PILES affect a large number of people. It is estimated that one-third of the population generally suffers from piles. Piles are more common in women during pregnancy and childbirth, and there is some evidence that piles run in families.

Constipation has been identified as the main cause. Pushing hard to pass stools puts a strain on the veins in the anal canal which eventually dilate and enlarge to form piles.

Piles is a distressing condition which in the initial stages causes itching and discomfort around the anal opening. As it progresses, it causes heavy or dragging sensation and occasionally pain as well. In most cases piles are associated with the passage of fresh blood with stools.

In the initial stages, a lot of treatment options are available such as high fibre diet, banding, selerotherapy, cryotherapy, infra-red coagulation, etc. These modalities provide good relief in the initial stages but do not help much in the later stages of the disease. In the advanced stage, only surgery provides long lasting relief.

Conventionally, the piles operation is done by the open method in which the bunch of dilated veins (piles) are dissected in the lower part of the anal canal and then tied off. The dissection results in a wound in the lower anal canal which takes time to heal. Since the lower part of the anal canal is highly sensitive to pain, the patient experiences agonizing pain for four -five post operative days. Therefore, the patient is kept admitted in the hospital for three-five days. Normally, the patient resumes work after two weeks when the wound is at least partially healed. The patient also needs to do hot water baths (Sitz bath) two-four times a day till the wound heals completely which usually takes four-six weeks.

But now a technique is available which provides a very good alternative. This technique is called Stapler technique or MIPH (Minimally Invasive Procedure for Piles). In this technique, the pile mass is not directly operated or dissected. Instead, the operation is done in the upper anal canal which is insensitive to pain. A disposable Stapler device is used which cuts the lining of the anal canal and sutures it back instantaneously. In the process, the blood supply to the pile mass is obliterated and this results in shrivelling and hence disappearance of piles.

Since this operation doesn’t create any wound, the patient needs no post-operative dressings and hot water baths (Sitz bath). As the lower sensitive anal canal is not cut during this procedure, the patient is absolutely pain-free right after the operation and can resume work next day. Moreover, the time taken for operation, (15-20 minutes) and the blood loss in the Stapler technique is comparatively much less.

In short, the Stapler operation for piles has following benefits:

• Less post-operative pain
• Shorter hospital stay
• Early resumption of work
• No need for post-operative dressing and hot water baths (Sitz baths)
• Much less healing time
• Less blood loss during the operation
• Shorter operating time