Hemorrhoid Surgery: Key Questions and Considerations

Hemorrhoid surgery issues?

Hello, Doctor.
I would like to ask about the issue of surgery for hemorrhoids.
I have both external and internal hemorrhoids, and I am quite hesitant about whether to undergo surgery.
However, not having the surgery seems to lead to recurrent anal fissures, which is not ideal.
I visited two clinics in Taipei.
One uses traditional surgery with spinal anesthesia, while the other, which has a significant advertising presence and specializes in hemorrhoids as well as aesthetic procedures, claims to use medical aesthetic equipment for minimally invasive surgery, resulting in smaller wounds and less postoperative pain, without the need for sitz baths.
They use sedation anesthesia, but I still have many doubts.
Both clinics mentioned that I could return home for care after the procedure, but my father had hemorrhoid surgery at a public hospital and stayed hospitalized for several days.
The doctors also mentioned that sedation anesthesia is safer, but I still feel quite scared.
The clinic with less postoperative pain is indeed appealing, but I hope to get some advice from your expertise.
Additionally, I have some questions: Is it really possible to avoid hospitalization after hemorrhoid surgery? Is surgery at a large hospital better than at a clinic? Does minimally invasive surgery truly result in less pain? Can sitz baths be avoided? And is sedation anesthesia really as safe as the doctors claim? Thank you.

Xiao Cheng, 30~39 year old female. Ask Date: 2016/02/17

Dr. Chen Qifeng reply Gastroenterology and Hepatology

Hemorrhoid surgery falls under the scope of colorectal surgery.
There are various types of hemorrhoid surgeries, and the choice depends on the specific condition.
Recurrence may still occur after surgery.
Wishing you good health.

Reply Date: 2016/02/17

More Info

When considering hemorrhoid surgery, it's essential to weigh the benefits and risks associated with the procedure, as well as the different surgical options available. Hemorrhoids, whether internal or external, can cause significant discomfort, and recurrent issues such as anal fissures can further complicate the situation. Here are some key considerations and answers to your questions regarding hemorrhoid surgery.

Types of Surgery
1. Traditional Surgery: This involves a more invasive procedure, often performed under spinal or general anesthesia. It may require a longer recovery time and can lead to more postoperative pain. Patients typically stay in the hospital for a few days for monitoring and pain management.

2. Minimally Invasive Techniques: These include procedures like stapled hemorrhoidopexy or laser therapy. They are designed to reduce recovery time and postoperative pain. The use of advanced medical equipment can lead to smaller incisions and less trauma to surrounding tissues.

Anesthesia Options
- General Anesthesia: This is commonly used for traditional surgeries and may involve more risks, particularly for patients with underlying health conditions.

- Sedation (Comfort or Conscious Sedation): This method allows patients to be relaxed and comfortable during the procedure while remaining conscious. It is generally considered safe, but like all anesthesia, it carries some risks, particularly for those with respiratory issues or other comorbidities.

Postoperative Care
- Hospital Stay: Many minimally invasive procedures allow for outpatient care, meaning you may be able to go home the same day. However, traditional surgeries often require a hospital stay for a few days to manage pain and monitor for complications.

- Pain Management: Minimally invasive techniques typically result in less postoperative pain, which can be a significant factor in your decision-making process. However, individual experiences vary, and some patients may still experience discomfort regardless of the technique used.

- Sitz Baths: Traditionally, sitz baths are recommended post-surgery to promote healing and comfort. However, some minimally invasive procedures may not require this, as the recovery may be less painful.

Choosing the Right Facility
- Hospital vs. Clinic: Generally, hospitals may offer more comprehensive care, including access to specialists and advanced imaging if complications arise. However, reputable clinics that specialize in hemorrhoid treatment can also provide excellent care, especially if they utilize advanced techniques and have experienced surgeons.

Risks and Considerations
- Complications: As with any surgery, there are risks involved, including bleeding, infection, and recurrence of hemorrhoids. Discuss these risks with your surgeon to understand how they apply to your specific situation.

- Recovery Time: Recovery can vary based on the type of surgery performed. Minimally invasive procedures typically allow for a quicker return to normal activities, but it’s essential to follow your surgeon's postoperative instructions for the best outcomes.

Conclusion
Ultimately, the decision to undergo hemorrhoid surgery should be based on a thorough discussion with your healthcare provider, considering your specific symptoms, the severity of your condition, and your overall health. It’s crucial to ask questions about the surgical techniques, anesthesia options, and postoperative care to make an informed choice. If you feel more comfortable with a particular facility or technique, trust your instincts while ensuring that the provider is qualified and experienced in treating hemorrhoids.

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