Stapled hemorrhoidectcomy consent - Dr Chopin-Laly

Docteur Xavier CHOPIN-LALY
Chirurgien conventionné Secteur II Ancien Interne
et Assistant des Hôpitaux de Lyon
Chef de Clinique à la Faculté
69 1 70760 8
CHIRURGIE GENERALE ET DIGESTIVE
Chirurgie cancérologique - Cœlioscopie
Chirurgie endocrinienne - Proctologie chirurgicale
RPPS : 10100083350
PREOPERATIVE INFORMATION
STAPLED HEMORRHOIDECTOMY
PATIENT
Last Name
First Name
NATURE OF THE OPERATION
The purpose of this document is to equip you with the information regarding your
intervention. Do not hesitate to ask your proctologist or colorectal surgeon Xavier CHOPIN-LALY, MD
for more details (Tel: + (33) 04 72 38 07 48).
WHY OPERATE?
Hemorrhoids are made up of tissue rich in blood vessels and are present in all individuals,
inside the anus (internal hemorrhoids) or under the skin of the anus (external hemorrhoids).
Hemorrhoids become a disease when swollen, inflamed or otherwise troublesome, and are the cause
of symptoms such as pain, bleeding, or prolapsing of internal hemorrhoids. The first stages of
treatment involve either prescription drugs or instrumental manipulation performed during the
consultation. In case of failure or significant disease progression, one can consider surgical
treatment.
WHAT IS THE PROCEDURE FOR THE OPERATION?
HEMORRHOIDECTOMY?
WHY CHOOSE A STAPLED
Alongside the conventional surgery involving the removal of internal and external
hemorrhoids, for more than ten years surgeons have used another, fundamentally different
operation: stapled hemorrhoidectomy. Rather than remove the internal hemorrhoids, the surgeon
places them back in the anal canal and fixes them in place by removing part of the hemorrhoid and
stapling it to the underlying mucosa. This operation treats only prolapsed internal hemorrhoids and
therefore cannot be performed on all patients, especially those who also suffer from external
hemorrhoids. It has been practiced on a large number of patients. The technique uses a specialized
instrument (pinch stapler). A flap of mucosa is removed with a portion of hemorrhoidal tissue. This
technique is also known as "Longo surgery or hemorrhoidopexy". When applicable, its advantages
are:
- A noticeably dramatic decrease in postoperative pain
- No postoperative wound
- A shorter hospital stay and very minimal postoperative care.
Hospitalization, depending on the situation, varies from 1 to 3 days on average.
Secrétariat : 04 72 38 07 48
Fax : 04 72 38 22 29
Hospitalisation : 04 72 32 68 68
e-mail : [email protected]
51-53, rue du Commandant Charcot
69110 Sainte Foy-Lès-Lyon
Siret : 799 212 238 R.C.S. Lyon
Docteur Xavier CHOPIN-LALY
Chirurgien conventionné Secteur II Ancien Interne
et Assistant des Hôpitaux de Lyon
Chef de Clinique à la Faculté
69 1 70760 8
CHIRURGIE GENERALE ET DIGESTIVE
Chirurgie cancérologique - Cœlioscopie
Chirurgie endocrinienne - Proctologie chirurgicale
RPPS : 10100083350
The operation is performed either under general or local anesthesia (spinal anesthesia during which
only the lower body is sedated).
WHAT STEPS ARE TAKEN AFTER THE OPERATION?
The aftermath of this surgery is usually simpler than it is for others. There is no need for local
care as it leaves no exposed wound; it is within the rectum. Defecation can resume quickly. An
increase of laxative treatment may be necessary. Pain does not generally persist very long, and is
well controlled with simple analgesics. The patient can normally resume daily activities shortly after
the operation (8 to 14 days on average).
Early complications:
Even when well performed according to the highest surgical standards, stapled
hemorrhoidectomy can come with complications. Early complications include:
- Unusually strong pain: normally short, but may require prescription of opioids
- An inability to empty the bladder (urinary retention) in 10-20% of cases. This is most often
linked to a reflex phenomenon. It is treated medically but can sometimes require temporary
placement of a catheter into the urethra (the tube that allows urine disposal)
- Abundant early bleeding requiring a secondary operation.
Medium-term complications:
- A rare secondary hemorrhage (between the 8th and 15th day) due to the collapse of scar
tissue. It usually requires a short hospital control the bleeding. It is therefore advisable not to
leave the area, and refrain from all travel by train or plane for a period of 2 weeks
- Sometimes the formation of a true "plug" of materials may require the use of an enema.
- A local infection is very rare but may nonetheless require further surgery.
Long-term complications:
- Although rare, the anus may become constricted
- Trouble with continence; difficulty retaining gas or a liquid stool, seepage, usually
disappearing in 3 to 4 weeks. Real incontinence is exceptional and normally suggests a preexisting abnormality unveiled by the surgery (sphincter injury after a difficult childbirth for
example)
- A persistent feeling of pushing or false need to use the bathroom. This discomfort usually
disappears, but sometimes takes several weeks to do so
- The occurrence of anal fissure in less than 3% of cases
- The appearance of "skin tags" (growths of flesh) is possible after this operation
Secrétariat : 04 72 38 07 48
Fax : 04 72 38 22 29
Hospitalisation : 04 72 32 68 68
e-mail : [email protected]
51-53, rue du Commandant Charcot
69110 Sainte Foy-Lès-Lyon
Siret : 799 212 238 R.C.S. Lyon
Docteur Xavier CHOPIN-LALY
Chirurgien conventionné Secteur II Ancien Interne
et Assistant des Hôpitaux de Lyon
Chef de Clinique à la Faculté
69 1 70760 8
CHIRURGIE GENERALE ET DIGESTIVE
Chirurgie cancérologique - Cœlioscopie
Chirurgie endocrinienne - Proctologie chirurgicale
RPPS : 10100083350
- A recurrence of hemorrhoidal disease; a benign complication, but one that is five times
more common with this technique than with conventional surgery. It would still be treatable,
whether by conventional surgery or by instrumental manipulation.
I, Mr. / Ms. ........................................ acknowledge having been informed by Xavier CHOPINLALY, MD of the risks associated with the procedure described above, that I have asked all pertinent
questions and thus agree to let Xavier CHOPIN-LALY, MD perform this surgery.
If using the online version:
I certify to have read and understood every page of this document and by checking this box I confirm
my digital signature and agreement to the above terms.
If using a physical copy:
Date the document was given to patient:
Date and patient signature:
Secrétariat : 04 72 38 07 48
Fax : 04 72 38 22 29
Hospitalisation : 04 72 32 68 68
e-mail : [email protected]
51-53, rue du Commandant Charcot
69110 Sainte Foy-Lès-Lyon
Siret : 799 212 238 R.C.S. Lyon