What are hemorrhoids or piles?
Hemorrhoids, also known as” piles”, are natural cushions of tissue and veins located at the junction between rectum and anus. Hemorrhoids play a significant physiologic role in protecting the anal sphincter muscles and work with them to close the anal canal when abdominal pressure increases (e.g., coughing, sneezing) to prevent incontinence and contribute 15 to 20% of the resting anal canal pressure. This tissue is also thought to help differentiate stool, liquid and gas in the anal canal. Everyone has them, even newborns; problems only arise when they prolapse and become larger than they should. In fact, when Parks ligaments become loose for different reasons (pregnancies, childbirth, chronic constipation.), hemorrhoids prolapse down to the anal verge, get enlarged, the overlying tissue becomes thinner and prone to bleed. For this reason is more correct to call the disease ‘hemorrhoidal prolapse’ or simply ‘prolapse’, since hemorrhoids are present in the normal anal canal.
According to the Goligher classification, hemorrhoids can be of 4 grades
Symptoms of hemorrhoidal prolapse:
As a general rule: most hemorrhoidal prolapses require only medications and lifestyle modifications, but some of them are best treated with surgery.
Traditional methods like Ferguson and Milligan-Morgan procedures require surgical asportation of the 3 hemorrhoidal packages, with a very painful postoperative course.
Conversely, we believe in modern hemorrhoids treatment surgery, with the aim of guaranteeing to the patients a smooth and quick recovery after surgery.
So either we use the Doppler ligation of the vessels feeding the hemorrhoids and a pexy of the redundant tissue or we definitely resect the prolapse with a circular stapler, therefore repositioning the hemorrhoids in the normal anatomical position (Longo technique and STARR)
Hemorrhoidal Artery Ligation and Recto Anal Repair Systems (HAL-RAR) is a Day Case procedure, with no cutting, no removal of tissue and no open wounds, with a short procedure time and quick return to daily activities.
*hemorrhoid surgery, same day hemorrhoid surgery