Stapled haemorrhoidopexy: is it time to move on?

Area of Science:

• Colorectal Surgery
• Gastroenterology
• Surgical Innovation

Background:

• Stapled haemorrhoidectomy (procedure for hemorrhoids) was introduced as an optimal surgical solution.
• It was promoted for reduced pain, minimal wound care, and shorter operative times.
• Initial studies and reviews supported its efficacy and safety for hemorrhoid treatment.

Purpose of the Study:

• To evaluate the long-term safety and efficacy of stapled haemorrhoidectomy.
• To address the growing concerns regarding serious complications associated with the procedure.
• To re-evaluate the role of stapled haemorrhoidectomy in the context of modern hemorrhoid treatment.

Main Methods:

• Review of randomized controlled trials and published literature on stapled haemorrhoidectomy.
• Analysis of reported outcomes, including postoperative pain, wound care, operative time, and complications.
• Comparison of stapled haemorrhoidectomy with alternative surgical techniques for symptomatic hemorrhoids.

Main Results:

• While initially perceived as advantageous, stapled haemorrhoidectomy is increasingly linked to severe and life-threatening complications.
• Evidence suggests that the procedure may not be as safe as initially reported.
• Alternative approaches focusing on interventions above the dentate line are gaining attention.

Conclusions:

• Stapled haemorrhoidectomy may have fulfilled its role in highlighting the need for less invasive hemorrhoid treatments.
• Modern surgical strategies for hemorrhoids should prioritize avoiding excision of perianal skin.
• Interventions above the dentate line represent a more favorable direction for contemporary hemorrhoid surgery.