Stapled Hemorrhoidectomy

A hemorrhoid can be described as clumps of tissue (piles) that can form either internally or externally and are made up of blood vessels, muscle and elastic fibers. A stapled hemorrhoidectomy does not remove the hemorrhoids but pulls the prolapsed tissue to allow for the removal of the excess tissues and the remaining hemorrhoidal tissue is stapled. The hemorrhoidal tissue returns to its original anatomical place.

How The Procedure Is Performed

A circular anal dilator is first inserted into the anus through which an anoscope passes. The purse-string suture anoscope pushes back the prolapse into the rectal wall. Tissues that protrude in the anoscope window will be sutured and the anoscope rotated and then the purse-string suture will be made around the anal circumference. The stapling process is done by a hemorrhoidal circular stapler that captures the prolapsed membrane. The device is then tightened so that titanium staples can be fired through the tissue. When fired, the stapler cuts off the ring of excess hemorrhoidal tissue trapped within the stapler and simultaneously staples together the upper and lower edges of the cut tissue. Remaining tissues can be removed by using a circular knife.

Preparing For The Procedure

Doctor Balasubramaniam will inform you of what you need to do before you have the procedure done.

Is The Procedure Right For You?

A stapled hemorrhoidectomy is usually reserved for third and fourth degree internal hemorrhoids.


There is a low incidence of complications arising from this procedure. Possible complications include damage to the rectal wall from excessive tissue being drawn into the device, short or long-term dysfunction of the internal muscles of the sphincter, and incidence of a recurring prolapse. Pelvic sepsis is also possible (just as it is possible with other surgical treatment).

Additional Information

The staples from the stapled hemorrhoidectomy will fall off and pass in the stool unnoticed several weeks after the procedure. The arterial blood vessels that travel within the excess hemorrhoidal tissue are cut which reduces the blood flow to the tissue and reduces the size of the hemorrhoids. During healing, scar tissue forms and anchors the hemorrhoidal cushions in their anatomical position. The staples only stay as long as it takes for the tissue to heal.