Piles Surgery Singapore

Dr Calvin Ong

MBBS M.MED (SURGERY) MRCS FRCS

A haemorrhoidectomy, commonly called piles surgery, is a procedure to remove haemorrhoids – swollen blood vessels in the rectum or anus that can cause pain, bleeding, and discomfort.

This procedure is typically recommended for cases of severe haemorrhoids or when non-surgical treatments have proven ineffective. By removing the affected veins, haemorrhoidectomy aims to reduce symptoms and prevent further complications associated with haemorrhoids.

Indications for Haemorrhoidectomy

Haemorrhoidectomy is typically recommended for specific cases where haemorrhoids cause persistent symptoms or complications.

Severe Pain and Discomfort

Haemorrhoidectomy is recommended when pain or discomfort from haemorrhoids is severe and disrupts daily activities. Surgery is considered when these symptoms do not improve with non-surgical treatments.

Chronic Bleeding

Frequent or severe bleeding from haemorrhoids can lead to complications like anaemia if left untreated. Haemorrhoidectomy is often necessary when bleeding persists despite other medical interventions.

Prolapsed Haemorrhoids

Prolapsed haemorrhoids extend outside the anus and are difficult to manage with conservative treatments. Surgery can be an effective solution to remove and alleviate symptoms associated with prolapsed haemorrhoids.

Recurring Haemorrhoids

Frequent recurrence of haemorrhoids despite lifestyle changes and non-surgical treatments may indicate a need for haemorrhoidectomy. Surgical removal reduces the risk of further flare-ups.

Non-Responsive to Other Treatments

Haemorrhoids that do not respond to medications, dietary changes, or less invasive procedures may require surgical intervention. Haemorrhoidectomy provides a definitive approach when other options have proven insufficient.

Benefits of Haemorrhoidectomy

A haemorrhoidectomy offers several key benefits for patients with severe or persistent haemorrhoids that haven’t responded to other treatments.

Relief from Haemorrhoid-Related Pain

Haemorrhoidectomy provides long-term relief from pain and discomfort caused by haemorrhoids, allowing patients to perform daily activities comfortably. Removing the haemorrhoids eliminates the source of these symptoms.

Reduced Risk of Complications

Haemorrhoidectomy lowers the risk of complications such as anaemia caused by chronic bleeding and infections related to prolapsed haemorrhoids. By addressing these issues, the procedure helps prevent further health concerns associated with untreated haemorrhoids.

Improved Bowel Movements

Following haemorrhoidectomy, patients often experience less straining and discomfort during bowel movements. This can help in preventing the formation of new haemorrhoids after surgery.

Lowered Risk of Recurrence

Haemorrhoidectomy reduces the likelihood of haemorrhoids returning, particularly beneficial for patients with a history of frequent episodes. This provides a more lasting solution compared to non-surgical options.

Types of Haemorrhoidectomy

There are several types of haemorrhoidectomy procedures, each aimed at addressing different haemorrhoid conditions and patient needs.

Conventional (Excisional) Haemorrhoidectomy

In this procedure, haemorrhoids are surgically removed through incisions around the affected area. This method is particularly effective for large or severe haemorrhoids and provides significant relief, however, recovery may take slightly longer than other techniques.

Stapled Haemorrhoidectomy

Also known as PPH (procedure for prolapse and haemorrhoids), this procedure uses a stapling device to reposition and secure prolapsed haemorrhoid tissue within the rectum. It is primarily used for internal haemorrhoids and generally results in less post-operative pain than conventional haemorrhoidectomy.

Laser Haemorrhoidectomy

This technique uses a laser to remove or shrink haemorrhoid tissue, minimising impact on surrounding areas. Laser haemorrhoidectomy may lead to reduced bleeding and faster recovery and is typically suited for mild to moderate haemorrhoids.

Transanal Haemorrhoidal Dearterialisation (THD)

THD is a minimally invasive approach that involves tying off the blood vessels supplying the haemorrhoid, which causes it to shrink. This method is often used for prolapsed haemorrhoids and also typically results in less post-operative pain and faster recovery than conventional haemorrhoidectomy.

Preparing for Surgery

Proper preparation prior to surgery is required to ensure a safe procedure, which includes the following:

Medical Evaluation

Patients undergo a medical assessment to determine their suitability for surgery, which includes blood tests and a review of any existing medical conditions. This evaluation helps identify and minimise potential surgical risks.

Pre-Surgery Dietary Guidelines

A low-residue diet may be advised in the days leading up to surgery to reduce bowel movements. Patients are generally instructed to fast from midnight on the day of the procedure to ensure the digestive system is prepared.

Medication Adjustments

Certain medications, such as blood thinners, may need to be paused before surgery to minimise bleeding risk. Specific instructions on medication management will be provided as part of pre-surgical care.

Post-Surgical Care and Recovery

Following specific care guidelines after surgery is necessary for a smooth recovery and the prevention of complications.

Immediate Care

Once stable, patients are discharged with detailed instructions on managing pain, wound care, and activity restrictions. Patients are advised to arrange transportation home due to anaesthesia effects.

Recovery Process

Most patients can resume light activities, such as walking or gentle daily tasks, within a week after haemorrhoidectomy. Some initial swelling and discomfort are common and expected during this time.

Complete recovery usually takes 2 to 4 weeks, depending on the surgical method and individual factors such as age, overall health, and the presence of any underlying conditions. Patients are advised to follow all post-operative care instructions, including activity restrictions such as avoiding heavy lifting or strenuous exercise, as well as wound care, to support healing.

Follow-Up Appointments

A follow-up appointment is scheduled within 2 to 4 weeks to assess healing progress and address any post-surgical concerns. These visits support a smooth recovery process and address any complications early.

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Common Risks of Haemorrhoidectomy

Common risks after haemorrhoidectomy include post-operative pain and minor bleeding, especially during bowel movements, both of which typically subside within a few days. Pain is manageable with medication, while bleeding generally resolves on its own; however, any persistent symptoms should be reported. Infection at the surgical site is a possible risk, so maintaining cleanliness and adhering to care instructions is necessary. Temporary urinary retention may occur due to anaesthesia or pelvic muscle pressure, usually resolving on its own but should be monitored if prolonged.

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Dr Calvin Ong Jianming

MBBS (S’pore)|

M.Med (Surgery)|

MRCS (Ireland)|

FRCS (Edin)|

王健名医生

Dr. Calvin Ong is a Senior Consultant with more than 15 years of surgical experience. He specializes in colorectal and general surgery, performing minimally invasive as well as advanced robotic surgeries for benign and malignant colorectal conditions, including inflammatory bowel disease, pelvic floor disorders, colorectal cancer, and hernia repair. He is dedicated to providing high-quality, personalised care for his patients.

Dr. Ong graduated with a Bachelor’s degree in medicine and surgery from the National University of Singapore in 2008 and completed his Masters of Medicine (Surgery) at the same institute. He finished his advanced specialist training in 2016 and became a fellow of the Royal College of Surgeons of Edinburgh.

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    Frequently Asked Questions

    How long does a haemorrhoidectomy procedure typically take?

    The duration of a haemorrhoidectomy procedure varies but generally lasts between 30 minutes and 1 hour, depending on the complexity of the case.

    Can haemorrhoids return after a haemorrhoidectomy?

    While the procedure removes existing haemorrhoids, new haemorrhoids can develop over time, particularly if lifestyle changes are not made to prevent them, such as maintaining a high-fibre diet and avoiding straining during bowel movements.

    Are there any long-term side effects of haemorrhoidectomy?

    Haemorrhoidectomy is generally safe, but some rare long-term side effects may include anal stenosis (narrowing of the anal canal) or issues with stool control. These are uncommon and usually related to extensive haemorrhoid cases.

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