Risks and Considerations of Removing PPH Staplers After Surgery

Removal of PPH (Procedure for Prolapse and Hemorrhoids) stapler?

Hello, Dr.
Ke! A few days ago, I inquired about some areas of my wound that have been persistently experiencing a pinching and swelling sensation.
Recently, the pinching and swelling have become more frequent, and sometimes I am afraid to sit down.
After having a bowel movement, I also noticed a small amount of bright red blood.
You previously mentioned that there are doctors who can help remove the anastomosis staples.
Could you please let me know what risks are associated with removing these staples? I have been considering the removal in the past few days, but I am worried that it might cause further damage to the anal area, especially since I am already in a lot of pain...

Zhang Xiansheng, 30~39 year old female. Ask Date: 2020/12/27

Dr. Ke Fangxu reply Surgery

This type of surgery is quite complicated and carries a risk of anal stenosis.
It is rarely performed by physicians other than the original surgeon.
You may want to consult the surgeon who performed the initial procedure.

Reply Date: 2020/12/27

More Info

The removal of PPH (Procedure for Prolapse and Hemorrhoids) staplers, while sometimes necessary, does come with its own set of risks and considerations that patients should be aware of. The PPH procedure is designed to treat hemorrhoids and involves the use of staplers to secure tissue in place. However, complications can arise, leading to discomfort or the need for further intervention.

Risks of Stapler Removal
1. Infection: Any surgical procedure carries a risk of infection. The area around the anus is particularly sensitive, and if the skin is broken during the removal of the staplers, bacteria can enter, leading to an infection.

2. Bleeding: There is a possibility of bleeding during or after the removal of the staplers. This is especially concerning if the area is already inflamed or if there are underlying issues with blood clotting.

3. Pain and Discomfort: Patients often report pain after the removal of staplers. This can be exacerbated if the area is already sensitive or if there is inflammation present.

4. Narrowing of the Anal Canal (Stricture): One of the significant risks associated with the removal of staplers is the potential for anal stricture, which is a narrowing of the anal canal. This can lead to difficulties with bowel movements and may require further surgical intervention.

5. Delayed Healing: The removal of staplers can disrupt the healing process, potentially leading to prolonged discomfort and a longer recovery period.

6. Recurrence of Symptoms: If the underlying issues that led to the stapler placement are not addressed, there is a risk that symptoms may recur after the removal.

Considerations Before Removal
1. Consultation with the Surgeon: It is crucial to discuss your symptoms and concerns with the surgeon who performed the original procedure. They can provide insights into whether the stapler removal is necessary and what the expected outcomes are.

2. Assessment of Symptoms: If you are experiencing significant discomfort, such as persistent pain, bleeding, or a feeling of pressure, these symptoms should be evaluated thoroughly. Sometimes, these symptoms can be managed without the need for stapler removal.

3. Timing of Removal: If removal is deemed necessary, the timing can be critical. It may be advisable to wait until the area has healed sufficiently to minimize risks.

4. Post-Operative Care: After the removal, following proper post-operative care instructions is essential. This includes maintaining hygiene, managing pain, and monitoring for any signs of infection or complications.

5. Alternative Treatments: Depending on the severity of your symptoms, there may be alternative treatments available that do not involve surgical intervention. Discussing these options with your healthcare provider can provide additional avenues for relief.

Conclusion
While the removal of PPH staplers can alleviate certain symptoms, it is not without risks. It is essential to weigh these risks against the potential benefits and to have a thorough discussion with your healthcare provider. They can help you navigate your symptoms and determine the best course of action for your situation. Remember, your comfort and health are paramount, and addressing any concerns you have with your medical team is crucial for a successful recovery.

Similar Q&A

Unremoved Surgical Stitches: Risks and Concerns After Orthopedic Surgery

Hello doctor, two weeks ago I had a car accident and fractured my hand. Last week, I returned for a follow-up appointment and had my stitches removed. Yesterday, I took off the bandage and noticed that it seems like the surgical stitches weren't completely removed; there are...

Dr. Shi Guozheng reply Orthopedics
If the sutures are absorbable, they will dissolve on their own. However, if they are non-absorbable sutures, it is best to remove them, as they can sometimes lead to infection.

Post-Surgery Concerns: Delayed Healing and Medication Queries for Hemorrhoids

Hello Dr. Ke, on March 18 of this year, I underwent surgery for internal hemorrhoids at Hospital A. However, since last September, I have already had three anal surgeries at Hospital B, including procedures for anal fistula and hemorrhoids, as well as a surgical repair for an inf...

Dr. Ke Fangxu reply Surgery
1. Anal fissures cannot occur as a result of stretching the anal opening, as there would be no injury present. 2. If the colonoscopy shows no abnormalities, performing a digital rectal examination or anoscopy will not yield new findings, but it can help assess the extent of woun...

Concerns About Retained Screws After ACL Repair Surgery: Pain and Complications

Hello, about 4 to 5 years ago, I underwent surgery for posterior cruciate ligament repair and fixation. A year later, after the screws were removed, the doctor mentioned that there were still three screws left inside because they were close to nerves and blood vessels, so they we...

Dr. Wang Shouji reply Orthopedics
In general, this type of steel pin does not necessarily need to be removed. If removal is required, there may be some minor risks involved, but as long as precautions are taken, the risks should be minimal. It is important to consider whether removal is absolutely necessary. Wish...

Understanding Pain and Complications After Hemorrhoid Banding Surgery

I have undergone rubber band ligation for external hemorrhoids, which has caused my anal sphincter to tighten intermittently, resulting in significant pain. I also experience a sensation of a foreign body in the anal area, along with the discharge of foul-smelling fluid mixed wit...

Dr. Ke Fangxu reply Surgery
According to health insurance regulations, rubber band ligation for hemorrhoids should not exceed four times a year. It is generally believed that if multiple ligations do not effectively improve symptoms, hemorrhoidectomy may be recommended. If the hemorrhoids are large and mult...