Stapler Surgery for Piles (Stapled Hemorrhoidectomy) - Procedure, Recovery & Cost

Diagnosis And Procedure Of Stapler Surgery For Piles

Diagnosis

If you are experiencing symptoms of piles like extreme itching and pain around the anus, uncomfortable lump, or swelling near the anus, you may need stapler surgery to treat it. To determine that, the surgeon will perform a variety of diagnostic tests like:

Physical exam – Your doctor will inspect the area around the anus for-

• lumps or swelling near the anus
• internal piles that have fallen through the anal opening, known as prolapse
• external piles with a blood clot in a vein
• leakage of stool or mucus

Digital rectal exam – Your doctor can perform a digital rectal exam to-

• analyze the tone of the muscles in the anus
• check for tenderness, blood, and lumps or masses

Anoscopy– An anoscopy is used to diagnose piles. For an anoscopy, the doctor uses a small tube known as an anoscope to view the lining of the rectum and anus. The doctor examines the tissues lining your rectum and anus to look for signals of lower digestive tract problems and swelling or hard lumps around the anus. A related procedure called high-resolution anoscopy uses a particular magnifying device called a colposcope and an anoscope to view the anus and rectum area.

Rigid proctosigmoidoscopy – Rigid proctosigmoidoscopy is similar to an anoscopy, except that here the doctor uses a proctoscope to view and inspect the lining of your rectum and lower colon

Procedure

In stapler surgery, piles are removed, and a part of the anal region is stapled. This surgery is performed under a locoregional or general anesthetic and takes around 30 minutes.

• In this procedure, a circular hollow tube is inserted into the anal canal. A long woven suture is placed circumferentially within the anal canal and above the piles through this tube. 
• A stapler is a 33mm disposable instrument with a circular stapling device attached to it. The stapler is placed through the hollow tube, and the ends of the suture are pulled. 
• The doctor drags the suture, which then draws the expanded piles tissues into the jaws of the stapler. 
• Then, the piles cushions are pulled back into their normal position within the anal canal, and the stapler is ejected. It cuts off the circumferential ring of expanded piles tissues which is trapped in the stapler, and at the same time, staples together the upper and lower edges of the cut tissue.
• Stapler piles surgery stops the blood supply to the piles causing them to shrink.

Risks of Stapler Surgery for Piles

Risks and complications are uncommon in stapler surgery for piles. However, there can be certain drawbacks that can be reduced when an experienced proctologist performs the surgery.

Some of the risks of stapler surgery may include the following:

• Fecal incontinence
• Recurrence chances (6-8%)
• Bleeding and infection
• Inflammation
• Restraints from the staple line

Risks and complications after stapler surgery have been negligible, with recurrence of prolapse in 1 %, perianal thrombosis in 3 %, and anal stenosis in 2 % of patients.