Anal and hemorrhoid surgery - Dr. Ayman Harakeh, MD, FACS
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Anal and hemorrhoid surgery

Anal and Hemorrhoid surgery removes swollen blood vessels inside or around the anus and rectum. Hemorrhoids cause a lot of discomfort to patients and in many cases surgery is needed to get relief. There are different surgical options available for treating hemorrhoids. Some aim to restrict their blood supply while others involve removing the hemorrhoid permanently. The recovery time from hemorrhoid surgery varies from person to person, but generally, it can last up to 1 week.

There are two types of hemorrhoids, depending on their location, internal or external. Internal hemorrhoids form within the lining of the anus and lower rectum, whereas external hemorrhoids form under the skin of the anus. These occur mostly without patients noticing them, but in some cases there is a lot of discomfort which may require immediate treatment.

The most effective form of treatment for moderate to severe symptomatic hemorrhoids is surgical intervention. Typically, this is an option for people who are experiencing extreme discomfort and are not responding to other forms of treatment. The surgery aims at shrinking the hemorrhoid by reducing its blood supply or by removing it completely.

Types of Hemorrhoid Surgery

There are several types of hemorrhoid surgery, which include

Rubber band ligation

This surgery involves placing a rubber band around the base of hemorrhoid, which results in restriction of its blood supply, eventually causing hemorrhoids to fall off.


This surgery is performed on internal hemorrhoids that are not protruding. The use of electric current or infrared light is common in such surgeries, which creates scar tissue on hemorrhoids and restricts the blood supply to the hemorrhoid, causing it to fall off.

Hemorrhoid Stapling

A special round shaped stapler is used to resect, staple, and elevate a complex protruding multi-quadrant hemorrhoid with prolapse. This technique is saved for specific cases and situations where it has proven superior to other kinds of intervention.


This surgery is performed by the surgeon to remove hemorrhoids. It involves opening the anus and gently cutting out the hemorrhoids using surgical instruments.

Hemorrhoid Dearterialization

Transanal hemorrhoidal dearterialization, THD, procedure, is mostly used in treating internal hemorrhoids that have grown large or prolapsed but they are not yet thrombosed. It cannot be used to treat external hemorrhoids. A special device with a doppler ultrasound at its end is used to locate the feeding arteries to the hemorrhoids. These are then suture-ligated and the anal canal lining is sutured and elevated into a normal position. This will restrict the blood supply to the hemorrhoids, causes them to reduce in size slowly, and repair the lining prolapse.

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