Hemorrhoidectomy (Piles Removal Surgery): Procedure, Purpose, Duration & Recovery

Definitive surgical treatment for severe piles with long-term relief from pain, bleeding, and prolapse

Overview

Hemorrhoidectomy is a conventional surgical procedure performed to remove enlarged or symptomatic hemorrhoids (piles), especially in advanced cases such as grade III or grade IV hemorrhoids, recurrent bleeding, thrombosed piles, or when non-surgical treatments fail.

Hemorrhoids are swollen veins in the anal canal that can cause pain, bleeding, itching, swelling, and prolapse during bowel movements. Hemorrhoidectomy removes the diseased tissue completely, providing definitive and long-lasting relief.

Unlike minimally invasive procedures that shrink piles, hemorrhoidectomy excises them directly, making it the most effective option for large, external, or complicated hemorrhoids. Although recovery may take longer compared to laser or stapler techniques, it offers excellent symptom control and very low recurrence rates.

Step-by-Step Procedure for Hemorrhoidectomy

Preoperative Assessment

• Medical history and symptom review
• Physical and proctoscopic examination
• Blood tests and fitness assessment
• Evaluation of bowel habits
• Anesthesia clearance

This ensures safe surgery and appropriate technique selection.

Anesthesia

Hemorrhoidectomy is usually performed under spinal or general anesthesia to ensure the procedure is painless and comfortable.

Surgical Removal of Hemorrhoids

The surgeon identifies the enlarged hemorrhoidal tissue and carefully removes it.

• Open Hemorrhoidectomy (Milligan-Morgan): The hemorrhoids are excised and the wound is left open to heal naturally.
• Closed Hemorrhoidectomy (Ferguson): The wound is sutured after removal for faster healing.

Control of Bleeding

Blood vessels are ligated or cauterized to ensure proper hemostasis and reduce postoperative bleeding.

Preservation of Anal Function

Healthy tissue bridges are preserved between excision sites to prevent narrowing of the anal canal and maintain normal continence.

Completion and Recovery

After ensuring no active bleeding, dressing is applied. The procedure typically takes 30–60 minutes. Patients are monitored and usually discharged within 24 hours depending on recovery.

Why the Treatment Plan Is Chosen

• Definitive Treatment: Complete removal of large or complicated hemorrhoids.
• Lowest Recurrence Rate: Long-term symptom relief compared to other methods.
• Effective for Severe Disease: Best suited for prolapsed or thrombosed hemorrhoids.
• Symptom Resolution: Relieves bleeding, pain, and swelling effectively.
• Comprehensive Management: Addresses both internal and external piles.

Risks & Possible Repercussions

• Postoperative pain (manageable)
• Minor bleeding during healing
• Temporary urinary retention
• Infection (rare)
• Delayed healing
• Anal narrowing (rare)

FAQs

What is hemorrhoidectomy?
It is a surgical procedure to remove hemorrhoids completely.

How long does surgery take?
Usually 30–60 minutes.

When can I return to work?
Most patients resume routine activities within 1–2 weeks.

How long does healing take?
Complete healing usually occurs within 3–6 weeks.

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