Stapler Surgery for Piles: What Patients Should Know

Stapled haemorrhoidopexy, also known as Procedure for Prolapse and Haemorrhoids (PPH) or stapler surgery for piles, is a minimally invasive surgical technique for treating Grade III and IV haemorrhoids.

How Stapler Surgery Works

A circular stapling device is inserted to:

1. Remove a ring of excess rectal mucosa (prolapsed tissue) above the haemorrhoids
2. Simultaneously staple the cut ends together
3. Reduce blood supply to haemorrhoidal tissue, causing it to shrink

The procedure does NOT remove the haemorrhoids directly — it repositions and devascularises them.

Advantages Over Traditional Haemorrhoidectomy

Feature	Stapler Surgery (PPH)	Traditional Surgery
Pain	Minimal to mild	Moderate to severe
Recovery	3–5 days	2–4 weeks
Hospital stay	1 day	2–3 days
Return to work	3–5 days	1–2 weeks
Recurrence rate	5–10% (higher than open)	2–5%

Who Is It For?

• Grade III haemorrhoids (prolapse needs manual reduction)
• Grade IV haemorrhoids (irreducible prolapse)
• Circumferential haemorrhoids

Not Suitable For:

• External haemorrhoids (stapler only treats internal ones)
• Grade I and II (injection or rubber band ligation preferred)
• Patients with inflammatory bowel disease

Before the Procedure

• Blood tests, ECG, and bowel preparation the day before
• General or spinal anaesthesia
• Typically performed as a day-care or one-night admission

Recovery Tips

• High-fibre diet from day 1 post-surgery
• Stool softeners as prescribed
• Sitz baths twice daily
• Avoid straining — constipation must be prevented
• Most patients return to desk work in 3–5 days

Iswarya Hospital's Colorectal Surgery team uses the latest stapling technology for precise, comfortable outcomes.