Hemorrhoid surgery, Hemorrhoid operations

Hemorrhoids are prevalent to epidemic proportions, affecting 20% of the adult population. Development of hemorrhoids starts with abnormal dilatation of submucosal veins about 4-5 cm from the anal opening. Dilated veins along with the mucosa are slowly increasing in size and when they reach in front of the anus they are called external hemorrhoids. Surgeons distinguish four categories (I.-IV) of the condition depending on severity. Hemorrhoids may present with various symptoms including itching, bleeding, pain, etc. Hemorrhoids may lead to various complications: mucosal fissures, venous thrombosis, bleeding, each of which can be extremely painful and prompt patients to see their doctors. An unpleasant complication is prolapse of the rectal mucosa that by impeding the function of the anal sphincter may cause encopresis, uncontrollable flatus or soiling.

We have several options to treat hemorrhoids. The method of choice will be determined primarily by the degree of severity. I. degree hemorrhoids are expected to resolve with application of creams, suppositories and treatment of constipation. II. degree hemorrhoids might require band ligation.
For III. - IV. degree hemorrhoids we perform surgery. Drawing on ten years of experience, our outpatient center employs exclusively laser hemorrhoidectomy.

Before the procedure the surgeon performs proctoscopy which also serves as a cancer screening test. During this we inspect the lower 20-25 cm of the large bowel. Following this, the doctor will give a detailed explanation about the severity of the condition, the possible treatment methods, and the CO2 laser hemorrhoidectomy that is used in our clinic. It is at this point that the patient is acquainted with the concept of one day surgery. It is also here, that the patient is informed about laboratory and other accessory studies (Imaging, ECG, medical exam etc.) that might be required for surgery, options for anesthesia, possible complications, home care-related issues, stages of recuperation, i.e. all the information that is relevant for the patient to make a decision on which treatment method, or surgery to choose.

"One day surgery" means, that patients can leave the outpatient center on their own feet, accompanied by a helper, within 24 hours of surgery (usually after few hours of observation), and continue the healing process in the familiar confines of their own home. "One day surgery" requires strict professional, social, and various other preconditions that are discussed at the stage of the consultation when the need for surgery becomes clear. (I.e.: good general health, absence of serious systemic disease, patient must take responsibility for arrangement of transportation, home care, must have phone to contact the clinic or the surgeon if necessary, etc).

At the booked operative time patients must bring their lab tests, slippers, night-suit. Before placed into sick-room a "STATEMENT" is to be signed in order to entitle our clinic for the performance of the procedure. Besides patients have to undertake home wound care.

Considering that operation is performed in general anesthesia, food and drink intake is allowed until 24:00 pm on the prior day to procedure -for patient have to arrive with empty stomach for the surgery!

Please take the regularly taken drugs in time and dose. Take morning drugs with little liquid at home before departure and in case you may have drugs to be taken in day-time, please bring them with to the clinic!

On the day of the surgery, the patient signs the consent form, then the necessary lab tests are done and the surgery fee is paid. Immediately before the operation, the patient is premedicated with an injection containing analgesics and sedatives. The operation can be performed under local, spinal or general anesthesia. The majority of our surgeries are performed with local anesthesia, which means infiltration of the surgical field with 1% Lidocaine. Next the hemorrhoidal nodes located in the typical directions are removed with laser. The procedure leaves three non-bleeding wounds, covering about 4X1 cm. The laser practically seals the incision, eliminating the need for sutures, thus the wounds remain "open". This allows the post-surgery edema to drain unhindered thus prevents development of tension, which greatly reduces post-surgery pain, allowing the patient to be discharged on the day of surgery.

No doctor may guarantee a complication free surgery. Complication even may arise following the most ever possible carefully performed procedures. Possible early complication is post-bleeding that is concerning the technique of the operation is very rare but there is 6-8 monitoring just for safety. Fever on the day of procedure and low-fever may occur in the next couple of days. In case of smaller bleeding in the first days and later on at dejection should not cause anxiety. Please contact your doctor surgeon 24/7 if you experience durable, fever, or bleeding who will necessary steps to remedy any of the complications. The late complications (like recrudesce, coarctation round anus) as well as early complications (bleeding) can be avoided by careful operation performance and by the home wound healing, appropriate nutrition. It is important to contact your doctor immediately as soon as you experience any the slightest indication of complications for laser wounds heal specially and therefore in order to remedy an early or late complication - considering thet this techniq is not wide-spreadied - doctors are not familiar with this method may confront difficulties in treatment or even may cause complications by choosing a not appropriate therapy.

The post-operative observation time is usually 6- 8 hours long and patients can leave clinic on their own feet with accompany afterwards. In the first week of recovery physical load and - work must be avoided but permanent bed-rest is not necessary. Post-operative pain in the first 8-14 days may occur spontaneously but mostly at dejections. Pain equals to the level of te operation performed so a phase IV. - external hemorrhoid surgery it is more intense. For termination of post-operative pain painkillers tablets and rectal suppository use works, supplemented by intervallic chilling of the operative area and camomile bath. Settlement of dejection (i.e. regular, soft dejecta) during recovery is prominently important therefore please do keep the attached nutritional instructions. Therefore intake of one spoon of liquid paraffin is proposed 3 times a day but usually no other ejective is necessary. Fever on the day of operation and low-fever may occur on the first couple of post-operative days. In case it may get longer than one day please do contact your surgeon immediately, who will recommend you to take antibiotics. After operation round anus painful knobs may be formed which are oedematous detritus recoil of operation (these are not re-grown hemorrhoids!) and will disappear slowly only after weeks or months. There are no further to-dos but ice-packing may accelerate their work off. On the first post-operative days slight bleeding, later at dejections is not distressing. Defluxion of wound is normal for 3-4 weeks and use of panty-liners are recommended. The total recovery time takes app. four weeks and in this period of time physical load is to be avoided but brain-work is allowed. The first control consultation takes place two weeks after surgery when we check on the healing process and the second on the fourth week followingly when the healed state is checked.

Surgery under local anesthesia: 0 HUF (paid by National Health Insurance Fund)
Charge for general anesthesia: 40.000 HUF (paid by patient, optional) > Euro
Charge for overnight stay: 0 HUF
Fees of control examinations: 0 HUF (paid by National Health Insurance Fund)

We provide air-conditioned, TV-, phone- and WIFI equipped one-or two-bedded rooms, personal nurse and meal but these mean no further costs for our patients.

Surgery under local anesthesia: 120.000 - 160.000 HUF > Euro
Charge for general anesthesia: 80.000 HUF > Euro
Charge for overnight stay: 30.000 HUF > Euro
Fees of control examinations: 5.000 HUF > Euro

50% of the fee is due at the time the operation is scheduled, as a prepayment.
These are estimated charges and may also be affected by the severity of the condition.

We provide air-conditioned, TV-, phone- and WIFI equipped one-or two-bedded rooms, personal nurse and meal.

HEMORRHOID SURGERY