Minimally Invasive Procedure for Haemorrhoids: A Retrospective Observational Study

Abstract

Introduction: The Minimally Invasive Procedure for Haemorrhoids (MIPH), also known as Stapled Haemorrhoidopexy (SH), has gained significant recognition and praise within the surgical community due to its speed and minimal postoperative pain. It was initially believed to have superior postoperative outcomes, resulting in reduced morbidity and mortality rates compared to traditional procedures. However, long-term follow-up data has now revealed previously undocumented sequelae and complications associated with SH. Aim: To share authors’ experience with SH, including patient demographics, operative details, recurrence rates, and postoperative complications, in a tertiary corporate teaching hospital. Materials and Methods: The present retrospective observational study was conducted at the Department of General Surgery and Advanced Laparoscopic Surgery, Dr. LH Hiranandani Hospital, Powai, Mumbai, Maharashtra, India. The study utilised data from the outcomes of SH performed by a single surgeon for Grade II and III haemorrhoids over a 15-year period, from December 2007 to December 2022. Data was extracted from the hospital’s Electronic Medical Records (EMR) and supplemented with information obtained through a telephonic questionnaire. A standard, prevalidated, semi-structured case record proforma was used for data collection. The parameters under study included donut completeness, haemorrhage, faecal urgency, urinary retention, anal stenosis, postoperative pain scores, return to work, and recurrence. Proportions, percentages, and means were calculated and reported for different groups. Results: A total of 245 patients were enrolled in the study. The average pain score at 12 hours postoperatively was 4, which decreased to 2 by day 10. Recurrent disease was observed in 16 patients (6%) at three months and in 24 patients (10%) at six months. Conclusion: The SH demonstrated advantages over conventional open surgery by causing significantly lower postoperative morbidity. However, its recurrence rates were slightly higher.