Hemorrhoids, or piles, can cause significant discomfort, and when conservative treatments fail, removal may be necessary. In Australia, several effective methods exist to remove or reduce hemorrhoids, ranging from minimally invasive outpatient procedures to surgical operations. This blog explains the common hemorrhoid removal techniques available locally, what each involves, and what patients can expect.
1. Rubber Band Ligation: Cutting Off the Blood Supply
Rubber band ligation is one of the most common methods of treating internal hemorrhoids in Australia. Using specialized tools, a tiny elastic band is wrapped around the hemorrhoid’s base during this outpatient operation. Within a week or so, the hemorrhoid will shrink and come off as a result of this band cutting off blood flow to it.
- Who is it for? Suitable for large internal hemorrhoids and early prolapsing piles.
- Anaesthesia: Usually none or mild sedation.
- Recovery: Minimal downtime; some mild discomfort or bleeding may occur.
- Effectiveness: Often requires repeat treatments but is highly effective for many patients.
2. Injection Sclerotherapy: Chemical Shrinking
Sclerotherapy involves injecting a sclerosing (shrinking) chemical into the hemorrhoid to reduce its size by cutting off the blood supply. This treatment is usually done in a clinic setting and is an option for patients who cannot undergo banding or require a less invasive approach.
- Who is it for? Mild to moderate internal hemorrhoids.
- Anaesthesia: None required.
- Recovery: Minimal discomfort; multiple sessions may be needed.
- Limitations: Effects may be temporary, requiring ongoing treatment.
3. Haemorrhoidectomy: Surgical Removal
For severe, large, or complicated hemorrhoids, haemorrhoidectomy is the traditional surgical procedure where hemorrhoidal tissue is excised. This operation is typically performed under general anaesthesia in a hospital or day surgery centre.
- Types:
- Open haemorrhoidectomy: The wound is left open to heal naturally.
- Closed haemorrhoidectomy: The wound is sutured closed.
- Recovery: Can be painful with a recovery period of 1-2 weeks or more. Pain management and stool softeners are essential.
- Hospital Stay: Usually day surgery, but some patients may require overnight observation.
- Effectiveness: Considered the most definitive treatment with low recurrence rates.
4. Stapled Haemorrhoidopexy: Repositioning and Stapling
Also known as the Procedure for Prolapse and Haemorrhoids (PPH), this technique uses a circular stapler inserted through the anus to pull prolapsed hemorrhoidal tissue back inside the rectum and staple it in place. This cuts off blood supply and reduces swelling.
- Advantages: Less post-operative pain and faster recovery compared to traditional surgery.
- Anaesthesia: General anaesthesia required.
- Who is it for? Large prolapsing hemorrhoids, especially grade 3 and 4.
- Limitations: Slightly higher chance of hemorrhoid recurrence.
5. Haemorrhoidal Artery Ligation (HAL) / Transanal Haemorrhoidal Dearterialisation (THD)
This minimally invasive surgery uses Doppler ultrasound to locate arteries supplying blood to hemorrhoids. The surgeon then ties off these arteries, reducing blood flow and causing hemorrhoids to shrink. For prolapsed hemorrhoids, the tissue is lifted and secured with sutures.
- Benefits: Virtually painless, minimal downtime, and most patients return to work within 1-2 days.
- Anaesthesia: General anaesthesia.
- Effectiveness: Over 85% of patients experience complete symptom resolution.
- Availability: Offered in specialist centres in Australia, including Melbourne and Sydney.
What to Expect Before and After Hemorrhoid Removal
- Pre-Operative Preparation: May include fasting, bowel preparation, and medical assessments.
- Post-Operative Care: Pain management, sitz baths, stool softeners, and a high-fibre diet to ease bowel movements.
- Recovery Time: Varies by procedure; minimally invasive treatments allow quick return to normal activities, while surgery may require 1-2 weeks off work.
- Follow-Up: Essential to monitor healing and address any complications.
Choosing the Right Treatment in Australia
The best hemorrhoid removal method depends on the severity, type of hemorrhoids, patient health, and preferences. Australian colorectal specialists assess each case individually to recommend the most appropriate and effective treatment, balancing benefits and recovery time.
Hemorrhoid removal in Australia ranges from simple outpatient procedures like rubber band ligation to more advanced surgeries such as haemorrhoidectomy and artery ligation. Advances like the HALO procedure offer effective relief with minimal pain and downtime. If hemorrhoids are impacting your quality of life, consult a colorectal surgeon to explore the best removal options tailored to your needs.