STAPLER HAEMORRHOIDECTOMY

A NOVEL AND SAFE TECHNIQUE

Abstract

Objectives: To demonstrate advantages of stapler
haemorrhoidectomy and its applicability to all patients who require surgical treatment of haemorrhoids. Design: Case
Descriptive Study. Place & Duration of study: Allied/DHQ Hospitals, Faisalabad. (February 2004 – July 2005).
Patients & methods: A total of 20 patients having grade III or IV haemorrhoids were included in the study. After a
detailed GIT history, patients were subjected to standard stapler haemorrhoidectomy under regional anaesthesia.
Patients were asked to record the postoperative pain intensity according to visual analogue score ranging from (0-10)
on daily basis and the drugs required for pain control noticed. Patients were followed at weekly intervals for one month.
Main outcome measures were postoperative pain, bleeding, sepsis, urinary retention, continence, relief of preoperative
symptoms, operation time, hospital stay & recovery time. Results: Pain was the most common postoperative
complication affecting 18 patients (90 %age).There was significant reduction in postoperative pain except for one
patient in which pain was severe (VAS=8) due to technical error. Two patients developed urinary retention on the day
of surgery. Postoperative bleeding was not observed in any of the patients. Pelvic sepsis & incontinence was not found
in any patient. Preoperative symptoms were resolved in majority of the cases (80%age) with marked improvement in
the rest(20 %age). The mean operative time was 17 minutes & mean hospital stay 1.3 days. Most patients were back
to their work after 11 post operative day. Conclusions: th Stapler Haemorrhoidectomy is a simple, quick & safe
procedure that gives benefit in terms of reducing the postoperative complications namely pain & its sequelae with early
return to activity. The vast majority of patients currently undergoing conventional surgical haemorrhoidectomy would
be suitable for stapler approach, however the long term benefits need to be evaluated.