Sustainable and proven
In the removal of hemorrhoids, a change in thinking has taken place in recent decades. Hemorrhoids are no longer regarded as pathological growths, but as a fundamentally useful part of the so-called continence organ, i.e. the anatomical structures that are important for sealing the rectum. This tissue is worth preserving.
Therefore, today we treat most patients with hemorrhoidal complaints with shirring and laser sclerotherapy (HAL-LHP). Removal of the hemorrhoids is the first choice only if either a lump can no longer be pushed back into the anal canal, an anal fissure is present at the same time, or a malignant change is suspected with the need for histological examination. Occasionally, the patient's desire for removal of an external mariske may also be the reason for conventional hemorrhoid removal.
For the removal of hemorrhoids we use the laser(Intros Lina 30). Our experience shows that this allows a particularly precise release of the hemorrhoidal knot in the layer specified by nature. The focused application of laser energy avoids undesirable thermal damage to the surrounding area. In terms of the basic principle, we follow the Milligan-Morgan open technique, which was developed at St. Marks Hospital in London. Numerous studies have shown that the closed techniques of hemorrhoidectomy offer no advantages in terms of postoperative pain or sphincter function.
Hemorrhoid removal through a surgical procedure is called hemorrhoidectomy in technical language. In this procedure, the surgeon cuts around the outer portion in an arc and detaches the enlarged hemorrhoid from the internal sphincter. A - dissolvable - suture cuts off the central, feeding blood vessels. The wound may be left open (Milligan-Morgan), sutured continuously (Ferguson), or closed reconstructively (Parks, each according to the initial describer of the technique). Most surgeons use an electric scalpel (diathermy). Alternatives may be sealing instruments (e.g. Ultracision®, Ligasure®) or a surgical laser.
Precise and effective
We operate on an outpatient basis and under anaesthesia (general or spinal). Our surgery day is every second Friday afternoon. The operations take place in the Iatros - Clinic, an outpatient surgery center. After the operation you will be monitored in the recovery room for 1 - 2 hours. Then you can be picked up again.
You will receive the prescription for necessary medication on the day of the surgery, as well as a mobile number for urgent matters at the weekend. I will bring you the necessary certificate of incapacity for work on the day of the operation. Most patients are on sick leave for 2 - 3 weeks after a haemorrhoidectomy.
Significant afterpains (dampness, wound pain) are to be expected until the second week after the operation. Once the healing has begun after this time, it goes steadily noticeable uphill.
Aftercare after hemorrhoid surgery is not demanding:
Sphincter injury does not occur when performed properly. Sensitivity in the anal area is best protected if sufficient sensitive anal skin is left behind. Scarred constrictions of the anus are very rare consequences, as are significant restrictions in the ability to hold stool (incontinence).
In our proctological practice in Munich, we also use laser haemorrhoidoplasty or haemorrhoid artery ligation. We will be happy to advise you in detail on all therapy options - do not hesitate to contact us.
Should skin folds (marisques) and anal vein thrombosis be surgically removed?