What is ambulatory hemorrhoidectomy?
The ambulatory hemorrhoidectomy is performed under local anesthesia. Your surgeon will check up your anus and surrounding tissues and resection of the hemorrhoids. The specimen will be sent to pathology laboratory if necessary. Please check in with operating room reception counter on your operative schedule day. After operation, you may go home on the same day.

The perioperative nursing care
  1. Preoperative nursing care
    1. Nurse staffs will ask you showing identifiers to confirm your identity, and inquiry your medical record and past allergic history. 
    2. Nurse staffs will confirm with you the acceptance of the surgery and anesthesia. If you have any questions please do not hesitate to ask nurse staffs.
    3. Remove all your accessories, watch, artificial denture, and wipe lipstick or nails polish. Please hand over your belongings to families or leave all in the locker at nursing station before entering into operating room.
    4. Wear loose-fitting clothing in order to change surgical attires at ease.
  2. Intraoperative nursing care
    1. Nurse staffs will help you maintain prone position and use equipment to prevent fall and hurt from positioning injury. We will keep you warm with warm blanket or heat lamp.
    2. Nurse staffs will use patient plate on the appropriate parts of your body to prevent electrical burns during intraoperative phase.
    3. The length of surgery will be around 20-30 minutes.
    4. We will play music during your intraoperative process. If you feel uncomfortable or have any needs please inform the nurse staffs.
    5. We will keep your privacy very carefully. We will protect the exposed part of your body for operative area as minimum as possible during the procedure.
  3. Post-operative nursing care:
    1. Nurse staffs will clean the area around the surgical site and cover the wound with a sterile dressing.
    2. We will continue to use the warm blanket or heat lamp to keep your warm.
    3. We will provide nursing instructions of home care, such as diet and wound care, etc.
       
Home care notifications
  1. After the surgery, you can eat solid food but can only start to drink water after urination.
  2. Please avoid alcohol, spicy food, and food that makes gas, such as pepper, garlic, peanuts, nuts, etc.
  3. It is common desiring defecation constantly due to the gauze filled in the anus. It is very important for female patients that they can only use water to clean the perianal area rather than wipe it after they go to the toilet, and then cover it with clean gauze or cotton pad.
  4. You may remove the dressing after 24 hours and begin to take a sitz bath. The gauze filled in the anus will be loosen gradually. You should take a sitz bath with warm water at 41-43 ℃. A sitz bath should be taken 15 minutes after bowel movement and at least 4 times a day. Every time after taking a sitz bath, please dry the wound smoothly and use cotton ball or pad to clean your anus.
  5. Please go to emergency room immediately, if you have syndromes such as massive bleeding, feeling difficulty at urination, fever.
  6. Please avoid strenuous exercise which will increase in abdominal pressure. Do not squat or sit for a long time.
  7. It’s important to keep regular bowel movement daily. Avoid rush in defecation or sit on the toilet too long.
  8. Eat plenty of food that is high in fiber such as fruit or vegetables. It might help you to prevent constipation and reduce the risk of hemorrhoid recurrence.
  9. Please follow the prescription medication from your doctors. Please do not take any medications without doctor’s prescription.
  10. Please see your doctor for review after one week.

Reference
  1. Lee, K. L., Wu, H. H., Wang, C. Y., Lo Y. P. (2018). Nursing Project of Utilizing Multimedia to Improve Hemorrhoid Surgery Nursing Education. Yuan-Yuan Nursing, 12(2), 41-49. doi:10.6530/YYN/201807_12(2).0005
  2. Hsiao, M. C., Cheng, L. C., Tian, Y. F., & Chou, C. L. (2016). Managements of an anorectal emergency: experience from a single institution. The Journal of Society of Colon and Rectal Surgeons (Taiwan), 27(4), 179-186. doi:10.6312/SCRSTW.2016.27(4).10515
  3. Yeh, M. L., Chung, Y. C., Hsu, L. C., & Hung, S. H. (2018). Effect of Transcutaneous Acupoint Electrical Stimulation on Post-Hemorrhoidectomy-Associated Pain, Anxiety, and Heart Rate Variability: A Randomized-Controlled Study. Clin Nurs Res, 27(4), 450-466. doi:10.1177/1054773816685745
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    Update
    2019-04-25 00:00:00