Assoc. Prof. Dr. Abdulcabbar Kartal
Colorectal Surgery and
Coloproctology Specialist
Hemorrhoidal disease, which is known to be one of the common diseases in our country, is more common especially in those with constipation, women who gave birth and people who work sitting. While diet and medication adjustments may be sufficient for patients in the early stages, it is important to resort to surgical methods in advanced stages. Depending on traditional surgeries, complications such as severe surgical pain and urinary problems, rectal bleeding, breech stenosis and chronic anal fissure (breech tear) can be seen. Today, however, hemorrhoid treatment with Hemorrhoid artery ligation transanal dearterization have become more comfortable with a painless method that can be performed without making any incisions.
This procedure, which is done under general anesthesia and guidance of Doppler is painless and a minimally invasive method. In standard hemorrhoid surgeries, the hemorrhoids are cut and removed and stitches are placed in that area. This procedure can be a painful for the patient. In the Doppler procedure, no incision is made, less anesthesia is given, and the patient does not feel pain. Patients can return to their daily lives after 1 day of hospitalization. There are no scars left after the procedure.
After traditional hemorrhoid surgeries, gas and stool leaks may occur, especially in advanced ages, due to the removal of the hemorrhoidal cushions and sometimes damage to the internal sphincter muscles. In the Doppler hemorrhoidal dearterization method, however, since cutting is not performed, the hemorrhoids remain in place and gas and stool leaks are not experienced even in advanced ages.
Since the procedure is applied without incision, there is no significant pain and suffering after the procedure. The Doppler method can be applied to the 2nd, 3rd and even 4th stage. It is an important advantage that it can be applied even in 4th grade hemorrhoids. Patients can return to work and social life the next day after the procedure.
Since the patient will receive anesthesia, there is no special preparation for the procedure other than an 8-hour fasting and an enema performed in the hospital. It is an application that takes about 25-30 minutes. Due to general anesthesia, the patient stays in the hospital for 1 day. The next day, the patient becomes able to perform normal daily activities. With a special system, both the blood vessel flow to the hemorrhoid is cut (dearterization) and the hemorrhoid is placed in its place (hemorrhoidopexy).
It takes about 2-3 months for the hemorrhoids to settle down completely. Patients should be careful while defecating during this period. Constipation and straining should be avoided. For this reason, stool softening drugs are given to patients after surgery.
In summary, Transanal hemorrhoidal dearterialization is a valid therapeutic option in patients with hemorrhoidal disease. It can provide effective control of symptoms in the vast majority of patients. Accuracy in both dearterialization and mucopexy (repositioning the prolapsing rectal mucosa and submucosa, completely sparing the piles) seems the key to therapeutic success. The limited number and severity of complications makes Transanal hemorrhoidal dearterialization very safe. Finally, Transanal hemorrhoidal dearterialization can be used in case of recurrent disease.
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