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MEDICAL ANIMATION TRANSCRIPT: Your doctor may recommend a hemorrhoidectomy to remove your hemorrhoids if they do not respond to more conservative treatment. Hemorrhoidal veins are blood vessels within the walls of the rectum and anal canal. Hemorrhoids, also known as piles, occur when these veins become swollen and the tissue around them becomes inflamed. A swollen vein near the opening of the anal canal is called an external hemorrhoid. A swollen vein within the rectum is called an internal hemorrhoid. Internal hemorrhoids are classified by how advanced they are. First-degree internal hemorrhoids are those that always remain inside the rectum. Second-degree internal hemorrhoids will extend outside the rectum during a bowel movement, and then return to the inside of the rectum on their own. Third-degree internal hemorrhoids extend outside the rectum during a bowel movement, and then must be pushed back inside the rectum. Fourth-degree internal hemorrhoids always remain outside the rectum, and cannot be pushed back in. Before a hemorrhoidectomy, you may be given local or general anesthesia. For general anesthesia, you will be given medications to put you to sleep through breathing mask or through an IV line. A breathing tube will be inserted through your mouth and into your windpipe to help you breathe during the operation. Your surgeon will begin by using a scalpel, electrocautery, or laser to make an incision in the tissue around the hemorrhoid to expose the swollen vein. Your surgeon may tie off the swollen vein in order to keep it from bleeding when it is removed. Your surgeon will then remove the swollen vein and inflamed tissue. Your wound may be left open, or your surgeon may suture it closed. Finally, your surgeon will place medicated bandages over the wound, to aid in healing and protect from infection. The procedure generally takes about an hour. After your procedure, your breathing tube will be removed. You will be instructed to eat a high-fiber diet and drink plenty of fluids to help prevent constipation during your recovery, which usually lasts two weeks to two months. Your doctor may recommend warm baths, medications, and/or stool softeners, to make you more comfortable in the days after your procedure. Most people are able to return home the day after the procedure, but some will need to stay in the hospital for one to two days. After you return home, you should call your doctor immediately if you experience fever, excessive pain, drainage from your wound, redness, or swelling.
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Richard E. Seroussi M.D., M.Sc.
Diplomate, American Boards of Electrodiagnostic Medicine and PM&R
Seattle Spine & Rehabilitation Medicine
www.seattlespine.info
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Burts, Turner, Rhodes & Thompson
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Sullivan Papain Block McGrath & Cannavo, P.C.
New York, NY
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