Hemorrhoid stapling is a relatively new and increasingly popular procedure in treating hemorrhoids. However, this is associated with a higher risk of recurrence of prolapsed than the conventional hemorrhoid removal surgery. This procedure uses a circular stapling device that exercises a band of prolapsed anal tissue above the hemorrhoid. The device pulls in the prolapsed mucous membrane, cuts the redundant tissue with a circular knife then fires staples to attach the remaining tissue to the anal wall.

Since it is performed in the anal canal, hemorrhoid stapling restores hemorrhoidal tissue to its original anatomical position. As compared to the removal surgery, this procedure does not remove hemorrhoids but treats them by inhibiting blood flow to the tissue.

Stapling was first introduced in the late 1990s and in some small studies was shown to be less painful and offer faster healing as compared to conventional surgery. Few studies also suggested that hemorrhoid stapling is equal to excision for controlling further hemorrhoid symptoms. Though there are notable benefits to this kind of hemorrhoid procedure, there are also several risks associated to it.

Let’s tackle first the benefits of stapling. This procedure is less painful in contrast with others because there is no surgery in the anus. Aside from this, patients are able to return to their normal activities than those treated with conventional techniques. And lastly, the average inpatient stay is lower than with conventional techniques.

In terms of the potential risks of hemorrhoid stapling, the rectal wall can be damaged once too much tissue is drawn in the device. Also, if the internal muscles of the sphincter stretch from the insertion of the stapling device, it can cause short-or long-term dysfunction. There are also cases of pelvic sepsis that have occurred after the hemorrhoid stapling procedure. And lastly, if a patient has confluent hemorrhoids, there may not be enough room for the stapling device.

A group of researchers conducted a study on patients who had undergone circular stapling were significantly more likely to have recurrent hemorrhoids in long-term. Out of the 269 patients, 23 of whom suffered recurrences as compared with four recurrences among 268 patients in the surgical-removal group. The study also revealed that a significantly higher proportion of stapling subjects complained of prolapsed both within 12 months and longer.

Researchers of the study suggested that rather than simply offering stapling to hemorrhoid patients, there may be a subset of patients for whom it is more beneficial and that identifying the subset needed further and deeper research. The high recurrence of hemorrhoids and prolapsed cases would still imply that conventional surgery remains the standard in the surgical treatment of internal hemorrhoids according to the researchers.

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