Hemorrhoids, commonly known as piles, can cause significant discomfort, pain, and bleeding. While many cases improve with lifestyle changes and non-surgical treatments, surgery may be necessary for severe or persistent hemorrhoids. In Australia, several surgical options are available, tailored to the type and severity of the condition. Here’s a comprehensive, easy-to-understand guide to hemorrhoid surgery in Australia.
When Is Surgery Recommended?
Surgery is usually considered for:
- Grade 3 or 4 hemorrhoids (severe prolapse or large hemorrhoids)
- Strangulated internal hemorrhoids
- Cases where other treatments like banding or medication have failed
- Associated anorectal conditions requiring surgical intervention
Most hemorrhoids can be managed conservatively, but surgery offers a more definitive solution for advanced cases.
Types of Hemorrhoid Surgery in Australia
1. Haemorrhoidectomy (Hemorrhoid Removal)
This is the traditional and most effective surgical procedure, involving the excision of hemorrhoidal tissue. It can be performed as:
- Closed Haemorrhoidectomy: The wound is stitched closed after removal.
- Open Haemorrhoidectomy: The wound is left open to heal naturally, often used when closure is difficult or infection risk is high.
- Combination: Sometimes both techniques are used depending on the case.
Haemorrhoidectomy is usually done under general anaesthesia as a day surgery or with a short hospital stay. Recovery can be more prolonged and painful compared to other methods, but it offers the best chance of permanent relief.
2. Stapled Haemorrhoidopexy (Procedure for Prolapse and Hemorrhoids – PPH)
Also known as stapling surgery, this technique involves repositioning the hemorrhoidal tissue and cutting off its blood supply using a circular stapling device. It causes less post-operative pain and a quicker recovery than traditional haemorrhoidectomy. However, there is a somewhat higher risk of hemorrhoid recurrence.
3. Hemorrhoidal Artery Ligation and Recto Anal Repair (HAL-RAR) / Transanal Hemorrhoidal Dearterialisation (THD)
This minimally invasive procedure uses a Doppler ultrasound probe to locate and tie off the arteries supplying blood to the hemorrhoids, reducing their size. For prolapsing hemorrhoids, the surgeon lifts and secures the tissue back into place with sutures. Patients experience less pain and a faster return to normal activities, often within 1-2 days.
4. Rubber Band Ligation (Banding)
Though not a surgical removal, banding is a common minimally invasive treatment where rubber bands are placed around the base of internal hemorrhoids to cut off blood flow, causing them to shrink and fall off. It is usually done in a clinic setting, causes minimal discomfort, and may be repeated if necessary.
What to Expect During and After Surgery
- Preparation: Depending on the procedure, you may undergo bowel preparation or an enema before surgery.
- Anaesthesia: Most hemorrhoid surgeries in Australia are performed under general anaesthesia or regional blocks.
- Recovery: Pain and discomfort are common, especially after haemorrhoidectomy, and may last one to two weeks. Pain management includes medications, sitz baths, stool softeners, and dietary fibre.
- Risks: Possible complications include bleeding, infection, anal narrowing (stenosis), and muscle damage. Discuss these with your surgeon beforehand.
- Follow-up: Regular check-ups ensure proper healing and address any concerns.
Finding Hemorrhoid Surgery in Australia
Experienced colorectal surgeons across Australia, including in major cities like Sydney, Melbourne, Brisbane, and Newcastle, offer these procedures. Many surgeries are performed in private hospitals such as St John of God, Epworth, and Box Hill Hospital, as well as public health facilities.
Hemorrhoid surgery in Australia offers several effective options, from traditional excision to minimally invasive techniques like stapling and artery ligation. The best choice depends on the severity of your hemorrhoids, your overall health, and your surgeon’s expertise. While surgery can involve some discomfort and recovery time, it often provides lasting relief when other treatments have failed.
If you’re struggling with severe hemorrhoids, consult a colorectal specialist to discuss your symptoms and explore the most suitable surgical options tailored to your needs.