Dr. Shobitha S S

Your body starts sending signals well before a condition can assume a critical state, and hence it becomes essential to listen to your body to avoid getting into complications. Internal haemorrhoids, less painful than external haemorrhoids, can worsen over time if left untreated and can result in bleeding.

The term haemorrhoids, commonly known as piles, refer to inflamed and swollen veins in the anus and the rectum that cause bleeding and discomfort, especially during sitting and bowel movements. When the blood veins inside of the rectum become engorged and swollen, it is referred to as internal haemorrhoid.

When internal haemorrhoids take moderate to severe form, they require surgery. Here is a closer look at the surgical options available for treating internal haemorrhoids.

1. Closed hemorrhoidectomy: Closed hemorrhoidectomy is the most common surgical procedure used for treating internal haemorrhoids. In this case, excision of the haemorrhoid bundles is performed by using sharp instruments like electrocautery or scalpel or scissors, followed by complete closure of the wound with absorbable suture. Closed hemorrhoidectomy has a success rate of around 95% for treating internal haemorrhoids completely.
2. Open Hemorrhoidectomy: In this surgical procedure, hemorrhoidal tissues are excised in the same way as that of the closed hemorrhoidectomy. The only difference here is that the incision is not closed but left open. Open hemorrhoidectomy is usually performed at such locations where the closing of the wound is difficult or may have a high risk of postoperative infections. Depending on the requirement of the patient's internal haemorrhoid conditions, a combination of both closed and open hemorrhoidectomy may be carried out.
3. Stapled Hemorrhoidectomy: Stapled hemorrhoidectomy, also known as hemorrhoidopexy, is another surgical procedure where a stapling device of circular shape is used for excising a circumferential ring portion of the excess tissues of internal haemorrhoid. This procedure helps to lift the haemorrhoids back in their normal position inside the anal canal. This surgical technique is comparatively a new addition to the surgical treatment options for internal haemorrhoid treatment. Stapled haemorrhoidectomy is most widely accepted technique of haemorrhoidectomy. Advantages of this technique are: 
   • There is a minimal pain after surgery. 
   • There is minimal or no bleeding after surgery. 
   • Patients can resume their routine activities after 2-3 days. 
   • There is no external wound or scar after this surgery.
4. Rubber Band Ligation: Rubber band ligation surgery doesn’t require anaesthesia and can be performed for treating internal haemorrhoids. Here, a rubber band is used around the base area of haemorrhoid that is there inside the rectum, which helps in cutting off the blood circulation making haemorrhoid wither away within weeks. However, banding isn’t suggested for those who take blood thinners as it may increase bleeding complications.
5. Lateral Internal Sphincterotomy: In lateral internal sphincterotomy, the muscles of the inner anal sphincter are opened. This surgical procedure is for those patients with internal haemorrhoids who have high resting pressure on the sphincters. Though rarely used, this surgical method doesn't cause much pain after the operation.

A gastroenterology surgeon can determine the suitable surgery option only after a thorough analysis of one's physical health, and the condition and complications of the internal haemorrhoids. While sometimes, laparoscopic surgeries do help, for some a more traditional open kind of internal haemorrhoid surgery may become necessary. In case you have a concern or query you can always consult an expert & get answers to your questions!