Stapled Hemorrhoidectomy (Hemorrhoidopexy)

Hemorrhoids occur when the veins in or around the rectum become inflamed and swollen. In some cases, the swollen veins can prolapse and protrude from the anus. A stapled hemorrhoidectomy, also known as a Procedure for Prolapse and Hemorrhoids (PPH), is an effective surgical option for third- or fourth-degree internal hemorrhoids that have prolapsed and do not respond to at-home treatments.

While other types of hemorrhoidectomies actually remove the inflamed tissue, a stapled hemorrhoidectomy does not. Instead, the procedure focuses on the enlarged and lax tissue surrounding the hemorrhoid. The goal of a stapled hemorrhoidectomy is to secure a prolapsed hemorrhoid into a higher position inside the anal cavity, returning it to it’s normal anatomic location.  This is called a pexy.

The Procedure: How a Stapled Hemorrhoidectomy Works

During this 30-minute procedure, the patient is sedated.  The hemorrhoids are replaced into the anal canal using the PPH instrument.  A special stitch is then placed by the surgeon to hold the hemorrhoids in place.  The PPH stapler is then opened and the hemorrhoidal tissue is pulled into the stapler.  The stapler is fired, removing the excess hemorrhoidal tissue.  The lining is secured by the staples which are placed by the instrument almost simultaneously with the firing of the stapler.

Benefits and Side Effects

A stapled hemorrhoidectomy is generally much less painful than other types of hemorrhoid operations, and patients can expect to return to work sooner. There is very slightly an increased risk of hemorrhoids recurring, however. Other side effects include postoperative discomfort, postoperative bleeding and a rare syndrome of longer term postoperative pain.

The risks greatly outweigh the benefits however and if you think that you might be a candidate for a PPH, you should contact a specialist for a consultation and evaluation.