Hemorrhoid treatment (2)

Traditional surgery – Hemorrhoidectomy 

 Principles
- Decrease the blood flow to anorectal ring
- Remove redundant hemorrhoidal tissue


 Indications
- Grade II, III and IV hemorrhoids
- Failure of non-operative treatment of 2nd degree pile
- Thrombosed hemorrhoid 
- Interoexternal pile when the external pile is well defined


 Types
- Excision of hemorrhoids without (open hemorrhoidectomy) or with (closed hemorrhoidectomy) suturing 
- Using different energies for excision
 Diathermy
 Harmonic scalpel
 Bipolar scissors









Reference: psclinic.com.hk/

The information aims to provide educational purpose only. Anyone reading it should consult 
Surgery Specialist before considering treatment and should not rely on the information

above.

Hemorrhoid treatment (1)

Dietary and lifestyle modifications
 Goal: to minimize straining at stool  minimizing constipation
 Diet
- Increase fluid intake
- Stool softeners
 Lifestyle modifications
- Regular defecatory habits


Medications
 Local and oral medications
 Arrests bleeding
 Relieves pain, irritation, and inflammation
 Guard against infection


Outpatient hemorrhoid treatment
 Rubber band ligation, endoscopic ligation
 Ultroid system
 Sclerotherapy
 Infrared coagulation
 Bicap electrocoagulation
 Cryotherapy
 Laser treatment


Banding / Ligation of hemorrhoids
 For Grade 2 and 3 internal hemorrhoids
 Principle: Banding  ischemic necrosis  slough off within few days
 Successful respond rate: 60-70% cured with a single treatment session

http://youtu.be/K7HKrBwuKSw (Video demonstration)




Reference: psclinic.com.hk/

The information aims to provide educational purpose only. Anyone reading it should consult

Surgery Specialist before considering treatment and should not rely on the information above.