Hemorrhoidectomy by Dr Shanthi Vardhani

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Description
Milligan-Morgan hemorrhoidectomy: a detailed explanation
 
Hemorrhoids and Hemorrhoidectomy | Clinical Gate
Haemorrhoid Clinic Melbourne | Bayside Colorectal Experts
 
 
The Milligan-Morgan hemorrhoidectomy is a common surgical technique for removing hemorrhoids, particularly effective for symptomatic Grade III and IV cases. This procedure involves the excision of hemorrhoidal tissue while carefully preserving the underlying anoderm (skin of the anal canal) and sphincter muscles to avoid complications. 
 
Procedure steps
  1. Preparation:
    • Diagnosis and assessment are confirmed with patient evaluation, including anoscopy or proctoscopy.
    • Anesthesia, typically general or regional, is administered.
    • Bowel preparation is performed the night before.
    • The patient is positioned for surgical access.
  2. Surgical procedure:
    • An anal retractor is used to expose hemorrhoidal tissue.
    • The hemorrhoidal mass is grasped with forceps and outlined with a surgical marker.
    • The tissue is excised with an elliptical incision, avoiding sphincter muscles.
    • Bleeding is controlled using electrocautery or ligation.
    • Traditionally, the wound is left open to heal (open hemorrhoidectomy), though partial closure may be considered.
    • A final check for bleeding is done.
  3. Post-operative care:
    • Pain medication and laxatives are prescribed.
    • Sitz baths are recommended for hygiene and healing.
    • Follow-up appointments are scheduled to monitor recovery. 
 
Potential risks and benefits
 
Benefits
  • High success rate in relieving symptoms.
  • Effective for both internal and external hemorrhoids.
  • Well-established technique. 
 
Risks
  • Post-operative pain is common and can be severe.
  • Healing can be prolonged.
  • Potential for complications like bleeding, infection, and anal stenosis. 
 
Recovery time
Recovery typically takes 2 to 4 weeks. Pain usually subsides within 2 weeks, but strenuous activities may require 6 to 8 weeks before resuming. Recovery may be longer if complications occur. 
Note: Some studies suggest continuous wound drainage might reduce pain and improve healing, but further research is needed. 
 
This is for informational purposes only. For medical advice or a diagnosis, consult a professional. AI responses may include mistakes. Learn more
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