28 February 2020
An explanation of ostetomies around the knee by Mr Andrew Legg
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Haemorrhoids (piles) are very common and their symptoms can often disappear on their own after a few days. Sometimes though, these symptoms - such as itchiness, discharge, soreness and bleeding - are severe and don't go away. Haemorrhoid removal treatment is needed to treat them.
You may have haemorrhoids because you have strained too hard when going to the toilet as a result of being constipated for a while. This could be because you don't have enough fibre in your diet.
Being overweight, pregnant or over 45, or having a family history of piles, can raise your risk of having haemorrhoids, according to clinical sources.
Your doctor may have suggested surgery because changing your diet, over-the-counter treatments and GP-prescribed medication have failed to get rid of your piles.
If you decide to have your treatment with us, you will be looked after by an experienced multi-disciplinary care team.
Our patients are at the heart of what we do and we want you to be in control of your care. To us, that means you can choose the consultant you want to see, and when you want. They'll be with you every step of the way.
All of our consultants are of the highest calibre and benefit from working in our modern, well-equipped hospitals.
Our consultants have high standards to meet, often holding specialist NHS posts and delivering expertise in complex sub-specialty surgeries. Many of our consultants have international reputations for their research in their specialised field.
You will have a formal consultation with a healthcare professional. During this time you will be able to explain your medical history, symptoms and raise any concerns that you might have.
We will also discuss with you whether any further diagnostic tests, such as scans or blood tests, are needed. Any additional costs will be discussed before further tests are carried out.
We've tried to make your experience with us as easy and relaxed as possible.
For more information on visiting hours, our food, what to pack if you're staying with us, parking and all those other important practicalities, please visit our patient information pages.
Our dedicated team will also give you tailored advice to follow in the run up to your visit.
We understand that having surgery can potentially be a time of anxiety and worry - even for a relatively straightforward procedure like this one. Our experienced and caring medical staff will be there for you, holding your hand, every step of the way.
Haemorrhoid removal treatment is usually performed under a general anaesthetic. This means you will be asleep throughout the operation.
Some people choose epidural anaesthesia instead. This numbs your body from the waist down, but you will still be awake.
We use a number of techniques for removing haemorrhoids:
A tight stitch (ligature) is placed around the base of the haemorrhoid to control any bleeding during the operation. Your surgeon will then make a cut on the outer part of the haemorrhoid and remove any excess tissue.
The wound may be closed with dissolvable stitches. Most of the stitches will be inside the anal canal and will dissolve over the course of about two to four weeks.
The surgeon may place an absorbent pack into your rectum to help stem any further bleeding. This usually stays in place until your first bowel movement. The operation usually takes between 30 and 60 minutes.
A circular stapler is placed inside the rectum and removes a ring of the rectal tissue above the haemorrhoids. This blocks the blood supply to the haemorrhoids so that they shrink.
This is a fairly new technique, and the National Institute for Health and Clinical Excellence (NICE) has found that it works as well as the usual technique. There also seem to be fewer problems, such as bleeding afterwards.
THD - also called haemorrhoid ligation, haemorrhoidal artery ligation or doppler guided ligation - is an innovative, minimally invasive surgical procedure approved by NICE, which involves treating the piles by closing off the arteries that are feeding them. It is designed to cure them in a gentle way and provide excellent long term results.
The procedure does not involve cutting or removing any haemorrhoidal tissue, so minimises pain and reduces post-operative complications.
During THD, your surgeon will locate the haemorrhoid’s feeding arteries using an ultrasound Doppler probe mounted on a specially designed proctoscope (an instrument used to examine the rectum). He or she will then suture (close up with stitches) each of these arteries through an opening window in the proctoscope.
The procedure is carried out in an area without sensory nerves so you won't feel any stitches during or after it. THD treatment can also re-position prolapsed tissue (piles that are hanging down from your bottom).
The Transanal Haemorrhoidal De-Arterialisation (THD) or HALO procedure is not available at all Spire hospitals.
Using the safe and established technology of radiofrequency ablation, the Rafaelo procedure is performed as a short day-case procedure. It does not require a general anaesthetic and you will be able to return to your normal daily activities immediately after treatment. The Rafaelo procedure is designed to treat haemorrhoid grades 1–3. Some grade 4 haemorrhoids may be reduced but it is unlikely that they will not reach a complete resolution, which often will require surgery.
The Rafaelo procedure is not available at all Spire hospitals.
Haemorrhoid removal treatment is usually carried out as a day case procedure, so you won't usually need to stay in hospital overnight.
After this, you will be taken to your room or comfortable area where you can rest and recuperate until we feel you're ready to go home.
After a haemorrhoidectomy, you will have some pain at the site of the operation for a few days and there may be a small amount of bleeding or discharge from the anus.
Rafaelo is a quick day case procedure. Very little pain relief is required after the procedure, some people do take a couple of paracetamol for a day or two, but others don’t need any pain relief.
We will provide you with a supply of all the medicines your consultant feels you need to take home with you after you've left hospital, up to 14 days. This may be at an additional cost to some patients.
You may have some discomfort lasting for up to three weeks. Continue taking painkillers as advised by the hospital.
Follow your surgeon's advice about going back to work. You can expect to be off work for one or two weeks, depending on the nature of your job. Your surgeon will give you specific advice about when you can resume your normal lifestyle. You shouldn't do any heavy lifting, standing for long periods or strenuous exercise, but light exercise, such as walking, will help to speed up your recovery.
Most patients can expect to experience immediate cessation of their symptoms post Rafaelo procedure. Apart from possibly some slight bleeding within the first two weeks of treatment, there should be no other significant side effects.
Once you're ready to be discharged from hospital, you'll need to arrange a taxi, friend or family member to take you home as you won't be able to drive.
Even after you've left hospital, we're still looking after you every step of the way. After haemorrhoid removal surgery, we will provide you with all the advice on what to do and not to do and the follow-up support you need.
Typically your consultant will want to see you after your treatment to see how you're doing. A follow up appointment will be made before you leave the hospital.
On rare occasions, complications can occur. If you experience any of these symptoms – constipation for a few days after the operation, you get a high temperature or fever, the amount of blood loss suddenly increases, you do not have a bowel movement for several days or you experience severe pain after a bowel movement, stitches coming apart, difficulty passing stools, bleeding that starts a week or more after surgery – call us straight away. Very occasionally, faecal incontinence, or a painful tear in the anus (fissure) can develop and further surgery may be needed.
The chance of complications depends on the exact type of procedure you are having and other factors such as your general health. Your consultant will talk to you about the possible risks and complications of having this procedure and how they apply to you.
If you have any questions or concerns, we're here to help.
We are committed to delivering excellent individual care and customer service across our network of hospitals, clinics and specialist care centres around the UK. Our dedicated and highly trained team aim to achieve consistently excellent results. For us it's more than just treating patients, it's about looking after people.
The treatment described on this page may be adapted to meet your individual needs, so it's important to follow your healthcare professional's advice and raise any questions that you may have with them.
28 February 2020
An explanation of ostetomies around the knee by Mr Andrew Legg
27 February 2020
An explanation of alopecia with Consultant Dermatologist Dr David Fairhurst.