Longo surgery for hemorrhoids is the essence of the method of indications and contraindications

After discharge, the doctor will definitely recommend the right diet for the time of rehabilitation. It will help normalize digestion, avoid the undesirable consequences of the formation of solid feces, which injure the mucosa of the anal canal.

From the diet you have to exclude:

  • grapes and raisins;
  • black bread;
  • fresh milk;
  • kvass;
  • any kinds of legumes (beans, beans, lentils, etc.);
  • raw vegetables;
  • carbonated drinks;
  • meat of goose, sheep, pork;
  • mushrooms;
  • smoked products;
  • pickled foods;
  • sausages;
  • baking.
  • products cooked or steamed;
  • porridge;
  • fruit;
  • vegetable stews and salads;
  • low-fat soups;
  • boiled meat and fish.

Such a diet will help to avoid the occurrence of constipation, which can adversely affect the restoration of the intestinal mucosa after surgery.

If nevertheless arises difficult stool, you should avoid muscle strain of the rectum, strong prolonged straining.

To eliminate constipation, it is recommended to use a cleansing enema with liquid paraffin or with herbal infusion.

A distinctive feature of hemorrhoidal disease is its steady progression, which in the absence of timely treatment leads to a chronic process, the occurrence of complications. The initial degree of hemorrhoidal vein deformity can only be corrected by a change in nutrition and lifestyle, hemorrhoids of the 2nd degree can be treated with medication.

9abf9391388d29e4f057c4c9d6cbe2d9 - Longo surgery for hemorrhoids is the essence of the method of indications and contraindications

The internal hemorrhoid comes out of the anus.

  • lack of results from conservative therapy (this is indicated after three months of ineffective drug treatment);
  • 3-4 stage of hemorrhoidal disease with large nodes of any localization;
  • non-guided prolapse of hemorrhoid cones from the rectum with thrombosis, strangulation, necrosis or heavy uncontrolled bleeding;
  • the addition of inflammation of the periorectal tissues;
  • fistulous passages, deep anal fissures;
  • severe pain with bowel movements, walking, physical effort;
  • swelling of the anal ring;
  • weakening of the tone of the anus, incontinence;
  • copious mucous discharge from the anus, forcing the use of pads in everyday life.

The only way to avoid fatal complications in such situations is the timely radical removal of hemorrhoidal caverns.

Often, after trying traditional and folk methods of treating inflammation of the hemorrhoidal nodes, doctors come to the conclusion that surgery is advisable.

Longo’s operation for hemorrhoids involves the resection of mucosal areas and the raising of hemorrhoidal formations. Patients who have gone through such a procedure, note its obvious advantages over other operations.

But any medal has two sides.

87b919a695c3a9ef9fe67095dd7d3a06 - Longo surgery for hemorrhoids is the essence of the method of indications and contraindications

The technique was developed by a famous Italian coloproctologist. Its other name: mucous-submucosal resection, hemorrhoidopexy or PPH.

Such an operation is recommended only to patients with hemorrhoid cones of the 3-4th stage of pathology, as well as in rare cases at the initial stages, when the formations reach too large sizes and bring unbearable pain to the patient.

Anesthesia is administered intravenously and topically. This measure allows you to painlessly insert the dilator into the anus.

After excision of the sections of the mucous edges of the wound are fastened with a medical stapler. The result of such an operation is a violation of blood circulation in the nodes and a decrease in the size of the cones. Longo’s operation is not accompanied by pain, since the mucosa near the hemorrhoidal nodes has no nerve endings.

Schematically, the operation consists of 6 stages:

  1. After the patient is placed on a chair, the skin near the anus is stretched with clips at a depth of 1 cm from the anus.
  2. Then, an expander is introduced into the anus region and secured with four sutures. An anoscope with an obturator follows.
  3. A purse string suture is applied a few centimeters above the gear line.
  4. A circular motion with a special tool removes a piece of fabric. The wound is stitched with staples.
  5. The seam is checked for correctness and the anoscope and stapler with removed tissues are pulled out.
  6. A swab moistened with a disinfectant and a flue pipe are introduced into the operated site, which must not be removed for 24 hours.

Such an operation takes an average of 15-20 minutes. The operated patient is in the hospital for another 3-4 days, and then goes home, where a rehabilitation period takes place for several more days. In exceptional cases, the patient manages to leave the walls of the hospital in a day.

As a home aftercare, daily swab replacements and therapeutic baths with chamomile or pine needles are prescribed.

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Prepare

First of all, before the Longo operation, the patient must undergo an appropriate examination by a proctologist and the prescribed diagnostic tests. Only after providing medical confirmation of the need for surgical intervention is this procedure prescribed.

If the patient experiences fear or stress, then sedatives or sleeping pills may be prescribed.

Before proceeding with the operation, the patient’s intestines must be cleaned of feces with an enema. A few days before surgery, it is recommended to eat only light foods that do not cause constipation. And a few hours before the operation, you need to refrain from eating food and water.

Rehabilitation

After Longo’s surgery, the patient should refrain from working for a week, as he needs some care (replacing swabs with antibacterial compositions and regular washing of the anus).

The rehabilitation period implies the exclusion of weight lifting and exercises that exert pressure on the veins of the pelvic floor. It is necessary to perform therapeutic exercises to avoid stagnation of blood in the operated area.

Outdoor walks and frequent hygiene are also recommended.

During the rehabilitation period, the patient must follow the diet recommended by the attending physician, which completely eliminates rich, fatty, spicy and fried foods. All food should be steamed. It is advisable to eat cereals, plant foods, vegetable stew, soups and broths, boiled meat and fish.

The patient must maintain water balance in the body and consume at least 2 liters of fluid per day. Thus, it will be possible to normalize the metabolism and prevent the occurrence of constipation. If stool difficulty is already observed, then for its elimination it is better to use an enema with liquid paraffin or medicinal infusions.

Method advantage

Hemorrhoidopexy is an operation that has virtually no drawbacks. The main advantages of this method of surgical intervention include painlessness due to the absence of pain receptors in the rectum and a short rehabilitation period.

Both the operation itself and the recovery period after it are considered painless. In 83% of cases, people did not experience the slightest discomfort.

Other advantages of mucosal submucosal resection include:

  • speed of the procedure;
  • minimization of possible serious consequences;
  • local anesthesia;
  • the possibility of getting rid of adverse symptoms at any stage of the pathology;
  • restoration of the previous appearance of the anal canal;
  • lack of aesthetic changes after surgery.

Longo surgery is the best solution for hemorrhoids in pregnant women or in mothers during lactation.

Complications after hemorrhoidopexy are extremely rare. Their appearance is most often associated with non-compliance with hygiene rules and ignoring the recommendations of the attending physician. These include:

  1. intraperitoneal bleeding – manifested as a result of a discrepancy in the edges of the mucosa;
  2. rectovaginal fistula – inflammation during infection of a wound;
  3. retroperitoneal sepsis – is a deadly complication that manifests itself due to infection from the intestine into the peritoneum, which causes blood poisoning;
  4. vena cava thrombosis – if this occurs, removal of the kidney may be necessary.

The disadvantages of Longo surgery are:

  • cost – directly depends on the stage of pathology, clinical conditions, drugs and tools used. The average price is 38–48 thousand rubles;
  • lack of effectiveness in eliminating external hemorrhoids;
  • little information about the condition of the operated patients years after surgery.

Longo’s surgery is indicated for people with chronic internal hemorrhoids and circular node prolapse.

In no case should you allow the implementation of this technique for inflammatory bowel diseases, malignant neoplasms and blood diseases.

Laser hemorrhoid surgery is performed on an outpatient basis. As a rule, on a proctological chair. The pose should be comfortable with legs apart.

  • they treat the anus with anesthetic (infiltration of Novocaine or Lidocaine solution in the area of ​​the node, lubrication with Eml cream), wait 5-7 minutes for the medicine to work;
  • use short-term intravenous anesthesia;
  • removal of external hemorrhoids involves an incision with a beam above each node with layer-by-layer evaporation of the tissue and at the same time gluing of the vessels of the treated area (lack of bleeding);
  • when removing internal hemorrhoids, an anoscope with a backlight is used, through which a coagulator is introduced into the rectum;
  • Having determined the localization of the node, the surgeon coagulates burns tissue layer by layer and seals the vessels;
  • small nodes coagulate by affecting the stem, large nodes – over the entire surface;
  • after hemorrhoid removal with a laser, rest is required for half an hour, no dressings are required.

In one procedure, no more than three hemorrhoids are removed. There are two ways to cauterize hemorrhoids:

  • transmucosal start from the proximal edge of the node, the electrode is fed outside, sequentially moving 2 mm to the edge of the formation: the node is significantly reduced in size, the leg ceases to be fed with blood;
  • subdermal-submucous: the fiber is inserted into the node through a puncture, which allows the node to burn out from the inside.

Laser coagulation of hemorrhoids

Earlier surgery to get rid of hemorrhoids involved a partial resection of the part of the rectum where the inflamed hemorrhoidal nodules had accumulated. Such an operation was considered very traumatic, since there was a high probability of postoperative complications, and the patient also needed a long recovery period.

At the end of the last century, Italian professor Antonio Longo came up with an alternative technique, which is much less dangerous for the patient. The operation was named after its creator, although in surgery it is often referred to as hemorrhoidopexy.

During the intervention, not a fragment of the affected rectum is removed, but a mucous epithelium in the area located above the line of hemorrhoids. Then the wound is fastened with titanium brackets. As a result:

  • extruded nodules are pulled into the anus;
  • in the affected veins, the blood stops flowing;
  • the veins stick together and gradually disappear, leaving behind a small scar.

bvgfr5ee - Longo surgery for hemorrhoids is the essence of the method of indications and contraindications

The operation is painless, since sections of the mucous membrane in the rectum where there are no pain endings are subjected to resection.

Any surgical intervention involves: preparation, which minimizes the likelihood of complications, the operation itself and the postoperative period. We will analyze all the steps in more detail.

Prepare

Before the appointment of surgery, the patient is examined by a proctologist. During the examination, some tests and examinations are prescribed:

  • general blood tests, urine tests;
  • blood test for sugar;
  • electrocardiography;
  • chest x-ray;
  • palpation of the rectum;
  • sigmoidoscopy or colonoscopy.

If no contraindications are revealed (we mentioned them earlier), then two days before the day of surgery, the patient is put on a diet. Fiber-rich foods that contribute to flatulence are completely removed. The diet is converted to easily digestible food: vegetable soups, milk products, lean meat, poultry and fish.

A couple of hours before surgery, the patient is given an enema to cleanse the stomach, hygienic procedures are performed to clean the anus, perineum and genitals.

Operation

Surgery is performed under local anesthesia. In rare cases, the use of epidural anesthesia is allowed, when the patient can remain conscious or doze off. To perform the operation itself, special tools are required:

  1. Anoscope is an empty plastic tube equipped with a handle. With its help, it is possible to increase the lumen of the rectum, making it easier for the doctor to access the damaged area.
  2. The device is a resector. Used for partial excision of the mucous membrane of the hindgut.
  3. Circular stapler. It is necessary for tightening the edges of cut tissues with titanium clips.

Проведение

Here is the phased progress of the operation Longe:

  1. The patient is placed on the table, legs are fixed on supports.
  2. Local anesthesia is given, after which, with the help of surgical clamps, the anus skin is stretched to the sides.
  3. An expander is introduced into the anus, fastened with four sutures.
  4. An anoscope is placed in the rectum through the dilator.
  5. On top of the toothed line, the mucous membrane is hemmed with a circular purse-string suture to protect it from twisting and to ensure an even seam line. Using an anoscope, the surgeon checks the quality of the seam throughout the area.
  6. A circular stapler is inserted into the lumen of the anus.
  7. The edges of the purse string suture are tightened with threads, their ends are brought out through the stapler.
  8. The stapler is rotated in a circle, cutting the hemorrhoidal nodules with a blade.
  9. The cut-off section of the mucosa is removed, the edges of the incision are connected and stitched with titanium brackets.
  10. A stapler is removed from the anus, the result of the operation is assessed using an anoscope, then it is also removed. The last to take out the expander.
  11. A tampon with a medicated ointment or gel is placed in the anus, as well as a tube for venting gases. All this is removed exactly one day after the end of the operation.

The operation takes no more than 20 minutes, although much depends on the complications and experience of the doctor. If everything went well, the patient is discharged from the hospital after three days. A sick leave is issued for a week.

operatsiya longo pri gemorroe12 - Longo surgery for hemorrhoids is the essence of the method of indications and contraindications

In order for the consequences of the operation to heal successfully, the patient is prescribed:

  • antihemorrhoidal suppositories and ointments, soaked with substances against bacteria;
  • postoperative diet.

We explain the last point in more detail. From the daily menu are completely removed:

  • sweet and baking;
  • fried and fatty foods;
  • carbonated drinks;
  • alcohol.

A daily diet should include:

  • liquid soups;
  • porridge;
  • vegetable and fruit salad;
  • White bread;
  • boiled meat of low-fat varieties;
  • bird or fish.

It is also prescribed to drink at least two liters of liquid per day, preferably drinking water.

The diet is prescribed to prevent constipation in the patient. If, nevertheless, the patient suffers from them, they are prescribed laxatives, such as Dufalac, Normase, Lactulose, glycerin suppositories and so on.

Ligation is a modern, safe, almost non-invasive method for treating hemorrhoids, the essence of which is to squeeze the arteries and veins that feed the hemorrhoid, latex rings. As a result, the access of nutrition, oxygen to hemorrhoids is blocked, followed by necrosis of the affected tissues, their death.

0ca400d14180e632c8b979ed17d60aa8 - Longo surgery for hemorrhoids is the essence of the method of indications and contraindications

The essence of the procedure for ligation of hemorrhoids

The latex ring is hypoallergenic, made of environmentally friendly material, safe for patients of any gender, age.

Operatsiya - Longo surgery for hemorrhoids is the essence of the method of indications and contraindications

Depending on the method of installing latex rings, ligation of hemorrhoidal nodes is carried out either mechanically or using a vacuum.

Mechanical method

Ligation of hemorrhoids is carried out in a special chair. An anoscope is introduced into the rectum, through which a ligator, an exciting node, is delivered to the varicose vein. The enlarged vessel is isolated from the surrounding tissues, a ligature is thrown onto the node, the latex ring compresses the hemorrhoids without damaging the nearby sections of the rectum or anus. The operation is possible only if the base of the hemorrhoid is well visualized. The operation lasts no more than half an hour.

Vacuum way

The operation consists in bringing a special ligator with a suction to the hemorrhoidal node through the anoscope. The hole in the device is closed to pressurize, which leads to a tightening of the node, on the base of which the doctor places two ligatures.

After the operation, the hole in the suction is opened to stabilize the pressure and prevent the separation of the node with bleeding. Vacuum is an easier way to latex ligation of hemorrhoids, which does not require a clear outline of the varicose cavity.

When there is no effect of drug therapy, the patient is concerned about frequent exacerbations of hemorrhoids, bleeding, severe pain, prompt removal of varicose veins is necessary.

vg5644 - Longo surgery for hemorrhoids is the essence of the method of indications and contraindicationsSpecialist

  • The initial stages of internal hemorrhoids, which are accompanied by large sizes of varicose dilated cones
  • Internal hemorrhoids 3 – 4 degrees.
  • Circular prolapse, when hemorrhoids fall out around the anus along with the intestinal mucosa.
  • Concomitant prolapse of the rectum.
  • Rectocele in women – protrusion of the intestinal wall towards the vagina.

Longo surgery for internal hemorrhoids is a popular effective treatment. It allows the patient to quickly get rid of painful, bleeding nodes. Women during pregnancy and lactation should refrain from performing such manipulations. This method is not carried out according to emergency indications, it is a planned type of surgical manipulation. In addition, the course of the postoperative period is complicated due to the impossibility of prescribing antibiotic therapy.

Longo method requires the use of special disposable tools.

  • Anoscope, which is a plastic tube with backlight. With its help, you can conveniently carry out manipulations and examine the area of ​​the surgical field.
  • A special resector with which the intestinal mucosa and hemorrhoids are excised.
  • A circular stapler resembling a stapler. It is used for suturing fabrics.
The patient is placed in a special chair, his legs are fixed in supports.This facilitates the access of the doctor to the surgical field.
In the area of ​​hemorrhoidal protrusions, perineum, anus, the skin and mucous membranes are treated with an antiseptic.Such manipulation is necessary to disinfect and prevent complications.
Spend intravenous, epidural or local anesthesia.The mucous membrane of the hemorrhoids and intestines does not have pain endings. Anesthesia is necessary for the introduction of the dilator into the rectum.
Clips are applied to the anus.With their help, stretch the anus to provide better visibility.
An anal dilator is introduced into the intestine.Fix it with sutures to prevent loss.
An anoscope is passed through this dilator; a purse string suture is applied to the rectal mucosa with a stapler.They pull it up, tighten it and tie it.
Cut off the formed areaIts ends are stitched together. Impose titanium brackets.
Remove the anoscope with the expander.Check for correct suture
Turunda with medicinal ointment and a vent tube are introduced.This prevents the attachment of a secondary infection and contributes to the normal discharge of gases.

a202d7cb54281251432fea19e939afa4 - Longo surgery for hemorrhoids is the essence of the method of indications and contraindications

On this, the operation performed by the longo method ends. It lasts no more than 20 – 25 minutes. Such surgical intervention is the most effective and effective way to treat internal hemorrhoids.

Laser removal of hemorrhoids by exposure to high temperature exclusively on the lesion of the smallest size leads to:

  • tissue destruction in the right place;
  • aseptic burn;
  • local necrosis with subsequent scarring;
  • sealing vessels with the destruction of nerve endings;
  • sterilization field operation.

That is, the laser simultaneously cuts and cauterizes tissue – this is the essence of laser coagulation.

Contraindications to surgery

Immediately before the operation, the patient is examined by an anesthesiologist, the pulse and pressure are measured.

Removing hemorrhoids even in the later stages may be contraindicated. Moreover, the restrictions are directly related to the nature of the proposed intervention: with minimally invasive methods – one, and with radical methods – others. General restrictive framework when hemorrhoids cannot be operated on:

  • hemorrhoidal disease during an exacerbation;
  • neoplasms in the rectum of any genesis;
  • diabetes mellitus, which violates the rate of wound healing, creating a risk of heavy bleeding;
  • exacerbation of somatic diseases, especially from the digestive system;
  • severe pathology of the heart, blood vessels;
  • Crohn’s disease;
  • pregnancy, lactation;
  • infections of any etiology;
  • HIV infection, AIDS;
  • old age, limiting the possibility of using general anesthesia.
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The severity of the process is stopped by symptomatic therapy, after which the operation can be successfully performed.

Techniques for conducting

Before the operation, the patient is assigned a full examination to identify contraindications.

Ligation of internal hemorrhoidal nodes is recommended for:

  • inefficiencies of conservative therapy in the early stages of hemorrhoids;
  • constant discomfort in the anorectal region;
  • loss of nodes with the impossibility of reduction;
  • frequent relapses of the pathology;
  • life-threatening complications.

There are more contraindications to the operation:

  • initial and late stages of hemorrhoids;
  • blood diseases and coagulation systems;
  • combined form of pathology;
  • tumor growth;
  • inflammation of the rectum region with and without cracks;
  • proctitis or paraproctitis;
  • problems with the cardiovascular system and central nervous system.

The question of the advisability of dressing hemorrhoidal nodes with latex rings in each individual case is decided by the doctor after a clinical and laboratory examination of the patient.

Hemorrhoidopexy is prescribed in situations where hemorrhoidal processes are internal local in nature. It helps with the following diagnoses:

  • the disease is in its initial stages, but the nodules have developed to large sizes, which causes serious discomfort and suffering to the patient;
  • the disease has reached the third or fourth stage;
  • hemorrhoidal cones constantly fall out at the slightest physical exertion;
  • extrusion of nodules occurs simultaneously with prolapse of the rectum;
  • the rectal intestine protrudes into the vagina.

In all these situations, sparing medication and minimally invasive methods, alas, can not help, because Longue is the most preferable and completely reliable solution.

The described method has a number of contraindications. Surgical intervention cannot be performed in case of:

  • poor coagulation of lymph;
  • the presence of malignant tumors in the colon;
  • bowel lesions acute infection.

The operation is not dangerous for pregnant women suffering from hemorrhoids, and for nursing mothers.

Advantages

We list the main advantages of the described technique:

  • passes without loss of blood and without pain;
  • the patient’s stay in the hospital is minimized;
  • the intervention takes little time;
  • carried out under local anesthesia;
  • there are practically no complications;
  • the wounds do not hurt, the rehabilitation period is short;
  • the operation is performed with disposable instruments.

Disadvantages

Nevertheless, this technique is not a panacea. In addition to the contraindications already listed above, we will name a few more shortcomings:

  1. You can not intervene with external hemorrhoids.
  2. Used disposable tools cost a lot of money.
  3. It is not yet possible to judge the long-term consequences for the patient.

Проведение

If the doctor has prescribed an adequate treatment for hemorrhoids to the patient, this is 95% success. Therefore, the importance of indications for laser removal of hemorrhoids is difficult to overestimate:

  • internal or external hemorrhoids complicated by bleeding (stage 1-3);
  • a combination of pathology with rectal fissures or fistulas;
  • Large, non-adjustable nodes
  • inflammation of the rectum;
  • thrombosis of nodes.

In an extreme case, it is possible to remove hemorrhoids with a laser and with 4 stages of the disease, but the effectiveness with such an intervention is small, since the laser cannot cauterize large nodes.

The minimally invasive technique of laser coagulation has practically no contraindications. The limitation is the last stage of the disease or infection of the anal and perianal region (stopping the infection process will open access to laser coagulation).

As for thrombosis of nodes or severe inflammation of rectum, laser hemorrhoid removal is necessarily combined with conservative therapy.

It is carried out on an outpatient basis, bloodless, under local anesthesia. After surgery, a dense swab is placed in the anus. This is the only discomfort for the patient.

The presence of hemorrhoidal nodes of the third and fourth degree arising from chronic internal pathology of the rectal veins are the main indications for the appointment of Longo surgery specialists.

The main indications for appointment:

  1. 3-4 stage of hemorrhoids, when there are only internal large hemorrhoids.
  2. Rectocele, in which the walls of the rectum protrude into the back of the vagina. Most often this happens during childbirth when a woman’s internal genital organ ruptures.
  3. Thrombosis of internal nodes.
  4. Removal of cones that have fallen around the entire circumference of the intestine.

Often, manipulation is prescribed for children, if necessary, for pregnant and lactating women.

It is more rational to assign the Longo operation precisely in such states when there are no external nodes. Otherwise, the treatment takes a long time, which is not always effective.

The technique has few contraindications, but it is important to know them. You can not perform Longo surgery in cases:

  1. Acute inflammatory processes in the intestines.
  2. Oncological formations of the colon.
  3. Blood diseases.

Indications for conduction

Проведение

1c5467f5683726625c7fe0bc5969aeb5 - Longo surgery for hemorrhoids is the essence of the method of indications and contraindications

  • minimal impact on tissues adjacent to the inflamed cones of hemorrhoids;
  • short duration of the procedure (no more than half an hour);
  • almost complete absence of pain when using local anesthesia (anesthesia is not required);
  • the patient does not need a stationary rehabilitation period, returns home – on the day of surgery, starts work – the next day;
  • minimally invasive techniques do not leave scars, do not deform the rectum, anus;
  • the absence of serious contraindications involves the use of a minimally invasive technique for removing the hemorrhoid in older patients with many concomitant diseases;
  • The low morbidity of the technique allows them to be used at any stage of hemorrhoidal disease.

Today they use a number of such innovations:

  • Desarterization is the most effective way of non-surgical removal of hemorrhoidal cones. The bottom line is ligation of the arteries that feed the cavity through an anoscope, after preliminary determining the location of each vessel using ultrasound. The result is the exclusion of hemorrhoidal nodes from the general nutritional system of the anorectal zone with their subsequent death. The procedure provides 95% cure, guarantees the absence of relapses, but expensive due to the equipment used. Prices in Moscow: from 14 rubles to 800 rubles (depending on the number of bundled nodes, the qualifications of the surgeon, the status of the clinic);
  • Latex ligation is the second most effective procedure: more than 90%. The bottom line is the exclusion of hemorrhoidal formation from the bloodstream after a latex ringlet is thrown on the node leg, which gradually contracts. After a couple of weeks, the internal site of hemorrhoids dies, is brought out naturally along with the ringlet. Minus – the indication is only the internal bumps. In addition, while the ring is pulled together, the patient can feel a foreign body in the anus. The cost of ligation in Moscow: from 2 rubles (per node) to 400 rubles;
  • Sclerosis is the elimination of hemorrhoids by introducing a special drug into the node that glues the walls of the cone itself, the vessels supplying it. Blocking nutrition leads to the death of hemorrhoidal formation. The procedure is quick, painless. Minus – applicable only to the internal nodes of hemorrhoids, excluded with individual intolerance to the sclerosant drug, relapse is possible, since the cause of the disease is not eliminated. Prices for sclerotherapy in Moscow: from 1 rubles to 500 rubles, depending on the number of nodes removed;
  • Laser coagulation – indicated for hemorrhoids of any localization. The bottom line is the effect of the laser on the venous cavity as a whole, which causes coagulation of proteins in the walls of blood vessels and cones. The veins and arteries are fused, the cavern nutrition stops, the nodes disappear without bleeding for a couple of weeks. The cost of the procedure in Moscow: from 12 to 000 rubles (for 18 hemorrhoidal node);
  • Infrared photocoagulation – exposure of a cavernous leg to a beam of focused infrared light with coagulation of proteins in the walls of blood vessels, blocking normal nutrition. The procedure requires several sessions. It is used mainly in the first stage of hemorrhoidal disease. The procedure is comfortable, painless, but often gives relapses. Prices in Moscow: from 1 to 000 rubles.
  • Cryodestruction – freezing of hemorrhoidal nodes with liquid nitrogen (temperature below 180-200 C), which affects only damaged areas, since healthy areas through the arteries create a thermal “border” that prevents the penetration of cold into nearby tissues. Dead cells exit the rectum in about a week. Cryodestruction is painless, does not leave scars, does not cause bleeding. But – it stimulates the immune system. Contraindication is thrombosis or necrosis of the node, progressive proctitis and paraproctitis. The procedure is not performed for pregnant and lactating mothers. In Moscow and large regional centers, the price of manipulation is 4 – 000 rubles. In regions, the cost is slightly lower: from 8 to 000 rubles. The cryodestruction operation is extremely rare.

Therefore, before conducting an operation to remove hemorrhoids, you should collect all the necessary information about the clinic and the surgeon, whom you trust your health, get acquainted with the reviews of the operated patients.

Prepare

Before the operation of ligation of hemorrhoidal nodes, each patient goes through several preparatory stages:

  • clinical minimum examination, including: OAA, OAM, biochemistry, ECG, FLG, RW, HIV testing, blood for viral hepatitis, anoscopy (digital examination), sigmoidoscopy, colonoscopy;
  • adherence to a weekly diet, excluding fried, fatty, spicy, smoked, canned, salty dishes, soda, alcohol;
  • in agreement with the doctor, the cancellation of anticoagulants a week before the operation;
  • bowel cleansing: on the day of surgery in the morning – microclysters or laxatives (Bisacodyl, Glycerin, Calciolax);
  • hygiene measures.

The operation is performed on an outpatient basis or in a day hospital.

The patient is required to be examined at a clinical minimum:

  • OAC, OAM, biochemistry (sugar, cholesterol);
  • PTI (prothrombin index);
  • RW, HIV, hepatitis;
  • ECG;
  • FLG;
  • anoscopy, sigmoidoscopy, colonoscopy – as prescribed by the doctor;
  • for women – the conclusion of a gynecologist, for all – the conclusion of a therapist.

The list of studies may be expanded at the discretion of the physician.

A few days before the intervention, the patient goes on a diet to form a light stool after surgery.

NeverAllowed
BreadDairy products
MuffinVegetable stew
All flour productsLiquid porridge
Gassing foods: cabbage, grapes, legumesWater at least 2,5 l/day

For the prevention of flatulence on the eve of the operation, Smecta or Espumisan is taken. If the internal nodes are subject to removal of hemorrhoids, they put cleansing enemas: in the evening and in the morning or appoint laxatives in the evening (Fortrans, Lavakol). With external hemorrhoids this is not required.

Not always less traumatic methods lead to the desired result. Then, a traditional hemorrhoid removal operation is prescribed. Hemorrhoidectomy is the only solution for hemorrhoidal disease of the 4th degree. For its implementation, special preparation is required: clinical and laboratory examination, relief of acute processes, adjustment of drugs that are taken by the patient for health reasons.

Surgery to remove hemorrhoids involves a standard examination algorithm:

  • history taking, digital audit of rectum to determine the localization and condition of nodes;
  • OAC, OAM, biochemistry – screening for general health;
  • coprogram;
  • blood coagulation test;
  • blood type;
  • testing for lyues, HIV, viral hepatitis;
  • ECG;
  • FLG;
  • Ultrasonography of the abdomen;
  • anoscopy, sigmoidoscopy, colonoscopy, irrigoscopy – on the recommendation of a doctor.

A few days before the operation on hemorrhoids, the patient goes on a diet, which is designed to normalize digestion, stool. To do this, the diet includes foods rich in fiber, vegetables, fruits, yogurt, low-fat yogurt.

In the absence of the desired result, laxatives are connected (Guttalax, Dufalac, a short course of senna preparations). Independent choice of a drug is excluded.

On the eve of the operation, a number of rules should be strictly followed:

  • the last meal – no later than 11 hours before surgery;
  • the perineum is shaved, hygiene of the intimate area is carried out, clean linen is prepared and put on;
  • in the morning on the day of surgery, they make a cleansing enema;
  • if general anesthesia is planned, the patient should not drink water.

Today, two variants of radical excision of hemorrhoidal nodes are available by the compulsory medical insurance policy: hemorrhoidectomy with varieties and hemorrhoidopexy.

Hemorrho >e9f80aa71be86fb7e50ac8612149e737 - Longo surgery for hemorrhoids is the essence of the method of indications and contraindications

This is a classic operation for hemorrhoids. A similar rectal intervention has been used since the mid 30s of the last century. Hemorrhoidectomy gives excellent results (efficiency – more than 98%), practically no relapses. But it is traumatic, characterized by great blood loss, the presence of many complications. Modern proctology practices three options for hemorrhoidectomy: removal of hemorrhoids according to Milligan-Morgan, Ferguson, Parks.

After surgery: how is the rehabilitation period

The recovery period after removal of hemorrhoids in each proceeds differently, depending on the severity of the condition, symptoms, age, and concomitant pathology. Of great importance is the type of surgical intervention performed. After an open hemorrhoidectomy, a month and a half is required for rehabilitation, after a closed one – three weeks. Hemorrhoidopexy involves a week to restore disability.

During the rehabilitation period, it is important to follow the recommendations of the proctologist, to be in constant contact with him. The doctor provides postoperative follow-up for each patient after discharge from the hospital, until all problems arising after the operation are resolved. The main areas of efforts during the recovery period look like this.

Removal of hemorrhoidal nodes involves limiting the load associated with an increase in intra-abdominal pressure – lifting weights, active, abrupt movements, straining during bowel movements. Instead, turning over from one side to the other, sipping, breathing exercises is allowed. The goal is the prevention of thrombosis, varicose veins, and in the first three days – just a distraction from postoperative sensations.

You can get up on the second or fourth day, depending on the well-being of the patient. As the wound heals, the number of exercises expands, but when lying or standing. Effective Kegel exercises that train the muscles of the pelvic floor.

You can sit down after the disappearance of pain in the anorectal region, not earlier than a week later. Slowly, gradually. Proctologists advise a cushion for sitting or a swimming circle for a start.

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The first two months can not carry a load of more than 2 kg. The gym is allowed only after three months, with the exception of power load.

Proper diet is the main condition for the prevention of recurrence of hemorrhoids. Surgery to remove hemorrhoids according to patients’ reviews radically changes gastronomic preferences. On the first day after surgery – hunger, so that bowel movements do not damage the stitches. In the following days, you need to follow simple rules:

  • fractional nutrition, in small portions, food – chopped to the maximum for complete, but easy assimilation;
  • 80% of the diet – plant foods, fruits and vegetables in boiled, baked form or raw;
  • meat and fish are only lean;
  • every morning – a teaspoon of vegetable oil and a glass of clean water before eating;
  • drinking diet is calculated by the formula: 40-50 ml per 1 kg of weight (depending on the nature of the stool).
AllowedProhibited
Buckwheat, millet porridge on the waterSorrel, cabbage, turnip
Low fat kefir for the nightRaw apples, raspberries, dates
Skim cheeseCoffee
Baked vegetables, fruitsSmoked, salted, pickled, canned
Whole wheat breadLegumes, mushrooms
Boiled chicken, beefBaking, sweets
Vegetable soupsFat meat
Herb teaWhole milk

Pain syndrome

After surgery to remove hemorrhoids, the pronounced soreness of the anorectal zone lasts long enough. Severe pains disappear on the 5-7th day, but the periodic soreness of the anus, especially after defecation, can last for months. For stopping use NSAIDs: Nise, Ketanov, Ibuprofen. Locally: Relief – the entire lineup, Ultraproct, Anestezol, Procto-Glivenol, Aurobin, Proctosan. If pain is excessive, painkillers are used, consult a doctor.

Wound healing

Restoring the anorectal ring after surgery for hemorrhoids is one of the most important rehabilitation tasks. A number of drugs will help in this: Solcoseryl (gel, ointment), Levomekol, Natalsid, Methyluracil, Sea buckthorn oil. You can use recipes of traditional medicine, especially sessile baths with decoctions of medicinal herbs.

Rehabilitation after removal of hemorrhoids includes daily intimate hygiene: after each bowel movement at home, washing the anorectal zone, anus with cool water, outside the house – using wet sanitary napkins instead of toilet paper. Blot the treated surface with sterile wipes, not with a towel. Linen should be without rough seams, from natural fabrics.

Treatment of hemorrhoids with rings does not require hospitalization in a hospital. But after the operation, patients should be under the supervision of a doctor for several hours. If after an hour there are no complications, the patient goes home. For several days, the presence of a foreign body in the rectum can be felt.

At home, certain rules of conduct recommended by your doctor should be followed. This will help speed up a full recovery, minimizing the risk of complications:

  • after the operation, you can’t sit for several days, as the ligature may come off;
  • need to eliminate stress, physical activity;
  • daily hygiene procedures are required after each act of defecation, it is better to wash with decoctions of herbs;
  • for a couple of weeks banned sports, weight lifting, hard physical work;
  • it is necessary to take care of the prevention of constipation: adjust the diet, include the daily use of vegetables, herbs, fruits, fiber in any form;
  • exclude coffee, strong tea, fatty foods, alcohol from the menu;
  • all food should be steamed or liquid;
  • daily drinking regimen – at least 2,5 liters of water.

If the doctor has recommended, special preparations should be taken:

  • analgesics (Nurofen, Askofen, Pentalgin);
  • anticoagulants (Cardiomagnyl, Aspirin, Thrombo ass) – no more than 5 days;
  • Laxatives (Guttalax, Dufalac, Normase) – up to 6 weeks;
  • anti-inflammatory suppositories (Relief, Natalsid, Ultraproct) – prevention of complications;
  • antibiotics (Tetracycline, Levofloxacin, Levolet) – with the addition of a secondary infection.

Ligation of hemorrhoidal nodes is a simple procedure that requires careful attention to the patient.

During the operation, the ligamentous internal apparatus of the rectum is not injured at all, so a long rehabilitation is not required.

After surgery, the patient will have to spend no more than 3-4 days in the clinic. When using the Longo method, the pain in the anus during this period will be much less than with classical hemorrhoidectomy.

The time of labor rehabilitation may vary depending on the specific case. More often the patient needs to refrain from going to work for at least 3-5 days.

After returning home, it is important to observe the following recommendations:

  1. Exclude weight lifting and heavy load on the veins of the pelvic floor.
  2. Perform light exercises daily that help prevent the development of blood stasis in the pelvis. The complex should be selected by the attending physician.
  3. Take walks in the fresh air.
  4. Observe hygiene of the anal area, regularly take a shower.

Features of the rehabilitation period

After surgery according to the longo method, the patient spends in the hospital from 1 to 3 days. It depends on the presence or absence of the inflammatory process in the area of ​​the postoperative suture, the speed of wound healing and the patient’s well-being. Further recovery and rehabilitation is carried out on an outpatient basis.

8ec449d8d493d1540cf18103f4542a4c - Longo surgery for hemorrhoids is the essence of the method of indications and contraindications

Such interventions are usually well tolerated. The patient is considered incapacitated for 7 days, at this time a sick person is issued a sick leave. Over the next week, it is recommended to observe a gentle regime. After going to work, if it is associated with physical labor, you should switch to a lightweight mode for several weeks.

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7gbvfddd - Longo surgery for hemorrhoids is the essence of the method of indications and contraindicationsHoney staff

  • Use antibacterial, anti-inflammatory local and systemic drugs, if necessary, laxatives.
  • Exclude active physical activity and weight lifting.
  • Try not to cause an increase in intra-abdominal pressure: do not cough strongly, do not push, do not laugh.
  • You need to perform special exercises to eliminate stagnation of blood in the pelvis.
  • Stay upright for a long time, walk.
  • Conduct daily hygiene procedures of the anorectal region. A cool shower should be used for these purposes.
  • Follow a diet with a predominance of dairy and plant products, fluids, food mucosa: jelly, cereal. It is recommended to use vegetable and fruit salads, low-fat beef or poultry, steam cutlets, fish. It is necessary to refuse fried, spicy, seasonings, alcohol, carbonated drinks.
  • The act of defecation within 7 to 10 days is recommended to be performed only after cleansing enemas or taking laxatives: dufalac, lactusan, biscodil.

Independent bowel movement is possible after the end of this period.

  • To prevent possible complications in the early and late recovery period, the patient is prescribed antibiotics of a wide spectrum of action: flemoklav, augmentin, ciprofloxacin. As local anti-inflammatory drugs, suppositories, ointments: proctosedil m, levomecol, methyluracil are used.

The purpose of dietary nutrition is necessary in order to provide relaxation of the stool and minimize the possibility of mucous solid feces.

The vent pipe is removed the very next day. In the future, gas discharge and defecation are normalized. During this period, it is recommended to use washings or baths with potassium permanganate, chamomile, oak bark.

I let the patient go home on the day of surgery: for about an hour, he is under the supervision of a doctor. There are no special restrictions during the rehabilitation period. A person leads a familiar lifestyle, with the exception of weight lifting during the first week after laser coagulation of hemorrhoids.

be876496e09c55eab793349d7567547e - Longo surgery for hemorrhoids is the essence of the method of indications and contraindications

Fiber in all variants and a large amount of drink (alcohol is prohibited) should prevail in the diet. Constipation can be prevented by taking Guttalax, Lactulose, Mukofalk).

Doctor’s consultation – in a week, and if negative symptoms appear – immediately.

Preparations after surgery

Hemorrhoids involve continuous treatment after surgery to speed up rehabilitation and prevent complications. Mandatory – the use of medicines. For pain – painkillers, for constipation – laxatives, for bleeding – hemostatics. The basis, as before the operation, is still made up of venotonics.

  • Detralex tablets. One of the best for the prevention of recurrence of hemorrhoids in the rehabilitation period, the most popular. The drug is a representative of venotonics, consists of a complex of bioflavonoids based on diosmin, hesperidin. Detralex increases the tone of veins, relieves congestion of the pelvic organs, improves microcirculation of the anorectal region.
  • Pills Venarus. Domestic analog of Detralex. Synthetic venotonic with angioprotective properties.
  • Flebodia 600 capsules. A drug from the group of venotonic diosmin-based. After removal of the deformed hemorrhoidal nodes, tones the veins of the rectum, restores the wall of blood vessels, stops inflammation, blood stasis in the anorectal zone, and balances microcirculation.
  • Hemoroidin tablets. Supplement venotonic with inulin – a natural precursor of chicory, which improves bowel function. Contains flax, dandelion leaves, juniper fruits, dill seed, plantain leaves, ginkgo biloba, haze roots – only 15 natural ingredients. In this case, side effects are completely absent. The main action is a painkiller, anti-inflammatory. Additionally – normalizes the stool.
  • Pills Proctonis. Plant-based barterial pressure with haemostatic properties. The drug is often used to prevent bleeding. Composition: shark cartilage, yarrow, cilantro, licorice, senna. Proctonis increases blood coagulability, regenerates rectal tissues, relieves inflammation, spasm of the anus, prevents secondary infection, and normalizes stool.
  • Methyluracil tablets. The representative of the group of immunostimulants with angioprotective, photoprotective properties based on dioxomethyltetrahydropyrimidine. The drug has an anti-inflammatory effect, regenerates tissues, is an angioprotector.
  • Guttalax tablets. Soft laxative, acts in the large intestine, does not affect the digestion or absorption of essential nutrients in the small intestine. The active substance – picosulfate, stimulates intestinal motility, accumulates fluid in the large intestine, which softens feces, stimulates emptying.
  • Pills Senade. The senna drug, which stimulates bowel movements due to increased peristalsis, liquefies fecal stones, prevents constipation, and is not addictive. A cheap but effective remedy for violation of bowel movements in the postoperative period.
  • Capsules Nemesulide Teva. The representative of non-steroidal anti-inflammatory drugs for oral administration. The main property is that it stops inflammation and pain during the recovery period after surgery to remove hemorrhoids. In case of an overdose, it can thin the blood, causing bleeding, so it is used with caution.
  • Ibuklin tablets. Combined drug from the NSAID group based on ibuprofen, paracetamol with anti-inflammatory, analgesic properties. It inhibits the synthesis of prostaglandins, relieves exudation, reduces the pastorality of rectal tissues after surgery, has an antipyretic effect.
  • Pills Nise. The drug from the NSAID group based on nimesulide is a mono-drug with anti-inflammatory, analgesic effect. Prostaglandin synthesis corrector. The active substance inhibits COX-2, inhibits inflammation, exudation, proliferation in the anorectal region, the drug has antipyretic properties.
  • Ointment and gel Solcoseryl. The drug is a regenerant. It accelerates the healing of damaged areas of the mucosa, skin by improving tissue metabolism, increasing collagen production, restoring the functioning of capillaries and veins.
  • Ointment Levomekol. It accelerates the regeneration of rectal tissues, disinfects the postoperative surface due to the combination of methyluracil and levomecin. In parallel, liniment resists secondary infection.
  • Ointment and suppositories Methyluracil. The drug belongs to the class of immunostimulating agents. Penetrating into tissues and cells, methyluracil accelerates metabolic processes, tissue regeneration and restoration, as well as the resistance of the epithelium to negative environmental influences. Additionally, the substance stops bleeding, reduces the intensity of inflammation and generally improves the condition of wound surfaces.
  • Candles Sea buckthorn oil. The drug is an extract from sea buckthorn berries. Natural and effective remedy, heals the wound surface, disinfects the mucosa of the rectum, anorectal zone. The oil component relieves inflammation, pastus anus, relieves pain.
  • Candles Natalsid. The drug is based on sodium alginate, which is a polysaccharide of seaweed. The main property is the healing of the wound surface in the rectum, anorectal region. In parallel, the medication exhibits anti-inflammatory properties, relieves pain.
  • Candles and Relief Ointment. Drugs based on shark liver oil, phenylephrine, Oil – improves the condition of the anus epithelium, rectum, which stimulates regeneration. Phenylephrine constricts blood vessels, reduces swelling, inflammation. Relief Advance due to the addition of an anesthetic benzocaine relieves pain.
  • Bezornil ointment. The drug is based on pearls, amber, borneol, zinc, bezoar. The drug relieves inflammation, relieves pain, activates immunity, and disinfects the wound surface. Pearls regenerate tissues, prevents thrombosis. Amber is an antiseptic. Zinc – disinfects anorectal tissues.

What are the benefits of surgery?

Laser hemorrhoid removal has several advantages over other minimally invasive technologies:

  • carried out at any stage of hemorrhoids;
  • anesthesia – local;
  • painlessness (according to patients’ reviews after the operation of removing hemorrhoids with a laser, there is only a sensation of a slight burning sensation);
  • three nodes are removed in just 20 minutes;
  • the beam acts pointless without affecting nearby tissue;
  • no seams, scars;
  • the patient returns home almost immediately after the operation (several hours of ambulatory observation by a doctor);
  • lack of bleeding;
  • good tolerability;
  • the disinfecting effect of the laser prevents secondary infection;
  • the minimum recovery period (to work, if it is not associated with heavy physical labor), you can begin almost the next day;
  • practically has no contraindications;
  • allows you to treat at the same time: hemorrhoids and fissures, hemorrhoids and polyps, hemorrhoids and fistula.

The disadvantages of laser coagulation include:

  • lack of effectiveness in large caverns or in the late stages of the disease;
  • risk of relapse;
  • high cost.

Unfortunately, the operation is still not carried out according to the MHI policy, that is, it is practically inaccessible to the majority of the country’s population.

Operation benefitsDisadvantages of intervention
Speed ​​of execution (about 20 minutes)Expensive operation
No need to be in the hospitalThe inability to eliminate the cause of hemorrhoids (problems with the gastrointestinal tract immunity, cardiovascular system)
Return to the usual way of life, if the profession is not associated with heavy physical labor, immediately after discharge from the clinicRisk of recurrence of hemorrhoids with repeated surgery
The rapid disappearance of the symptoms of varicose veins rectum, the disappearance of pain, itching, burning, and straighteningRisk of complications due to constriction of mucous rectum

Features of the operation

This method differs from conventional hemorrhoidectomy in that a portion of the rectal mucosa along with the nodes is circularly removed. For longo surgery, a special suture machine is used. Its use reduces the risk of developing stricture of the rectum. The essence of this method is that sections of the mucosa are tightened, blood outflow from varicose cones is reduced.

This leads to their decline, a gradual overgrowth of connective tissue. Longo surgery is performed only with internal hemorrhoids.

If there is a combined form, then the surgical intervention is complicated. The effectiveness of this option lies in the pathogenetic effect on the mechanism of hemorrhoids.

The ligaments and muscles of the anus are fixed with the simultaneous elimination of vascular pathology.

bvgfr5ee - Longo surgery for hemorrhoids is the essence of the method of indications and contraindicationsOperative intervention

This leads to their decline, a gradual overgrowth of connective tissue. Longo surgery is performed only with internal hemorrhoids. If there is a combined form, then the surgical intervention is complicated. The effectiveness of this option lies in the pathogenetic effect on the mechanism of hemorrhoids. The ligaments and muscles of the anus are fixed with the simultaneous elimination of vascular pathology.

7gbvfddd - Longo surgery for hemorrhoids is the essence of the method of indications and contraindicationsHoney staff

Cost of operation

The prices for laser treatment of hemorrhoids are quite high, made up of:

  • stage of the disease;
  • number of nodes to be deleted;
  • concomitant pathology;
  • volume of clinical and laboratory examination;
  • equipment used;
  • doctor qualifications;
  • status of the clinic.

In Moscow, an operation to remove 1 node with a laser will cost you in the Atlas Medical Center – from 3 rubles, and in Soyuz Clinic – from 000 rubles.

In St. Petersburg: in the SM Clinic – from 1 rubles, and in the Exclusive Clinic – from 999 rubles.

c27694a33bd2641ef067f683616a812b - Longo surgery for hemorrhoids is the essence of the method of indications and contraindications

Higher medical education. 30 years of working experience in practical medicine.

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Last Updated: November 19, 2019

18a8586d8722ec6f3feee4bb4844d211 - Longo surgery for hemorrhoids is the essence of the method of indications and contraindications

Ligation of hemorrhoids is an expensive medical service, the price of which is determined by several points:

  • hemorrhoids stage;
  • the number of ligated nodes;
  • the presence of concomitant pathology requiring correction;
  • preparatory period;
  • choice of anesthetic;
  • doctor qualifications;
  • status of the clinic;
  • form of ownership of Moscow Region;
  • equipment used;
  • time spent under the supervision of a doctor;
  • priority (out of turn or with a waiting list).

All together adds up to the total cost of the operation, which varies significantly among themselves.

For example, in Moscow an operation can be done for 3000 rubles (1 knot) in the A-Line metro station in Prague metro station or for 12 rubles in the clinic Capital on Leninsky.

In St. Petersburg, ligation of hemorrhoidal nodes will be performed for 800 rubles (1 node) – the treatment and diagnostic center Peterhof-honey or for 11 rubles – the multidisciplinary medical center of the Leningrad Regional Hospital.

To whom ligation is assigned

The gender of the patient and his age do not matter, but the use of rings is advisable only if other methods are ineffective. In addition, ligation of hemorrhoidal nodes is a way of choosing the removal of hemorrhoids during pregnancy, since it is absolutely safe for both mother and baby.

It all depends on the stage of hemorrhoids. At the initial stage, conservative therapy is more reasonable. The first stage of rectal varicose veins is treated by ligation, provided that inflammation occurs, causing severe pain with the threat of tissue necrosis of the anal area. The operation takes a minimum of time, is painless, the recovery period is two weeks.

According to patients ‘reviews and doctors’ strong conviction, it is the second stage, accompanied not only by pain, but by periodic bleeding from the anus, that is optimal for ligation of the internal hemorrhoids with hypoallergenic latex rings.

The third stage of hemorrhoids is accompanied by prolapse of nodes, the formation of external varicose formations, therefore, the method of ligation of hemorrhoidal nodes is used less frequently. But with a competent approach – the possibility of surgery is preserved.

With hemorrhoids of the fourth stage, ligation is ineffective; a classical hemorrhoidectomy surgery is required.

Pros and cons of the method

The disadvantage is the impossibility of carrying it out with external forms of hemorrhoids and the high cost of disposable consumables. The cost of the devices used is from 30 to 50 thousand rubles.

Longo surgery is an effective method for removing varicose protrusion of the rectal canal. It allows you to improve the patient’s condition and completely get rid of the manifestations of hemorrhoids.

Hemorrhoids are most often treated in advanced stages, when medication and physiotherapy can not help.

Longo surgery is a surgical procedure with minimal trauma, it is easier to transfer to patients, since the health risks are the smallest and a short recovery period is ensured.

An operation to remove hemorrhoids is prescribed to patients with stage 3 and 4 ailment. Most often, classical intervention is chosen, in which hemorrhoids are completely excised. The technique is radical, has a number of contraindications, requires a long recovery period, and sometimes provokes complications.

The Longo method for hemorrhoids is a safer procedure. Doctors resect a small part of the nodes, and then they cut off the power with brackets. Redistribution of blood leads to the elimination of nodes with minimal discomfort.

The Longo operation was invented back in 1993 by Professor Antonio Longo. Its essence is reduced to minimal trauma, resection is performed on the mucous and submucous layers of the cones. Removal of hemorrhoids by the Longo method in surgery is called hemorrhoidopexy.

Before external hemorrhoids are removed, a series of studies are still carried out, even taking into account the lower risks, the operation has separate contraindications.

At the heart of the Longo surgery technique is used circular resection exclusively of the intestinal mucosa. Localization – the upper part of hemorrhoids. After the operation to remove hemorrhoids along Longo, the incisions are fastened with braces, most often from titanium. After the intervention, the lumps are drawn into the rectal canal and become invisible.

Often the only way to get rid of inflamed and painful hemorrhoidal nodes is timely surgical intervention

Longo’s operation for hemorrhoids provides blocking of the veins that fed the nodes. Coagulated veins over time completely overgrow with connective tissue. After removal of the internal hemorrhoidal nodes and complete recovery, a small scar remains at the site of the resection.

The method of surgical intervention helps to get rid of problems with hemorrhoids painlessly, since the surgeon operates on a section of the rectum without nerve endings.

Longo hemorrhoid surgery is performed for the internal localization of nodes. In relation to the external arrangement of the cones, the procedure is not used.

Considering methods of removing hemorrhoids, the Longo method is most preferred. It is prescribed when the patient:

  • the initial stages of internal hemorrhoids with enlarged bumps, provoking severe discomfort;
  • internal advanced form of hemorrhoidal disease;
  • revealed a circular form of prolapse of cones;
  • together with the nodes found prolapse of the rectal rectal area;
  • hemorrhoids lead to interference in the vagina, the intestine protrudes into the genitals.

Surgical intervention is performed for various types, but with the listed conditions it is more rational to prescribe Longo surgery.

Other hemorrhoids are sometimes preceded by the Longo method, but they are already determined individually.

The Longo method for hemorrhoids is used only for internal hemorrhoid cones 3-4 stages of the disease

For the first time, they answered positively the question of whether it is possible to effectively and painlessly remove nodes with hemorrhoidopexy in the Baltic Clinic. From there went the spread of the operation.

Therapy of hemorrhoids according to the Longo method involves the removal of not the node itself, but only the mucous and submucous tissues. Fabrics are cut out in a circle, and then titanium staples are used for fastening. Due to the loss of blood supply, the nodes are gradually eliminated, and after surgery they change their location. Over time, the pathological site is replaced by connective tissue.

Only surgery in which ligation of the hemorrhoidal node and subsequent cryotherapy of hemorrhoidal cones is of similar effectiveness.

Advantages

When the means for the treatment of hemorrhoids do not have a due effect, the possibilities of surgical treatment of the condition are being considered. The method is popular due to the presence of advantages:

  • painlessness – the patient does not have anxiety and discomfort due to surgery. Only 10% have complaints of pain after the intervention;
  • a short postoperative period lasts 1 week, but the patient is entitled to write out after 3-4 days, if he feels well;
  • the main advantage of the operation is the effective restoration of the anatomical structure of the anal passage and canal;
  • An important advantage is the relative absence of contraindications, which is achieved due to the absence of injuries on the ligamentous apparatus. Minimum invasiveness largely determines a quick and easy recovery;
  • does not lead to blood loss;
  • the procedure takes a minimum period of time.

Intervention is universal for internal formations with various complications, but is not used for external forms.

After surgery, the wound does not bother the patient at all

8d60adfd75758e8d3569a043f99eedb4 - Longo surgery for hemorrhoids is the essence of the method of indications and contraindications

Sometimes the only way to eliminate inflamed and painful hemorrhoidal nodes is surgery.

One of the most famous and most radical methods is Longo surgery, also called hemorrhoidopexy. This method of combating hemorrhoids is aimed at excising and pulling up the areas surrounding the mucous membrane of the nodes.

The initial stage of the operation

This method was named after Antonio Longo – the famous Italian coloproctolon. Longo hemorrhoidopexy is considered relatively painless. It was developed in 1993.

In addition, Longo’s operation for hemorrhoids helps to turn the blood supply to the node, which ensures the drying out, and after that the formation disappears.

The patient’s gastrointestinal tract should be completely cleaned immediately before surgery. The procedure may be complicated due to the fear and stress of the patient, therefore, sleeping pills and antidepressants may be indicated to prevent them.

Techniques for conducting

An operation to remove hemorrhoids is done under local anesthesia. There are no nerve endings in the mucous membrane, so the process is almost completely painless, although the introduction of an expander and anoscope can cause discomfort.

  • The patient is seated in a special chair. The doctor installs an expander and inserts the anoscope into the anus.
  • Then a purse string suture is made.
  • Next, the excess section of the mucosa, in particular, the vessels, is cut off. For this, a special apparatus for Longo operation is used. The site of intervention is stitched with staples.
  • An examination is carried out, a special swab soaked in antiseptics is placed in the anus.

After the Longo hemorrhoid surgery is performed, the patient remains in the hospital for three days. In rare cases, it can be prescribed in a day. As a rule, you can return to work in a week.

During the rehabilitation period, you need to change tampons with medicines every day. To speed up recovery, you can take herbal baths, for example, with pine needles or sessile baths with chamomile.

Longo hemorrhoidopexy is performed in just 15 minutes, despite the fact that other types of surgical intervention will continue for 40 minutes and suggest serious blood loss.

Svetlana Borszavich

General practitioner, cardiologist, with active work in therapy, gastroenterology, cardiology, rheumatology, immunology with allergology.
Fluent in general clinical methods for the diagnosis and treatment of heart disease, as well as electrocardiography, echocardiography, monitoring of cholera on an ECG and daily monitoring of blood pressure.
The treatment complex developed by the author significantly helps with cerebrovascular injuries and metabolic disorders in the brain and vascular diseases: hypertension and complications caused by diabetes.
The author is a member of the European Society of Therapists, a regular participant in scientific conferences and congresses in the field of cardiology and general medicine. She has repeatedly participated in a research program at a private university in Japan in the field of reconstructive medicine.

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