Perioperative management - Stapled hemorrhoidopexy - general and visceral surgery
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Indications
- Third degree hemorrhoids (multi-segmental)
- isolated or in combination with completely reducible anal prolapse
Contraindications
- Acute inflammatory anal disease
Preoperative diagnostic work-up
- Proctological examination: Inspection, palpation, proctoscopy, rectoscopy
Special preparation
- None
Oral antegrade intestinal lavage or retrograde enema not mandatory; for personal reasons some surgeons prefer enemas.
Informed consent
General risks:
- Bleeding
- Thrombosis
- Embolism
- Pain
Special risks:
- Impaired continence due to scarring
- Sensory deficit with impaired continence
- Stenosis through scarring
- Partial suture dehiscence
- Inadequate wound healing
- Inflammatory changes
- Recurrence
- Remaining external piles
Anesthesia
Positioning
Operating room setup
Special instruments and fixation systems
Postoperative management
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