46255 Hemorrhoidectomy, internal and external, single column/group

Name of the Procedure:

Hemorrhoidectomy, internal and external, single column/group

• Common name(s): Hemorrhoid removal surgery
• Technical terms: Excisional Hemorrhoidectomy

Summary

A hemorrhoidectomy is a surgical procedure to remove hemorrhoids, which are swollen and inflamed veins in the rectum and anus that cause discomfort and bleeding. The procedure can address both internal and external hemorrhoids.

Purpose

• Medical condition: Hemorrhoids
• Goals: To relieve symptoms such as pain, swelling, bleeding, and itching by removing the problematic hemorrhoidal tissue.

Indications

• Persistent pain or discomfort
• Chronic bleeding
• Prolapsed hemorrhoids (hemorrhoids that have slipped outside the anus)
• Failure of non-surgical treatments (e.g., dietary changes, medications, minimally invasive procedures)

Preparation

• Pre-procedure instructions:
  • Fasting for several hours before surgery
  • Cease taking blood-thinning medications as advised by the doctor
  • Arranging transportation post-surgery
• Diagnostic tests/assessments:
  • Physical examination
  • Possibly a colonoscopy to rule out other conditions

Procedure Description

1. Anesthesia: Local, spinal, or general anesthesia is administered for patient comfort.
2. Positioning: The patient is positioned prone or lying on their side.
3. Incision: The surgeon makes small incisions around the hemorrhoidal tissue.
4. Removal: Both internal and external hemorrhoids in the targeted column or group are excised.
5. Closure: The wound may be left open to heal naturally or stitched closed.
6. Post-surgery care: Application of absorbent dressings to manage any drainage; possible use of antibiotic ointment.

Tools and equipment: Surgical scalpel, scissors, electrocautery device for sealing blood vessels, sutures

Duration

The procedure typically takes about 30-60 minutes.

Setting

Performed in a hospital or an outpatient surgical center.

Personnel

• Surgeon
• Anesthesiologist
• Surgical nurse
• Operating room assistant

Risks and Complications

• Common risks: Pain, bleeding, infection, urinary retention
• Rare risks: Fecal incontinence, anal stenosis (narrowing of the anal canal), recurrence of hemorrhoids
• Management: Pain management strategies, antibiotics for infections, secondary surgical intervention if needed

Benefits

• Significant reduction or elimination of hemorrhoid symptoms
• Improved quality of life
• Outcomes can typically be realized within a few weeks post-surgery

Recovery

• Post-procedure care: Keep the area clean, use sitz baths, take prescribed pain relief
• Recovery time: Typically 2-4 weeks
• Restrictions: Avoid heavy lifting and straining
• Follow-up appointments: Essential to monitor healing and manage any complications

Alternatives

• Non-surgical treatments:
  • Rubber band ligation
  • Sclerotherapy
  • Infrared coagulation
• Pros and cons: Less invasive but may not provide lasting relief for severe cases

Patient Experience

• During: No pain due to anesthesia
• After: Initially, moderate pain and discomfort, managed with pain medications
• Pain management: Prescription painkillers, sitz baths, and topical treatments for comfort measures

This markdown text provides a comprehensive overview of the hemorrhoidectomy procedure, emphasizing patient-friendly language and thorough detail.