Hemroids Surgery

Hemorrhoid Surgery: An Overview


Hemorrhoids, also referred to as hemroids or piles, are a medical condition characterized by the swelling of the blood vessels in the anal and rectal areas.

Hemorrhoids can be ranked in terms of severity, with level 1 being the least severe type of hemroids and level 4 being the most severe category.  These rankings help assess the intensity of hemroids and subsequently, the most appropriate treatment methods.

Severity Ranking of Hemorrhoids

The following are brief descriptions of the criteria used for the different severity levels of hemroids:

  • Level 1 – Level 1 hemroids are hemroids which may bleed, but do not become prolapsed.  Prolapsed hemorrhoids are internal hemroids which protrude from the opening of the anus.  They are not the same thing as external hemorrhoids, which develop outside the anal canal near the opening of the anus.
  • Level 2 – Level 2 hemorrhoids have become prolapsed but can manually be pushed back into place in the anal canal.  Bleeding may or may not occur with this level of hemroids.
  • Level 3 – Level 3 hemroids are hemroids that have prolapsed and cannot be pushed back into the anal canal without the help of a medical procedure.  Level 3 hemorrhoids are accompanied by bleeding.
  • Level 4 – Level 4 hemroids exhibit all the characteristics of hemroids at the lower severity levels, and in addition may contain blood clots.  Hemorrhoids that contain clotting are called thrombosed hemroids, and may require hemroid surgery.

Hemorrhoid Surgery

Hemroids can usually be treated successfully with medications or other less invasive treatment approaches than hemroid surgery.  Hemorrhoid surgery is usually only considered in the most severe cases of hemorrhoids, where less extreme measures have failed to provide permanent relief.  Prolapsed hemorrhoids are often candidates for hemorrhoid surgery, to provide sufferers with long-term relief.

There are several different types of hemorrhoid surgery:

  • Milligan-Morgan Hemorrhoid Surgery – This type of hemroid surgery was developed in the 1930s in Great Britain, and still remains the most popular type of hemroid surgery today.  It is used effectively on both internal and external hemroids and involves making three incisions in the hemorrhoidal tissue, which are then left open.
  • Ferguson Surgical Method – This particular type of hemorrhoid surgery was developed in the 1950s, and is very similar to the Milligan-Morgan type of hemroid surgery.  The primary different between this method and Milligan-Morgan is that the Ferguson method closes the incisions either completely or partially via either sutures or coagulation using a surgical device.  The main disadvantage to this method is there is a high risk of suture breakage, which can prolong the healing period for the surgical incisions.
  • Laser Hemroid Surgery – A more recent advance in hemroid surgery has been laser hemorrhoid surgery.  With this method, a high-infrared laser is used to vaporize or excise the hemorrhoidal tissue.  It is most often used alone, but can be used in conjunction with other types of hemroid surgery as well.  The advantage to this method over other types of hemorrhoid surgery is that the laser makes the procedure quicker, and also reduces the length and painfulness of the recovery period.  In general, less follow-up care is required after this type of hemorrhoid surgery, as well as less after-surgery medication.  It is, however, still a form of surgery, and as such there is still a recovery period involved.
  • Procedure for Prolapse and Hemroids (PPH) – Another recent advance in the field of hemorrhoid surgery has been the development of the Procedure for Prolapse and Hemroids, or PPH.  This type of hemroid surgery is also known by the name Stapled Hemorrhoidectomy.  This form of treatment can be used on all forms of bleeding hemroids.  It works by cutting through a band of prolapsed tissue, and using staples to hold the remaining tissue back in place.  This reduces the prolapse and actually creates scar tissue which serves to strengthen the walls of the anal canal, thus helping to prevent future hemorrhoids.  The advantage of this type of hemroid surgery is that it is less painful than other types of hemroid surgery and recovery time is quicker.  The disadvantage is that there is the risk of damaging the rectal walls utilizing this method of hemorrhoid surgery.  Additionally, the rate of recurrence of hemroids is actually greater with this form of hemroid surgery treatment than with some of the other more invasive types of hemorrhoid surgery.