Stapler Haemorrhoidectomy- A Step Forward in Surgical Management of Haemorrhoids.

Introduction : Haemorrhoids are the most common benign perianal disease which can impede quality of life. Grade 3 and grade 4 haemorrhoids need surgical intervention. The traditional approach for surgical management is open haemorrhoidectomy but unfortunately is associated with complications like faecal incontinence, bleeding, infections etc. A constant search for a better surgical method has led to the modern technique of stapler haemorrhoidectomy. In this study we aim to study the outcomes of stapler haemorrhoidectomy in terms of ease of use, intra-operative complications and morbidity. Material and Methods: A prospective single arm study with n=50 underwent stapler haemorrhoidectomy. Grade 2,3,4 uncomplicated haemorrhoids were included in the study. after anaesthetic fitness, patients underwent stapler haemorrhoidectomy. Postoperative pain scores, bleeding was noted and after discharge patients were followed up on 10th day,3rd month and 6th month.Complications like anal stenosis, stricture, sepsis,pain were noted. Results: out of the 50 cases,38 were male while 12 were female with an average age of 41 year (range 25-61 years). Most common symptoms were bleeding (80%), prolapsed (70%), pain (8%), soiling (4%). Patients presented with grade 2 (14%), grade 3(56%), grade 4(70%) haemorrhoids. The average operative time was 27.1 minutes. Postoperatively, 90% cases had mild pain while 10 % had moderate pain. 4 patients had bleeding with 3 having minor bleeding.After discharge,most of the patients resumed work within 3 days.Only 1 patient had recurrence and none had sepsis or stricture.Conclusion:It has been concluded that the staplers are a novel way of doing hemorrhoidal surgeries and has increased the horizons of hemorrhoidal surgery to a great extent. However, technical skills, good on table judgment, intelligence and knowledge of all possible pitfalls and errors of stapling are required to achieve optimal results.