Hemorrhoid surgery issues?
Hello Dr.
Ke,
I would like to ask you about hemorrhoid surgery.
In addition to traditional surgery and circular excision, there are some minimally invasive hemorrhoid surgeries recommended by aesthetic medicine.
The concept behind these procedures is to no longer treat hemorrhoidal tissue as a whole mass, as in traditional surgery, but to focus on tissue separation and mucosal preservation.
This involves delicately separating aged tissue in the submucosal area and above the sphincter, removing it, and then reattaching the normal tissue in its original position.
These procedures claim to result in less bleeding, reduced pain, quicker recovery, no need for hospitalization, and easier postoperative care.
If there are so many benefits, I believe this type of surgery should be feasible for you or other colorectal surgeons.
Currently, I am being treated at a Ministry of Health and Welfare hospital, but my attending physician has recommended traditional surgery.
Considering the recovery period and pain level, I am inclined to opt for the aesthetic procedure.
I would like to confirm with you whether there are any concerns regarding this type of surgery and why it is not adopted by larger hospitals.
Wei, 40~49 year old female. Ask Date: 2020/07/09
Dr. Ke Fangxu reply Surgery
First, it is important to clarify that hemorrhoids are not a pathological tissue; they have a normal physiological function, which is to maintain the closure of liquids and gases.
The concept of submucosal resection of all hemorrhoidal tissue was proposed and implemented over 50 years ago, leading to the occurrence of Whitehead deformity, a well-known complication in the field of colorectal surgery.
Although this procedure may prevent the recurrence of hemorrhoids for a lifetime, over time, patients may experience complications such as anal incontinence and mucosal prolapse.
I am unsure if the aesthetic medical clinic is referring to this type of surgery, but if they are licensed as colorectal surgeons and you trust their statements, then performing any type of surgery under informed consent and with a signed consent form is legally permissible.
Whether the postoperative outcomes align with their original claims is another matter, and it ultimately depends on the patient's own judgment.
Reply Date: 2020/07/09
More Info
Minimally invasive hemorrhoid surgery has gained popularity in recent years, primarily due to its promise of reduced pain, minimal bleeding, and quicker recovery times compared to traditional surgical methods. However, it is essential to understand the benefits and considerations associated with this approach before making a decision.
Benefits of Minimally Invasive Hemorrhoid Surgery
1. Reduced Pain and Discomfort: One of the most significant advantages of minimally invasive techniques is the reduction in postoperative pain. Traditional hemorrhoid surgeries often involve extensive tissue removal, which can lead to significant discomfort during recovery. In contrast, minimally invasive methods focus on preserving surrounding tissues, which can lead to a more comfortable recovery experience.
2. Less Bleeding: These techniques typically involve less manipulation of the tissues, which can result in reduced bleeding during and after the procedure. This is particularly beneficial for patients who may have concerns about excessive blood loss.
3. Faster Recovery: Patients undergoing minimally invasive procedures often experience shorter recovery times. Many can return to their normal activities within a few days, whereas traditional surgeries may require weeks of recovery.
4. Outpatient Procedure: Many minimally invasive hemorrhoid surgeries can be performed on an outpatient basis, meaning patients do not need to stay in the hospital overnight. This can be more convenient and cost-effective.
5. Preservation of Function: By focusing on tissue preservation, these techniques aim to maintain the normal function of the anal sphincter and surrounding structures, potentially reducing the risk of complications such as incontinence.
Considerations and Risks
1. Surgeon Experience: The success of minimally invasive procedures often depends on the surgeon's experience and familiarity with the technique. Not all surgeons may be trained in these newer methods, which can lead to variability in outcomes.
2. Availability of Technology: While many hospitals are adopting minimally invasive techniques, not all facilities may have the necessary equipment or expertise. This could explain why your primary physician recommends traditional surgery.
3. Long-term Outcomes: While short-term benefits are well-documented, the long-term outcomes of minimally invasive hemorrhoid surgeries are still being studied. It is crucial to consider whether these newer techniques provide lasting relief compared to traditional methods.
4. Potential Complications: As with any surgical procedure, there are risks involved. These can include infection, recurrence of hemorrhoids, and complications related to anesthesia. It is essential to discuss these risks with your surgeon.
5. Individual Suitability: Not all patients are suitable candidates for minimally invasive procedures. Factors such as the severity of hemorrhoids, underlying health conditions, and personal preferences should be considered when choosing a surgical approach.
Conclusion
In summary, minimally invasive hemorrhoid surgery offers several benefits, including reduced pain, less bleeding, and quicker recovery times. However, it is essential to weigh these advantages against the considerations and potential risks. Discussing your options thoroughly with your healthcare provider is crucial. They can provide insights based on your specific condition and help you make an informed decision that aligns with your health needs and lifestyle. If you are considering this type of surgery, ensure that you consult with a qualified surgeon who has experience in minimally invasive techniques to discuss your individual case and any concerns you may have.
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