Hemroids, also known as piles and hemorrhoids, arise due to the swelling of tissues and blood vessels in the area around the anal canal. Based on the degree of severity hemroids have been categorized into four main types or ‘degrees’ i.e. first degree hemroids (the least severe) to fourth degree hemroids (the most severe). While different non-surgical treatment options are available for treating the less severe cases of hemorrhoids, hemorrhoid surgery is necessary for providing long-term relief from severe hemroids, particularly those involving a significant degree of prolapse (emergence or hanging of hemroidal tissue out of the anal canal). Following are the important types of hemroid surgery currently available for treating severe hemroids.
Milligan-Morgan Surgical Method
This technique of hemorrhoids surgery was developed in Britain in the 1930s by Dr. Milligan and Dr. Morgan and it remains the most popular type of surgery for hemroids to date. The surgery is performed to excise three main hemroidal vessels. Three incisions, resembling a pear in their outline, are made and left open, separated from one another by gaps comprising skin and mucous membrane. Milligan-Morgan surgery for external and internal hemroids is considered the standard surgical procedure for treating severe hemroids.
Ferguson Surgical Method
Named after its originator Dr. Ferguson (1952), this technique is a modified form of the Milligan-Morgan hemroids surgery, the main difference being that in the Ferguson technique, the surgical incisions are closed (partly or completely) either by suturing or through coagulation by means of a surgical device. One of the main drawbacks of the Ferguson technique is the high rate of suture breakage which prolongs the time required for healing of the surgical wounds.
Procedure for Prolapse and Hemroids (PPH)
A comparatively recent type of hemorrhoid surgery for all hemroids including bleeding hemroids is the Procedure for Prolapse and Hemroids, or PPH. Also known as Stapled Hemorrhoidectomy, PPH works by reducing the prolapse of hemroid tissues through the excision of a band of prolapsed tissue while the remaining part of the tissue is stapled. PPH has proven a less painful type of hemroid surgery and most of the patients resume normal life activities quickly than in cases of other hemroid surgeries. However, PPH runs a higher risk of causing damage to the rectal wall muscles. Also, PPH has been associated with a higher risk of recurrence and prolapse than other types of hemorrhoid surgery.
Laser Hemroid Surgery
Lately, laser surgery for hemroids has been performed with appreciable accuracy. Hemroid surgery with laser is performed by a skilled laser surgeon who vaporizes or excises the unwanted, diseased hemroid tissue. Hemroid surgery with laser has several advantages over other surgical treatments for hemroids. Laser hemroid surgery takes less time; is less painful; allows quick healing of the surgical wounds; and does not require many healing medications for hemorrhoids. Laser surgery may be used alone or in combination with other surgical procedures. As with any surgical procedure, plan well in advance, and take the proper steps to recover from hemorrhoids surgery.