes (hemorrhoids can be set by hand in a warm bath);
a significant number of pathological elements;
the presence of complications (necrosis, thrombosis, bleeding, etc.).

The decision to surgically excise is made on an individual basis. This takes into account the condition of the terminal intestine and nearby organs, as well as the age and general health of the patient. To clarify all the data, it will be necessary to undergo a diagnostic examination.

Contraindications

The operation will have to be postponed for any acute illness or exacerbation of a chronic disease.
Patients with severe obese First, it is recommended to lose weight.
Hemorrhoids during pregnancy are treated conservatively, since there is a high probability of healing after the end of the period of feeding the child.
Some relative contraindications may include:
___ blood clotting disorders;
___ oncology of the large intestine;
___ diabetes;
___ cirrhosis of the liver;
___ unstable angina;
___ recovery period after injuries, operations, etc.

Surgical intervention can be performed after stabilization of the condition and consultation with a specialist doctor (cardiologist, endocrinologist, hematologist, hepatologist, etc.).

It must be remembered that only a doctor can evaluate the indications and contraindications and decide on the need for an operation. If you have any questions about choosing a treatment method, be sure to consult with a proctologist!

Preparation for excision of hemorrhoids

1. Diet

Diet is necessary to fully cleanse the intestines and prevent unwanted inflammatory reactions. Three days before surgery, foods that promote the formation of gases in the intestines, as well as dishes that can negatively affect the stool, are banned:
legumes;
cabbage;
fresh vegetables and fruits;
juices, mineral water, alcohol;
sweet dishes;
spices, marinades, pickles;
rice, semolina;
smoked products.

The last meal should be no later than 12 hours before the operation, and the last drink of water no later than 8 hours.

2. What needs to be done

If you need anesthesia, you need to visit dentist. Sick and loose teeth should be removed.

At the consultation with the operating surgeon, you need to tell about the cases drug intolerance. If you are forced to use any medication, be sure to tell your doctor.

Three days before surgery you need to stop taking any medications that affect blood clotting (ibuprofen, aspirin, birth control pills).

On the eve of the operation cleanse the intestines with a saline laxative of the Fortrans type, which is taken at about four o'clock in the evening. It will be necessary to prepare a solution in accordance with the weight according to the formula indicated in the instructions and drink one glass every fifteen minutes (3-4 hours). Bowel movement will begin a maximum of two hours after drinking the last glass of solution.

The procedure can be replaced with a double cleansing enema (in the evening and in the morning three hours before the operation) or microclyster "Microlax".

How is the excision of hemorrhoids

1. Open hemorrhoidectomy

Open hemorrhoidectomy is the most "ancient" traditional operation, which was first performed in the 30s of the last century by proctologists Milligan and Morgan.

Operation Milligan-Morgan performed under general anesthesia, less often under local anesthesia. The patient lies on the couch in the supine position, the legs are fixed on the stands in a raised position.

Hemorrhoidectomy is performed using a dilator and an anoscope. The surgeon grasps the internal nodules and turns them outward along with the surrounding tissues. The knot is removed after cutting the skin and stitching the feeding vessel.

A characteristic feature of the method: the wound surfaces are not sutured - hence the name "open hemorrhoidectomy". After the operation is completed, the surgeon sets a swab with an antiseptic and wound healing agent.

The patient stays in the hospital for 5-7 days. Softening feces and healing tablets are prescribed.

2. Closed hemorrhoidectomy

Closed hemorrhoidectomy is a modified Milligan-Morgan operation, first performed in the middle of the last century by surgeon Ferguson.

Surgery according to Ferguson may be performed under general or local anesthesia. When the action of the analgesic relaxes the anal sphincter, the surgeon inserts the anal mirror there. In the future, closed hemorrhoidectomy in general terms repeats the Milligan-Morgan technique: the vascular base of the hemorrhoid is sutured and bandaged.

Then the knot is removed, and the wound surface is sutured with a catgut thread, which is subsequently absorbed. The average length of hospital stay after Ferguson's hemorrhoidectomy is 5 days.

In the postoperative period, painkillers and mild laxatives are prescribed. You don't have to remove the stitches as the thread will dissolve on its own.

3. Operation Parks

Another modification of the Milligan-Morgan operation was proposed in the middle of the last century by the English proctologist Parks.

Surgical intervention is performed under general anesthesia. The patient lies on his back with divorced limbs. The surgeon dissects the mucous membrane located above the nodule, a ligature is applied to the base of the nodule and stitched with a thread.

Then the pathological element is removed, the thread is pulled, and the edges of the mucous membrane are sewn together. In this way Parkes hemorrhoidectomy is a kind of plastic surgery.

Upon completion of the intervention, a tampon with medicinal substances is inserted into the anal passage. To prevent spasm of the sphincter, a mechanical expansion of the anus is used.

After a Parkes hemorrhoidectomy, the patient must fast to delay defecation, which threatens to rupture the sutures. Subsequently, a sparing diet is shown, providing timely soft stools.

Advantages and disadvantages of the Milligan-Morgan, Ferguson and Parks methods

With the help of Milligan-Morgan, Ferguson and Parks operations, both internal and external hemorrhoids can be removed.

The advantage of open hemorrhoidectomy is a high percentage of complete healing (relapses occur only in 2% of cases), and the main disadvantage is a very painful and rather long recovery period.

Closed hemorrhoidectomy is characterized by less pain and a shorter recovery period. However, there are also disadvantages: it is possible for the sutures to open during bowel movements, as well as suppuration of the wound.

The Parkes operation is characterized by a short recovery period and a minimal risk of complications. However, the technique is considered more difficult for the operating physician.

It must be remembered that only a doctor can decide on the choice of treatment method.

Possible side effects and complications

1. Pain syndrome

Pain is an unpleasant side effect of any surgery, so after surgery, the doctor will prescribe painkillers. They should be taken at the dose prescribed by the doctor.

At the same time, it should be remembered that pain is the watchdog of the body, reporting danger. Be sure to tell your doctor if:
pain syndrome is not removed by standard means;
the pain changes its character (becomes pulsating, radiating, etc.);
pain syndrome is accompanied by other symptoms of trouble (weakness, headache, fever).

A change in the nature of the pain syndrome, an increase in the intensity of pain and the appearance of additional symptoms may indicate the development of complications.

2. Infectious and inflammatory processes

The most common complication of surgical interventions is infection of the wound with its subsequent suppuration. This development is facilitated by both the presence of a wound and a decrease in immunity after surgery (any intervention is stress for the body).

When excising hemorrhoids, the situation is aggravated by the fact that the wound surface is located in the rectum populated with microbes, through which stools filled with bacteria pass in transit.

The development of an infectious-inflammatory process can lead to the formation of an abscess (abscess), to intoxication due to the ingress of toxins of microorganisms into the blood, or even to sepsis (blood poisoning).

To prevent the development of infection, doctors regularly clean the postoperative wound and prescribe antibiotics orally or intramuscularly. If an abscess occurs, it is opened surgically.

3. Divergence of seams

The divergence of the seams most often develops as a result of trauma to the postoperative wound with hard feces. Prevention of this complication is a special diet.

This complication most often occurs in the early postoperative period. Depending on the specific situation, the problem can be solved with the help of surgical intervention or conservatively.

The divergence of the seams is fraught with the addition of an infectious process and / or the development of other rarer complications.

4. Retention of feces and urine

Postoperative urinary retention, as a rule, has a reflex character. This complication occurs predominantly in men. In such cases, doctors use a catheter to empty the bladder in a timely manner. In the future, the passage of urine is completely restored.

Habitual retention of feces may occur as a result of the patient's fear of pain during bowel movements. Cases of chronic constipation and even "psychological" intestinal obstruction are described. Such a complication is easily treatable with "mild" laxatives.

However, it should be borne in mind that fecal retention after surgery is a symptom of many dangerous complications. Therefore, if there is a tendency to constipation, it is necessary to seek the help of a doctor.

5. Other complications

Complications during excision of hemorrhoids are rare. Some pathologies, as a rule, develop against the background of an infectious and inflammatory process, divergence of sutures, or other complications.

Relatively rarely, after surgery to remove hemorrhoids, there are:
rectal fistulas (abnormal communications between the rectum and another organ and/or perineal surface);
thrombotic complications (thrombosis or thrombophlebitis of the inferior vena cava);
bleeding;
thromboemboria (blockage of the main arteries by a detached thrombus);
narrowing of the anal canal.

All described pathologies are treatable. Fistulas and bleeding may require surgery, and narrowing of the anal canal is more often treated with mechanical stretching.

Be sure to inform the doctor if swelling suddenly appears - this may be a symptom of thrombophlebitis of the inferior vena cava. This complication requires urgent action.

To protect yourself from complications during surgery, it is enough to follow all the recommendations of the doctor.

Recovery period

Depending on the method of operation, the patient may stay in the hospital for 3 to 7 days. In some cases of closed hemorrhoidectomy, discharge from the hospital is possible after the doctor is convinced of the free discharge of urine. Further treatment is carried out at home under the supervision of a physician until complete recovery.

The rehabilitation period provides for a protective regimen and a diet sparing the intestines. In the first days after the operation, one should not be in a sitting position, heavy physical exertion is also prohibited. Rough, spicy, salty foods and alcohol should be abandoned.

For the speedy healing of the postoperative wound, it is necessary to strictly observe the rules of hygiene (washing after each bowel movement), as well as use all the local medicines recommended by the doctor (ointments and suppositories).

An important condition for preventing complications is the normalization of the stool. Bowel movements should be regular, preferably daily. If necessary, use mild laxatives.

Can Hemorrhoid Surgery Be Postponed?

Excision of hemorrhoids - planned intervention which is carried out at a convenient time for the patient. However, surgical treatment should not be delayed for a long time.

With a long course of chronic hemorrhoids, the following complications may develop:
bleeding with the development of chronic anemia;
thrombosis and / or gangrene of the node;
infectious and inflammatory processes;
depletion of the body;
anal fissure;
colon polyps, etc.

The development of complications is a longer, more painful and more expensive treatment. Take care of yourself and your loved ones, do not try to "heal" folk remedies, contact a proctologist in a timely manner.

Treatment of hemorrhoids in City Clinical Hospital No. 31

Hemorrhoids in women and men is a very common disease. Our doctors have many years of experience in this pathology.

Removal of hemorrhoids in City Clinical Hospital No. 31 is carried out both by traditional and the most modern methods. If it is possible to use non-surgical removal of hemorrhoids, our doctors will select the most appropriate method for your case.

Our clinic has an OMS policy.

You can find out about the paid services provided in the clinic

Do not put off visiting a proctologist from day to day. The sooner you start treatment, the easier it will be! Trust your health to professionals.

Surgical treatments for hemorrhoids are usually carried out in the last stages of the disease, when conservative therapy does not give positive results, or during exacerbation, which is accompanied by unbearable pain.

Removal of nodes allows you to forget about unpleasant symptoms forever, especially since surgeons offer not only traditional operations, but also minimally invasive treatment techniques. What are the features, pros and cons of various types of surgical intervention, we will tell further.

Indications for carrying out

It is formed as a result of the expansion of venous accumulations. Violation of blood flow in the anus leads to the appearance of blood clots, swelling of the walls of the veins and their damage by feces.

There are 4 degrees of severity of proctological disease. And if at the very beginning the disease is well treated with the help of systemic and local drugs, then at the last stage, surgical removal of hemorrhoids becomes mandatory.

There are several indications in which the surgical removal of hemorrhoids is considered an important and necessary measure for the treatment of an unpleasant disease. Among them:

• prolapse of internal nodules after defecation and even during light physical exertion;
• pinching of cones and thrombosis of venous accumulations;
• frequent or heavy bleeding from the rectum.

Thus, surgical treatment of hemorrhoids is indicated in the presence of various complications and negative consequences that seriously worsen the patient's condition and even threaten his life.

For example, it is necessary when inflamed cones exit the anus and the flow of blood, since such phenomena are dangerous for humans.

In addition, specialists prescribe surgery for a combination of enlarged hemorrhoids with other proctological diseases of the rectum, for example, anal bleeding fissures, polyps, pararectal abscess.

Methods for removing hemorrhoids are divided into minimally invasive and operational. The first techniques are characterized by less blood loss, associated pain syndrome and a shorter recovery period.

Minimally invasive techniques

Recently, removal has been practiced more and more often.

In addition to the fact that penetration into the rectal cavity and its trauma is minimal, the following features can be distinguished among the advantages of minimally invasive methods:

• insignificant damage to the tissues that surround the inflamed hemorrhoids;
• short duration of the intervention itself (about 20-30 minutes);
• the procedure is almost always performed not under general anesthesia, but under local anesthesia;
• patients practically do not feel pain and return home within a few hours after the manipulation;
• after the intervention, the risk of scarring and deformation of the tissues and mucous membranes of the rectum is minimal;
• the techniques have practically no restrictions, which is why they are prescribed for age patients and people with serious concomitant diseases;
• low-traumatic techniques can be used at almost all stages of hemorrhoids.

To date, there are several types of such sparing surgical interventions, each of which deserves a separate discussion.

Desarterization

This is the removal of internal hemorrhoids, during which the surgeon ligates the arterial vessels that deliver blood to the overgrown hemorrhoids. Since they now have no nutrition and blood supply, the bumps begin to die off, and soon disappear altogether.

Itself looks like this - an anoscope equipped with a sensor is inserted into the anus of the patient.

With its help, the exact location of the arteries leading to the nodule is clarified. Through a special window, the vessels are tied with threads.

Desarterization is carried out at all stages of the disease, however, patients with the second or third degree of inflammation of the hemorrhoidal cones see the most tangible effect.

Cryodestruction

The essence of this technique is to freeze enlarged venous plexuses with the help of liquid nitrogen, which cools parts of the body to almost -200 C. After such an impact, the node freezes, and after a while it completely disappears.

Liquid nitrogen affects only damaged areas, since healthy areas through the arteries create a thermal "border" that prevents the penetration of cold into nearby tissues.

Dead cells leave the rectum in about a week.

Cryodestruction is painless, without scarring and bleeding.

In addition, low temperatures activate the immune system, improve microcirculation, enhance metabolic and recovery processes.

Sclerosis

This procedure involves the elimination of hemorrhoids with the help of special medications that cause venous and arterial vessels to stick together in hemorrhoids.

The drug is injected into the area that supplies blood to the inflamed venous congestion. As a result of the injection, the nodule ceases to receive nutrition and soon decreases in size.

The procedure is done painlessly and very quickly, the therapeutic effect is detected after the first injection of the sclerotic solution. However, the technique is not suitable for the treatment of external hemorrhoids, in addition, a relapse is possible, since the cause of the disease is not eliminated.

Laser coagulation

This gentle surgery is used to treat both external and external hemorrhoids. The laser, acting on the venous congestion with heat, causes coagulation, or folding of protein substances. Arteries and veins are soldered, so that bleeding is excluded.

Removal of external and internal hemorrhoids occurs in different ways. In the first case, the skin is excised with a laser; with internal hemorrhoids, the device burns out the nodule from the inside.

After this minimally invasive surgical treatment of hemorrhoids, the feeding of the cones stops, they die off and after 14 days they come out with the feces. Most often used in stages 2 and 3 of the disease.

Ligation with latex rings

Similar. The procedure itself involves clamping the "legs" of hemorrhoids, as a result of which they cease to be supplied with blood, dry up and then completely die off.

Latex rings do not contain any harmful elements, so these devices do not lead to allergies. Elastic rings are thrown over the base of the hemorrhoidal bump and squeeze it. After 2 weeks, the dead nodule comes out along with the feces.

Only nodules located in the rectum are removed by this method. For the treatment of external hemorrhoids, ligation is not suitable. The main disadvantage is that the patient experiences a sensation of a foreign body in the anus, however, this feeling is short-lived.

infrared coagulation

You can also remove overgrown venous accumulations with the help of infrared rays.

After some time, hemorrhoidal cones die off.

Depending on the severity of the proctological disease and the severity of clinical symptoms, up to 6 procedures may be required. The method demonstrates particular effectiveness in the first stage of the disease.

If the intervention is successful, the damaged nodes fall out, and the bleeding stops.

However, recurrence of hemorrhoids is quite often observed.

Cons of minimally invasive techniques

Low-traumatic methods for removing enlarged hemorrhoids are distinguished by a minimal number of undesirable consequences, but they still exist.

• Pain syndrome. Unpleasant sensations after the procedures are possible, since the mucous membrane of the anus is extremely sensitive to all influences. Most often, pain occurs during ligation (especially if the rings are incorrectly applied or there is a capture of nearby tissues) or infrared coagulation.
• Bleeding. A similar complication is possible in almost every procedure. A pleasant exception is the removal of nodules with a laser (arteries and veins are cauterized) or cold (vessels are frozen). Moderate bleeding occurs when dead nodules come out of the rectum.
• Thrombosis of external nodules. This possibility is not excluded in the combined form of the disease, when internal nodules are ligated, and clots form in external ones. If the nodule is not completely removed during coagulation with infrared rays, then the probability of the formation of a blood clot is quite high.

Minimally invasive methods for removing developed hemorrhoids also have certain disadvantages, for example:

• the frequent return of clinical symptoms, since it is not the cause of hemorrhoids that is eliminated, but its result (a pleasant exception is desarterization);
• rather high cost of procedures;
• extremely high requirements for the skills of a surgeon (highly qualified specialists are not found in all medical institutions).

Not always the low-traumatic methods listed above lead to the desired result. In this case, a traditional operation is prescribed to remove hemorrhoids.

Surgery

Surgical removal of hemorrhoids involves the use of two main types of intervention - hemorrhoidectomy and. Most often they are used in the most severe forms of the disease or in the event of complications.

Hemorrhoidectomy

Another variant of the name of the procedure is . Such an event is designed to remove external enlarged venous accumulations and get rid of internal nodules with the help of excision.

The operation to remove hemorrhoids can be performed in two ways - closed or open. The first method is more preferable, as it has the following advantages:

• after the knot is removed, the wound is sutured (during an open operation, the wound remains open), which is why the consequences pass faster;
• operate under normal clinical conditions under local anesthesia, and in the case of open intervention, the operated person is in the hospital, and the procedure is performed under epidural or general anesthesia;
• an operated person is able to recover in about half a month, and with open hemorrhoid surgery, recovery can take 5 or 6 weeks.

Hemorrhoidectomy has one big plus - most patients say goodbye to the disease forever or forget about it for decades.

However, surgical removal of hemorrhoids has certain disadvantages:

• the operating period does not last so long, but the patient "falls out" of life for several weeks - does not work, does not move;
• operated on hemorrhoids does not involve treatment, but this is with minimally invasive methods, during surgical interventions, analgesics are likely to be taken, since a strong pain syndrome is expressed;
• there are serious limitations:
  • cancerous tumors;
  • Crohn's syndrome;
  • bearing a child;
  • inflammation of the anal area.

Longo method

With the diagnosis of "hemorrhoids", the surgical removal of nodules is carried out according to the Longo method, which is also called hemorrhoidopexy in another way. This intervention is carried out only with hemorrhoids localized inside the rectum. Removal of external hemorrhoids in this way is impossible.

How is the operation of excision of hemorrhoids according to the Longo technique performed? The doctor needs to excise the area of ​​​​the anus mucosa around the circumference. Simultaneously with the tissues, the areas protruding into the intestinal lumen are also pulled up.

This method differs in that the inflamed nodules themselves do not need to be operated on and cut out. During manipulation, hemorrhoidal cones rise to the intestinal surface, as a result of which their blood supply is disrupted. After a while they die off.

Surgery has advantages and disadvantages. The advantages include:

• a rather short recovery period - the patient is in the ward for only two or three days, and the recovery itself lasts a week;
• pain syndrome is observed only in 15% of patients, but it is very moderate and lasts only 24 hours;
• surgery can be done at any stage of hemorrhoids;
• the procedure is characterized by a minimum number of restrictions.

The disadvantages of hemorrhoidopexy include:

• application only to nodules located inside the rectum;
• relatively high cost of the operation.

After the diagnosis of "hemorrhoids" is made, the question of how to remove enlarged venous accumulations arises in each patient. The choice depends on many indicators, but first the patient should prepare the intestines for the procedure.

Cleansing the rectum with laxatives or enemas is carried out immediately before the operation, as well as within 2-3 weeks before it. In addition, doctors recommend observing a special diet that normalizes the functioning of the gastrointestinal tract.

Possible negative consequences of the operation

Surgery for hemorrhoids is often accompanied by the occurrence of various complications. The reason for the high probability of undesirable consequences lies in the traumatism of manipulations and the presence of bacterial components.

As a result, the following complications are likely to develop:

• the formation of pus is the most common consequence that occurs when pathogenic bacteria penetrate into open wounds. In such a situation, the patient is prescribed antibacterial and anti-inflammatory drugs. If an abscess is formed, it should be opened and cleaned;
• pararectal fistula is a serious complication of surgical intervention, which can occur even after 3-4 months. This formation is a tubule that arises in the wall of the anus and connects it with a gap on the surface of the body or with a nearby organ;
• narrowing of the anus - possibly with incorrectly applied sutures. To expand the anal canal, it is necessary to introduce special tools. In a particularly difficult situation, the narrowing will be removed with a new surgical intervention;
• bleeding - the loss of a large volume of blood may occur due to poorly performed cauterization of arteries and veins or injury to nearby mucosal areas during stitching of wounds;
• stressful state - negative feelings associated with the very fact of the operation, often affect the mood of the patient. Particularly impressionable patients develop the so-called psychological constipation, in which a person is afraid to defecate. In such a situation, laxatives and sedatives will help;
• weakness of the anal valve is an infrequent consequence that occurs in case of injury to the nerve endings located in the anus. Most often, the work of the sphincter is restored with the help of a medicine; in difficult situations, surgery is required.
How best to get rid of hemorrhoids, the attending physician should determine, based on the stage of the disease, the presence of concomitant ailments.

In addition, any therapy involves an integrated approach, so the patient needs to make significant changes in their own lifestyle. In this case, it will be possible to forget about negative symptoms forever.

Diseases of the rectum are manifested by terrible symptoms. Hemorrhoids are no exception! Many in its acute phase cannot sit, walk, and even more so work. Methods of treatment of the disease are different, and do not exclude surgical interventions.

At the first stage of the development of the disease, rectal suppositories, creams and ointments, and a therapeutic diet save. If the pathology has passed into subsequent stages, then the removal of hemorrhoids is the most justified method of solving the problem.

When is surgery needed?

Surgical intervention is justified in the case when drug therapy does not give positive dynamics, and the patient continues to suffer from unpleasant symptoms.

Modern proctology distinguishes four stages of hemorrhoids:

1. 1 degree - manifestations are minimal. Distension of the rectum immediately after defecation, slight bleeding (specks, trickles), burning and itching of the anus.
2. 2 stage. Each bowel movement leads to bulging of the "bumps" from the anus, which themselves are drawn back.
3. 3 degree. Hemorrhoidal nodes continue to prolapse during defecation and other physical efforts, but now they have to be pushed into the rectum.
4. Severe stage 4. The increase in symptoms and the addition of various complications. Hemorrhoids fall out under any circumstances. Their reduction is impossible because of their infringement, thrombosis, development of inflammatory processes in the perianal region.

In recent decades, several surgical methods for the treatment of hemorrhoids have been developed with different tools and principles of influencing the cause of the disease.

Types of surgery

Despite the formidable term, many of today's interventions feel more like a procedure than a major operation. We are talking about minimally invasive methods of surgical intervention, after which the patient forgets about the problem in one day of visiting a doctor.

Popular hemorrhoid removal methods:

Laser exposure

To treat hemorrhoids of any type, the doctor acts on the patient's hemorrhoids with a laser beam. Literally seals the blood vessels that supply the nodes with blood. The cauterizing effect of the laser does not allow wound surfaces to form and does not leave bleeding.

At the first or second stage, laser removal of hemorrhoids is excellent for people who cannot be prescribed standard local remedies. In the later stages, the operation is ineffective. It is carried out on an outpatient basis.

infrared coagulation

This method is often confused with the previous one, but here we are talking about thermal effects. Problematic hemorrhoids are removed by cauterization. The method does not require hospitalization.

Latex ligation

Efficient mechanical method. To implement it, a tiny latex ring is put on the knot leg. The blood supply to the node stops, it dies and leaves the rectum along with feces. The method is very popular in Russia and CIS countries.

Sclerotherapy of hemorrhoids

In fact, this is the gluing of the hemorrhoid by introducing a special narrowing (sclerosing) solution into the cavernous cavity.


Adhesions form in the node, which do not allow the cavity to overflow with blood again. Justified for hemorrhoidal bleeding in the early stages of the development of pathology.

Suture ligation

Another modern technology is used here - dopplerometry. The doctor, using a special apparatus, finds exactly those arteries that supply blood to the problematic hemorrhoid and sutures them.

Longo method

This is a real operation to remove hemorrhoids. Hemorrhoidopexy of this type has been known for almost a quarter of a century and is not the removal of hemorrhoids, but their installation in physiological places by suturing the mucous membranes of the rectum.


Such a measure stops the excessive blood supply to the nodes and their prolapse. However, Longo's operation is not possible with external hemorrhoids.

Operation Milligan–Morgan

This surgical method has been known for more than half a century. In many cases, only a classic hemorrhoidectomy gives a person with stage 4 hemorrhoids a chance to be cured. The operation lasts 30-60 minutes and is performed in a hospital. The rehabilitation period lasts approximately 30-40 days.

Postoperative complications

It all depends on the professionalism of the proctologist and the discipline of the patient. The main problem is psychological! Intervened people begin to fear defecation. Such a phobia is solved by a diet with a lot of vegetables, dairy products, a sufficient amount of liquid. The doctor, prescribing the operation, will certainly recommend the optimal diet.

In the rehabilitation period, pain, bleeding, and some discomfort are also possible. After any intervention, it is important to see a doctor in time, who will monitor the healing processes and the general condition of the patient.

When is the best time to get pregnant after surgery?

The main condition is complete healing of the wound (scars) after excision of nodes, rectal fistulas or anal fissures. It is necessary to plan pregnancy after conservative treatment and after consultation with the attending physician.

Prices for operations

How much does it cost to get rid of hemorrhoids once and for all? It all depends on the type of intervention, region, clinic, qualifications of the proctologist. Prices for the same services differ several times.

Sclerotherapy of one node can cost from 3 to 7000 rubles. Latex ligation from 5000 rubles. Hemorrhoidectomy can cost 35 thousand rubles. However, in some clinics, the price may include not only the intervention, but also other services. For example, examination, support in the rehabilitation period, repeated consultation.

Which method to carry out the impact on the hemorrhoids should be decided by the proctologist after a detailed examination of the patient. A correctly chosen method, combined with the subsequent correction of lifestyle, can get rid of the disease, if not completely, then for a very long time.

After removal of hemorrhoids, the patient must follow the recommendations of the doctor. In order to prevent relapse, it is necessary to follow a diet, hygiene and drink courses of venotonic drugs.

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