If in addition to internal hemorrhoids there are small external hemorrhoids that are causing a problem, the external hemorrhoids may become less problematic after the stapled hemorrhoidectomy.ДЄnother alternative is to do a stapled hemorrhoidectomy and a simple excision of the external hemorrhoids. Fourth degree hemorrhoids are always outside. Third degree hemorrhoids can be pushed back into the anus after a bowel movement. Stapled hemorrhoidectomy, although it can be used to treat second degree hemorrhoids (hemorrhoids that extend outside the anus with a bowel movement, but return inside), usually is reserved for higher grades of hemorrhoids вЂ“ third and fourth degree. Stapled hemorrhoidectomy is less painful and faster than a traditional hemorrhoidectomy, taking approximately 30 minutes.ДЄs you can see in the video above, even though not a complicated procedure, it looks painful and can be avoided. The stapler is then fired, cutting off circumferential ring of expanded hemorrhoidal supporting tissue trapped within the stapler, at the same time staples together the upper and lower edges of the cut tissue. The hemorrhoidal cushions are pulled back up into their normal position within the anal canal. The stapler is placed through the hollow tube and the ends of the suture are pulled expanding the hemorrhoidal supporting tissue into the jaws of the stapler. The ends of the suture are brought out of the anus through the hollow tube.

The remaining tissue is then repositioned back to its normal anatomic. In a sentence, this operation aims to remove internal hemorrhoids and gives some benefit to the enlarged external hemorrhoidal tissues. In this procedure, a circular, hollow tube is inserted into the anal canal and a suture (a long thread) is placed through it and woven circumferentially within the anal canal above the internal hemorrhoids. A stapled hemorrhoidectomy or stapled hemorrhoidopexy is a procedure that is typically used for grade II or III internal hemorrhoids. This surgery does not remove the hemorrhoids but, rather, the expanded hemorrhoidal supporting tissue that has allowed the hemorrhoids to prolapse downward. Stapled Hemorrhoidectomy is a newer surgical technique that has rapidly become the treatment of choice for third-degree hemorrhoids.