When hemorrhoids get to very intense stage, they protrude and can never be manually reinserted, the sufferer has to perform an intervention that solves the problem definitively. In particular, the action involves the hemorrhoids of grade III and IV, the most serious ones, and such operations are proposed to decongest the hemorrhoids through mechanical ways, which provide the elastic ligature, of chemical nature such as sclerotherapy, and thermal nature, that use cold or hot as cryotherapy and laser therapy.

It is important to consider that surgery for hemorrhoids is only implemented when all other remedies, both pharmacological and natural and manuals, have not produced satisfactory results in resolving the problem.

Hemorrhoid surgery: rubber band ligation

The first intervention that is performed to treat hemorrhoids is based on the band ligation, a type of operation that is performed in the outpatient, without anesthesia and recovery time considered fairly prompt. The elastic ligature is used for the treatment of hemorrhoids and the internal rectal prolapse and consists of tying a rubber band at the base of the so-called internal hemorrhoidal gavocioli.

The tying prevents the flow of blood to the hemorrhoids and then leads to necrosis of the area, or to its decay. After the ligament is necessary to wait about ten days and then the resulting elastic fall that marks the successful necrosis of the treated area. The surgery is performed without the need for anesthesia and proves painless.

Those who choose to perform this surgery must not have particularly prolapsed hemorrhoids or the operation would not give optimal results. Some disadvantages of this surgery are based on an incorrect positioning of the garter or the possibility that it will come off before it has the necrosis, which requires that it is again fastened.

Hemorrhoid surgery: heat and cold

Now we analyze the intervention that uses heat and cold to heal hemorrhoids. It is the laser therapy, a painless surgery that is performed by means of laser beams, which are transformed into heat in contact with the haemorrhoidal tissue and induce its intravascular coagulation. Another method that exploits the temperature is cryotherapy, or the frost treatment. It is a method that employs the freezing to destroy the hemorrhoidal node.

The freezing is performed through the nitrous oxide and this particular intervention is used to treat hemorrhoids to the third degree, also in combination with ligation. Cryotherapy is considered the safest and most effective method by medical associations that deal with proctology and colon health, especially if it is applied with selective mode, that is destined only to the treatment area and not to surrounding tissues.

Hemorrhoid surgery: the use of chemicals

Chemical can also be used in the intervention for hemorrhoids. It is sclerotherapy, which is implemented with injections or coagulation of infrared rays, an intervention that provides for the use of irritants that are introduced into the haemorrhoid hemorrhoidal, causing coagulation and occlusion of the treated area. In this way the blood supply is reduced, and the irritation that affects the hemorrhoids can heal quickly.

This technique is applied up to the third degree hemorrhoids and can be combined with infrared sclerotherapy where the infrared rays are used to coagulate the vessels and cause its sclerosis. All these interventions, for the treatment of hemorrhoids to the third degree, are based on the desire to lead to necrosis or to coagulate the area to be treated, so as not to allow the blood to reach and then delete allowing the wound to be reabsorbed quickly and easily.

Hemorrhoid surgery: the Longo method

And what about grade IV hemorrhoids? In these situations surgery is recommended; it can be of different types. Among the interventions for the treatment of stage IV hemorrhoids we find Longo method, also called PPH technique. This is a technique invented by Dr. Longo in the 90s, which is based on a conservative concept of hemorrhoids, or on the desire to preserve the state intact as much as possible during surgery.

As we know, hemorrhoids serve to both contain and to evacuate properly, then bearings are proposed as indispensable to perform normal physiological functions in the human organism. The technique therefore seeks to retract the prolapsed hemorrhoids by applying microclip titanium using a special stapling device that closes the contact on the outside and allows the regeneration to happen from within.

As we know, the rectal area is not spent as nerve bundles, so it can do it without pain, it is followed under local anesthesia and promises a cure in a short time, about four or five days.

Hemorrhoid surgery: ligation of Doppler guide

Another intervention used on a large scale in the treatment of hemorrhoids is the ligation of hemorrhoidal artery on Doppler guide. It is a sophisticated intervention, that by an anoscope and the probe tries to seek the branches of the arteries and patches them with stitches, so as to block the blood flow. Another type of intervention is the dearterialization hemorrhoid, a recent method that is proposed not to remove the hemorrhoidal tissue and put the stitches in an area that is not sensitive to pain.

Hemorrhoid surgery: haemorrhoidectomy

Another intervention widely used to treat hemorrhoids is the Milligan Morgan hemorrhoidectomy, or surgical removal of hemorrhoids. This is the last attempt in the treatment of hemorrhoids, which is used in very serious cases and applied as a last resort, because involves the removal of the area and requires a longer hospital stay.

The hemorrhoidectomy may be realized by laser and provides a healing time of about a month. During this time the patient will feel a lot of pain and the physical looks quite debilitated, so this surgery is proposed as the last alternative to heal from stage IV hemorrhoids.