How Does The Haemorrhoid Embolization Procedure Work?
‘Embolization’ essentially means using special little medical particles or ‘coils’ to block off the blood flow to the area that is being treated.
Because the hemorrhoid is an imbalance between the blood going to the rectum (via the arteries) and the blood going away from the rectum (via the veins), if there is more blood going to the rectum than going away, blood begins to pool in the dilated anal cushions/veins forming a hemorrhoid.
Most treatments currently offered focus on treating the veins directly however the embolization procedure actually treats the problem from the arterial side by blocking the blood flow flowing into the hemorrhoid tissue instead of surgically removing the damaged anal cushions haemorrhoids. So, in essence, this is a great way of preventing haemorrhoid formation too! By reducing the blood flowing into the haemorrhoid it does not enlarge, bleed or cause pain.
Hemorrhoid embolization is a newly established way of treating the symptoms of hemorrhoids before having to commit to more permanent but more painful surgeries.
A small catheter is placed into the radial artery (the artery in the wrist) which is then navigated through the body and into the superior rectal artery which supplies the haemorrhoids. The procedure is performed under image guidance which uses specialised X-ray machines and contrast dye to create a ‘road map’ of the arteries.This allows the interventional radiologist to access the appropriate arteries and block them using specialised micro-coils ( made of a special platinum alloy) which form a small ‘nest’ in the artery blocking off blood flow to the haemorrhoids which causes them to shrink.
A small wrist band with a balloon is then applied to the small pinhole in your wrist after the catheter is removed. This is to prevent bleeding at the access point to the artery and is then taken off in the ward.
How Long Does The Procedure Take?
The procedure takes approximately 40minutes depending on how difficult it is to access the arteries which sometimes come off at tricky angles.
What Anaesthetic Is Used During The Procedure?
The procedures is performed under ‘deep sedation’ which essentially means a deep sleep. This involves medication given into the drip as opposed to general anaesthetic which is when a tube is inserted into the throat. It is therefore safer and associated with less complications.
What Happens After The Procedure?
You are taken to the ward for the sedative medication to wear off.
The small band that was applied to your wrist is deflated every 15 minutes and then removed. A small plaster is applied to the tiny pinhole through which the doctor worked. There are no stitches or cuts!
Once you are awake, comfortable and have had some lunch you can go home.
Do I Need To Stay Over Night?
No. Most patients can go home the same day unless your bleeding was very severe before the procedure and your doctors wants to keep you for a little longer.
What are the benefits of the haemorrhoid embolization over traditional haemorrhoid surgery?
Very low complication rates
No risk of post operative faecal incontinence
Works best for bleeding haemorrhoids
Quicker recovery and return to work
What are the limitations:
Very new procedure and there are still questions with regard to effectiveness in treating all symptoms equally.
Limited improvement in prolapsed haemorrhoids
Has less impact on itch and discomfort.
What are the risks:
The procedure is very low risk but of course, any anaesthetic carries a small risk of allergy or reaction. The anesthetic is a deep sedation and therefore is much safer than a full general anesthetic. The procedure is most often done through the wrist which can result in some bruising and injury to the artery this is also very rarely a significant problem.
What do I need to do to have this procedure
- See one of our affiliated surgeons in order to exclude that there is nothing more sinister causing your symptoms.
- Complete a history form for our doctors who will contact you
- Have some routine blood tests
- Have a CT scan of the pelvic arteries. This is a specialized non-invasive scan to ‘map out’ and evaluate the arteries in your pelvic area. This test is important to exclude any vessel abnormality that may affect the pathway through the arteries that supply the haemorrhoids. It also allows the doctors to assess the other structures in your pelvic area to make sure there is no other abnormality that may be causing your symptoms.