When there are several cracks
A typical anal fissure is one and is located along the posterior wall of the anal canal. Multiple cracks, especially of atypical localization, are a reason for caution: they occur with Crohn's disease, tuberculosis, HIV infection, syphilis and after radiation therapy. Therefore, before surgery, additional examination is carried out so as not to miss a systemic disease in which conventional excision will not yield results. The intervention itself is more complex than a single one: several defects are excised, the volume of tissue removed is larger, and healing requires longer observation.
Stages of hemorrhoids and choice of method
Hemorrhoids develop gradually: at first the nodes only bleed, then they fall out when straining and are reduced on their own, later they require manual reduction, and at the last stage they are not reduced at all. The treatment method is chosen according to the stage.
In the early stages, minimally invasive techniques work - latex ligation and infrared coagulation. In later cases, node removal is required: classic hemorrhoidectomy, laser technique, or desarterization with suturing of the feeding arteries.
Basic methods
- infrared coagulation - non-contact cauterization, outpatient, for early stages
- latex ligation - clamping the leg of the node with a ring
- classic hemorrhoidectomy - excision of nodes, the most radical method
- laser hemorrhoidectomy - less blood loss and pain
- HAL-RAR - suturing of arteries under ultrasound control with tightening of the mucosa
What determines the price of surgery
Scope of intervention: number of nodes removed, presence of thrombosis, combination with anal fissure or polyp. Combined operations are more expensive, but eliminate the need for a second anesthesia and a second recovery period.
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, plenty of fluids and, if necessary, laxatives are prescribed. You cannot push during this period.