Is Hemorrhoid Surgery Out-of-Pocket? Costs and Options - Surgery

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Is hemorrhoid surgery out-of-pocket?


Hello, doctor.
Yesterday, I took my mother to see a general surgeon at Tzu Chi.
My mother has had hemorrhoids for many years, and recently she has been experiencing rectal bleeding.
The doctor said she has stage 3 hemorrhoids and needs to be hospitalized for two days for surgery.
He mentioned that my mother is suitable for a specific type of surgery that costs 17,000 NTD out of pocket.
Is this true? Is it a circular excision procedure? He also said that traditional surgery is not as good and would be more painful.
Thank you.

Feng, 50~59 year old female. Ask Date: 2007/08/09

Dr. Ke Fangxu reply Surgery


Hello: In response to your question.
The circular excision surgery has developed in recent years, utilizing a specialized instrument to perform simultaneous circular excision and stapled anastomosis above the hemorrhoidal tissue.
The principle is to obstruct blood flow to the hemorrhoidal tissue, leading to its atrophy (note: this does not involve excising the hemorrhoids).
However, this specialized instrument is not covered by health insurance, and hospitals charge between 15,000 to 23,000 NT dollars.

The advantage of this surgery is that, if performed correctly, it is indeed painless because the incision is made within the hemorrhoidal tissue, an area lacking nerve supply, thus resulting in no pain.
The issue is that the complication rate for this type of surgery is relatively high, including pain (if the excision is too low), bleeding, perforation, and recurrence.

Currently, there is a general consensus within the colorectal surgery community that if the hemorrhoids are not too large and bleeding is the primary symptom, circular excision surgery may be applicable.
However, one must question whether surgery is truly necessary in such cases.
Traditional surgery typically results in postoperative pain lasting about a week, but it is generally more effective in removing hemorrhoidal tissue and has fewer complications compared to circular excision.

Ultimately, the choice of surgical method should rely on in-depth discussions between the physician and the patient.
Both surgical options have their pros and cons, rather than one being superior to the other.
The stance of public medical centers is neither to prohibit nor to encourage this procedure.
Personally, having witnessed unsuccessful cases by other physicians, I do not recommend this type of surgery.

Reply Date: 2007/08/09

More Info


When it comes to hemorrhoid surgery, understanding the costs, options, and potential out-of-pocket expenses is crucial for patients and their families. Hemorrhoids, particularly when they reach stage III, can cause significant discomfort and complications, such as bleeding during bowel movements, which your mother is experiencing.

Cost of Hemorrhoid Surgery
In the United States, the cost of hemorrhoid surgery can vary widely based on several factors, including the type of procedure performed, the facility where the surgery is conducted, and whether the patient has insurance coverage. For patients without insurance, the out-of-pocket costs can range from $3,000 to $15,000 or more, depending on the complexity of the case and the surgical technique used. In your mother's case, the quoted price of $17,000 for the procedure seems to be on the higher end, but it could be justified depending on the specifics of the surgery and the facility.


Types of Hemorrhoid Surgery
There are several surgical options for treating hemorrhoids, and the choice often depends on the severity of the condition and the patient's overall health. The most common procedures include:
1. Hemorrhoidectomy: This is the traditional surgical method where the hemorrhoids are excised. It is effective but can be painful and may require a longer recovery time. Patients typically need to stay in the hospital for a day or two post-surgery.

2. Stapled Hemorrhoidopexy: This is a less invasive option that involves using a stapling device to remove the hemorrhoidal tissue and reposition the remaining tissue. It generally results in less pain and a quicker recovery time compared to a traditional hemorrhoidectomy.

3. Laser Surgery: This is a newer technique that uses laser technology to remove hemorrhoids. It is often associated with less pain and quicker recovery, but it may not be available in all facilities.

4. Rubber Band Ligation: This is a non-surgical option where a rubber band is placed around the base of the hemorrhoid to cut off its blood supply, causing it to shrink and fall off. This is typically done in an outpatient setting and does not require hospitalization.


Pain and Recovery
Regarding pain management, traditional hemorrhoidectomy is known to be more painful than other methods, such as stapled hemorrhoidopexy or laser surgery. Patients often report significant discomfort during the recovery period, which can last from a few days to a couple of weeks. Pain management strategies, including medications and dietary adjustments, are essential for a smoother recovery.


Conclusion
In summary, your mother’s situation with stage III hemorrhoids necessitates surgical intervention, and the quoted cost of $17,000 may reflect the type of surgery being performed and the facility's pricing. It is essential to clarify with the surgeon whether this is for a traditional hemorrhoidectomy or another method, such as stapled hemorrhoidopexy. If the cost is a concern, it may be worth discussing payment plans or exploring other facilities that might offer competitive pricing. Additionally, understanding the type of surgery and its implications on recovery and pain management will help you and your mother make an informed decision. Always consult with the healthcare provider to ensure that the chosen method aligns with her health needs and preferences.

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