How is the operation performed?
Under spinal anesthesia, hemorrhoids are isolated from the submucosal layer, the vascular pedicle is sutured and ligated, and the node is excised. Standardly, three main internal nodes are removed. One bed-day is necessary for observation after spinal anesthesia and complete pain relief in the first hours, when discomfort is maximum. Discharge occurs the next morning with detailed recommendations for regimen and care.
When should hemorrhoids be operated on?
Conservative treatment - suppositories, ointments, phlebotonics - is effective in the first and second stages, when the nodes do not fall out or correct themselves. It relieves aggravation, but does not remove already formed nodes.
In the third and fourth stages, when the nodes fall out and do not reset on their own, with repeated bleeding with anemia and thrombosis, surgery remains a radical solution.
What are they often doing at the same time?
In a significant proportion of patients, hemorrhoids are combined with an anal fissure or anal polyp. It is irrational to eliminate them with separate operations: this is a second anesthesia and a second recovery period. Therefore, interventions are often combined—in one operation, nodes are removed and a fissure or polyp is excised at the same time.
Recovery
The most sensitive period is the first 7–10 days, especially the first bowel movements. The key condition for a smooth recovery is soft stools: a laxative diet, sufficient fluids and, if necessary, laxatives are prescribed. It is strictly forbidden to push during this period.