Classical Hemorrhoidectomy
Do you suffer from large and prolapsed hemorrhoids that do not respond to conservative treatments? Classical hemorrhoidectomy (Milligan-Morgan technique) is the reference surgical procedure for treating severe forms of hemorrhoidal disease. In Tunisia, experienced proctologists perform this radical surgery at competitive prices.
Classical Hemorrhoidectomy: What is it?
Classical hemorrhoidectomy (Milligan-Morgan technique) is a surgical procedure that removes internal and external hemorrhoids radically. It is considered the most effective method for grade III and IV hemorrhoids.
This technique consists of excising the distended skin and mucosa together with the enlarged vascular bundle at the upper part of the anus, at the origin of these vessels. Three excisions are generally necessary, leaving intact "bridges" of skin and mucosa between the excisions to prevent stenosis.
Indications for Classical Hemorrhoidectomy
Classical hemorrhoidectomy is indicated in several specific situations. It concerns grade III hemorrhoids, where prolapse requires manual reduction. It is also indicated for grade IV hemorrhoids, with permanent non-reducible prolapse. Thrombosed, painful and large external hemorrhoids also justify this procedure. Failure of conservative treatments, such as medications or rubber band ligation, is another indication. Finally, circumferential hemorrhoids may require staged surgery.
Procedure Process
Classical hemorrhoidectomy according to Milligan-Morgan follows a precise protocol. Anesthesia is general or epidural. The procedure lasts 20 to 40 minutes. The surgeon proceeds with excision of the three main hemorrhoidal bundles. Wounds are left open to avoid infection and stenosis. Hospitalization is 2 to 3 days.
Post-Operative Course
Post-operative recovery after hemorrhoidectomy is well codified. Pain is significant but controlled with painkillers. The first night is covered with local anesthetic and morphine. Pain then decreases in 7 to 15 days. Minimal bleeding is normal until healing is complete. Oozing is also normal and requires wearing pads. Temporary gas incontinence disappears with healing. Local care is required until complete healing, 15 to 30 days. Self-dilation by daily rectal touch is recommended from the 7th day to prevent stenosis.
Risks and Complications
Classical hemorrhoidectomy carries certain risks and complications. Bleeding can be early, in the first hours, or delayed on the 10th day. It occurs in less than 5% of cases. Anal stenosis, or narrowing of the anus, is prevented by self-dilation. Infection is rare and prevented by antibiotic prophylaxis. Urinary retention is possible, sometimes requiring catheterization. Finally, anal fistula is an exceptional complication.
Results and Satisfaction Rate
Results of classical hemorrhoidectomy are very satisfactory. The satisfaction rate is close to 90%. Healing is definitive in the vast majority of cases. However, recurrence is possible in the long term, in 5 to 10% of cases. It occurs especially in case of chronic constipation.
Classical Hemorrhoidectomy Prices in Tunisia
Tunisia offers very competitive prices for classical hemorrhoidectomy. A proctological consultation costs between €80 and €120. Classical hemorrhoidectomy costs from €800 to €1,500. The procedure combined with complementary treatment ranges from €1,200 to €2,000.
Frequently Asked Questions about Classical Hemorrhoidectomy
1Is classical hemorrhoidectomy a painful procedure?
Post-operative pain is significant but well controlled with painkillers. The first night is covered with local anesthetic and morphine. Pain gradually decreases in 7 to 15 days. Recent technical modifications have reduced discomfort.
2How long is the hospital stay for classical hemorrhoidectomy in Tunisia?
Hospitalization is generally 2 to 3 days. The procedure lasts 20 to 40 minutes under general or epidural anesthesia. Post-operative monitoring is provided during the stay.
3When can you return to work after classical hemorrhoidectomy?
Time off work is 15 to 30 days depending on the profession. Complete mucosal healing takes 20 to 30 days. Intense physical activities are resumed after 4 to 6 weeks.
4What are the risks of classical hemorrhoidectomy?
Risks are rare: bleeding (2-5%), anal stenosis (prevented by self-dilation), infection (prevented by antibiotics), temporary gas incontinence. Patient satisfaction rate is high, close to 90%.
5Why are wounds left open after classical hemorrhoidectomy?
Wounds are left open to avoid infection risks related to fecal matter and to prevent anal narrowing (stenosis). Healing occurs naturally from the inside out.
6When is classical hemorrhoidectomy indicated?
It is indicated when medical treatments (ointments, suppositories) and instrumental treatments (rubber band ligation, sclerotherapy) have failed, or in case of large and constantly prolapsed hemorrhoids (grades III and IV).
7Is classical hemorrhoidectomy definitive?
Yes, classical hemorrhoidectomy offers definitive healing in the vast majority of cases. The recurrence rate is low (5-10%) in the long term, especially in case of untreated chronic constipation. A healthy lifestyle helps prevent recurrence.
Why Choose Tunisia for Classical Hemorrhoidectomy?
Our clinic is specialized in hemorrhoid treatment. Our proctologists are experienced and trained in Europe. They are specialists in anal surgery. We use the reference Milligan-Morgan technique, reliable and proven. Our prices are very competitive, 40 to 60% cheaper than in Europe. Care is rapid, with an appointment within 48 hours. We provide personalized support with complete pre and post-operative follow-up.
In Conclusion
Classical hemorrhoidectomy (Milligan-Morgan technique) is the reference surgical procedure for severe hemorrhoids. Although associated with significant post-operative pain, it offers a high satisfaction rate (90%) and definitive healing in the vast majority of cases. In Tunisia, Tunisie Esthetic offers this quality procedure, performed by experienced proctologists, at competitive prices. Do not hesitate to contact us for a personalized and free quote.