Hemorrhoid Surgery

Hemorrhoid Surgery is the surgery to remove hemorrhoids.

April 25, 2022

Hemorrhoid Surgery is the surgery to remove hemorrhoids.

Some facts about Hemorrhoid Surgery:

  • Hemorrhoids are swollen veins that can be internal or external. They are internal when lies inside the rectum, and are external, when lies outside the rectum.
  • Eating a high fiber diet and drinking more of water can usually help you manage the symptoms of most hemorrhoidal flare-ups by promoting softer and more regular bowel movements.
  • A stool softeners can also be used to reduce straining during bowel movements, as straining can make your hemorrhoids worse.
  • Surgery become necessary in some cases when external or prolapsed hemorrhoids become too infected, irritated or when there are complications.

Types of Hemorrhoid Surgery:

Surgery and the type of procedure best for you can be determined by your doctor based on the severity of your symptoms, and whether you have complications.
The severity of hemorrhoids is classified by grades as no prolapse, prolapse that goes away by itself, prolapse that you have to push back in on your own and prolapse that you can't push in on your own and causes you pain. Surgery can be done using a scalpel or knife, a tool that uses electricity called as cautery pencil, or a laser. Hemorrhoid surgery can be done without anesthetic or with anesthetic.

Surgeries without anesthetic:

Surgeries without anesthetic can be done in your doctor's clinic without anesthesia.


Banding, also called rubber band ligation is used to treat internal hemorrhoids with a severity of up to Grade 3. A tight band will be used around the base of the hemorrhoid to cut off its blood supply. Two or more procedures will be required in Banding that take place about two months apart. It is not painful. However, you may feel pressure or mild discomfort during the procedure. Banding isn’t recommended for the person who is taking blood thinners because of the high risk of bleeding complications. Pain and infection are additional complications may occur rarely.


Sclerotherapy is used to treat internal hemorrhoids up to Grade 2 that involves injecting a chemical into the hemorrhoid. The hemorrhoid will get shrink and there will be no bleeding because of the chemical. Little or no pain will be experienced by most people with the shot.

Coagulation therapy:

Coagulation therapy, also called infrared photocoagulation is used to treat internal hemorrhoids of Grades 1 to 3. Infrared light, heat, or extreme cold can be used in this procedure to make the hemorrhoid retract and shrink. It can be done along with an anoscopy that is a visualization procedure in which a scope is inserted several inches into your rectum to get a view. Only mild discomfort or cramping will be experienced by most people during treatment.

Hemorrhoidal artery ligation:

Hemorrhoidal artery ligation, also known as transanal hemorrhoidal dearterialization (THD) is used to treat Grades 2 or 3 hemorrhoids. The blood vessels causing the hemorrhoid will be located or closes off using an ultrasound and ligates. It is a more invasive method of hemorrhoidectomy but involve less post operative pain.

Surgeries with anesthetic:

You will need to to go to a hospital and receive anesthesia for Surgeries with anesthetic.


Hemorrhoidectomy is used for large external hemorrhoids, internal hemorrhoids that have prolapsed, or ones that are not responding to nonsurgical management up to Grades 3 to 4 hemorrhoids.The best anesthesia to use during the surgery will be decided by you and your surgeon which may be full anesthesia, sedation, or a spinal block. Your surgeon will cut out the large hemorrhoids once the anesthesia takes effect.
A stapler like device will be used to reposition the hemorrhoids and cut off their blood supply for Prolapse and Hemorrhoids. No incision is made in this procedure, as the hemorrhoid is lifted and then stapled back into place in the anal canal. Hemorrhoids that have and have not prolapsed, or slipped down out of the anus can be treated by this procedure. It hurts less than a traditional hemorrhoidectomy as the hemorrhoid will be moved to where there are fewer nerve endings. There are generally fewer complications with faster recovery and less bleeding and itching. However, the stapled surgery is more expensive and people who have stapled surgery are more likely to have hemorrhoids come back and need surgery again.
A miniature Doppler sensor will be inserted in the anus to detect the arteries supplying blood to hemorrhoids in case of Hemorrhoidal Artery Ligation and Recto Anal Repair (HAL-RAR). The arteries supplying the hemorrhoids can be detected and can be tied off to cut the blood supply. The hemorrhoids will be reduced almost immediately and within weeks with almost no pain.
You will be taken to a recovery room for a brief period of observation when the operation is over. You will be able to return home once the medical team is sure that your vital signs are stable. Pain and infection are the most common risks associated with hemorrhoidectomy.


Hemorrhoidopexy, also referred to as stapling is used to treat prolapsed hemorrhoids up to Grades 3 to 4. The prolapsed hemorrhoid will be fixed back into place inside your rectum and the blood supply will be cuts off so that the tissue will shrink and be reabsorbed. The recovery time is less and is less painful than recovery from a hemorrhoidectomy.

Recovery from Hemorrhoid Surgery:

  • Bleeding, infection and reaction to anesthesia are the most common risk associated with Hemorrhoid Surgery.
  • You might experience some trouble peeing post surgery because of swelling or muscle spasms.
  • Rectal and anal pain are expected after having hemorrhoid surgery. Both medications and non-pharmaceutical treatments can be used to help you in your recovery.
  • Painkillers including Opioids, Nonsteroidal anti-inflammatory drugs (NSAIDS), Ativan and more will be prescribed by your doctor to ease the discomfort
  • Any activities that involve heavy lifting or pulling should be avoided.
  • Sitz baths can help ease post surgical discomfort that involves soaking the anal area in a few inches of warm salt water several times a day for about 10 to 15 minutes each time.