It is the most used surgical procedure for the treatment of internal hemorrhoids.
It removes hemorrhoids using a sharp instrument, such as a scalpel, scissors, electrocautery, or laser, followed by complete wound closure with an absorbable suture. Typically the three hemorrhoidal columns are treated at the same time. Postoperative care includes frequent baths, mild analgesics, and avoiding constipation. The closed hemorrhoidectomy is successful 95% of the time.
Potential complications include pain, bleeding, infection of the retention / urinary tract, fecal retention, very rarely, infection, dehiscence of the wound, fecal incontinence, and anal stenosis. Although this technique has the most postoperative discomfort, it has the best long-term results with the lowest recurrence rates. New methods are being designed to decrease the pain associated with surgery and should allow a better patient experience.
In an open hemorrhoidectomy, the hemorrhoidal tissue is excised in the same way as in a closed procedure, but here the incision is left open. Surgeons can opt for open hemorrhoidectomy when the location or size of the disease makes the closure of the wounds complex, or the probability of postoperative infection is very high, which requires more excellent care and hygiene. Often, a combination of the open and closed techniques is used. Complications after open hemorrhoidectomy are similar to those that occur after closed hemorrhoidectomy.