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MBChB PhD FRCS

FAQs

Consultant Laparoscopic Colorectal and General Surgeon

Laparoscopic colorectal surgery

Haemorrhoid surgery using the latest techniques

A high fibre diet can help prevent the need for haemorrhoid surgeryFor many people with haemorrhoids, ointments, creams and suppositories are highly effective when used in conjunction with a high fibre diet and drinking plenty of fluid. For others, the haemorrhoids can become large and painful and do not respond and need further treatment.

Less invasive treatments are usually tried first in the clinic, including rubber band ligation or injection sclerotherapy. If these are not successful, or your haemorrhoids are very severe, you may be advised to have surgery.

Traditional haemorrhoid surgery

Until recent, all severe haemorrhoids were treated using open surgery, known as an open haemorrhoidectomy.

This is a major operation in which the swollen blood vessels are cut away. The surgeon works through the anus, so you will not have abdominal scars, but you will be told to expect quite a lot of pain afterwards. This can persist for some weeks when opening your bowels. Most people need a couple of weeks off work at least.

Although open haemorrhoid surgery is effective at treating severe haemorrhoids, which rarely recur, surgeons have recently developed alternative procedures that are just as effective, but result in less post-operative pain and a faster return to normal activities.

Patient’s respond well haemorrhoidal artery ligation techniques such as HALO

“Although this is a relatively new technique, it is becoming more accepted because it leads to faster recovery and a better patient experience. The National Institute for Health and Clinical Excellence has reviewed the evidence and now recommends HALO as an effective treatment for severe haemorrhoids.”

Mr Jonathan Wilson is a colorectal surgeon who specialises in laparoscopic surgical techniques. He also operates routinely on patients with haemorrhoids using minimally invasive techniques such as HALO.

Haemorrhoidal artery ligation operation (HALO)

Life after HALO

Over the few weeks following your haemorrhoidal artery ligation operation, your haemorrhoids will shrink away, causing a general easing of symptoms such as pain, bleeding and prolapse. The operation is done as a day case, you get home quickly and you can get back to normal in just a few days.

Although still carried out under general anaesthetic, haemorrhoidal artery ligation (eg. HALO) is an operation with a much shorter recovery time. There are no cuts to the sensitive skin around the anus, which is what causes the severe pain following a traditional open haemorrhoidectomy.

A Doppler probe (small ultrasound transducer) is used to visualise the artery that supplies each haemorrhoid with blood and this vessel is surgically tied off internally.

Some people experience a little discomfort in the first couple of days, particularly when opening the bowels, but much less when compared to open surgery. Occasionally, small skin tags are left behind after the haemorrhoids have shrunk, and if troublesome (as is the case for a small proportion of people), these can removed with a second short operation.

Stapled haemorrhoidopexy

This is another alternative to open surgery, and it works best on piles that have prolapsed outside the anus. When this happens, the swollen blood vessel protrudes from the anus as a lump, becoming very inflamed and sore. Instead of removing the prolapsed haemorrhoids, they are hitched back up inside the anus and fixed to the wall of the inside of the bowel using a surgical stapling device. Again, patients experience less pain afterwards and recover faster than with open surgery.