Stapler Surgery for Piles: What Patients Should Know

Dr. Ilango Sethu

Surgical Gastroenterology · Iswarya Hospital

Stapled haemorrhoidopexy (PPH) offers less pain and faster recovery than traditional surgery. Here's everything you need to know before choosing this procedure.

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.

Tags:

#stapler surgery#piles#haemorrhoids#PPH#colorectal surgery

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